Krysiak Robert, Kowalcze Karolina, Szkróbka Witold, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Stefana Batorego 15, 41-902 Bytom, Poland.
J Clin Med. 2023 May 27;12(11):3715. doi: 10.3390/jcm12113715.
Metformin was found to decrease elevated levels of anterior pituitary hormones. Its impact on lactotrope secretory function was absent in women with vitamin D insufficiency. This study investigated whether vitamin D status determines metformin action on overactive gonadotropes. We compared the effect of six-month metformin treatment on the plasma levels of gonadotropins, TSH, prolactin, ACTH, estradiol, free thyroid hormones, IGF-1, and 25-hydroxyvitamin D, as well as on glucose homeostasis markers between three matched groups of postmenopausal women at high risk for diabetes: untreated subjects with vitamin D insufficiency (group A), untreated women with normal vitamin D status (group B), and individuals receiving vitamin D supplementation with normal 25-hydroxyvitamin D levels (group C). Only in groups B and C did metformin reduce FSH levels and tend to decrease LH levels, and these effects correlated with baseline gonadotropin levels, baseline 25-hydroxyvitamin D levels, and the improvement in insulin sensitivity. Follow-up gonadotropin levels were higher in group A than in the other two groups. The drug did not affect circulating levels of TSH, prolactin, ACTH, estradiol, free thyroid hormones, IGF-1, or 25-hydroxyvitamin D. The obtained results suggest that the impact of metformin on gonadotropin secretion in women after menopause is determined by vitamin D status.
研究发现二甲双胍可降低垂体前叶激素的升高水平。在维生素D缺乏的女性中，其对催乳素细胞分泌功能没有影响。本研究调查了维生素D状态是否决定二甲双胍对过度活跃的促性腺激素细胞的作用。我们比较了为期六个月的二甲双胍治疗对三组匹配的糖尿病高危绝经后女性血浆促性腺激素、促甲状腺激素（TSH）、催乳素、促肾上腺皮质激素（ACTH）、雌二醇、游离甲状腺激素、胰岛素样生长因子-1（IGF-1）和25-羟基维生素D水平的影响，以及对葡萄糖稳态标志物的影响：维生素D缺乏的未治疗受试者（A组）、维生素D状态正常的未治疗女性（B组）和25-羟基维生素D水平正常且接受维生素D补充的个体（C组）。仅在B组和C组中，二甲双胍降低了促卵泡生成素（FSH）水平并倾向于降低促黄体生成素（LH）水平，且这些作用与基线促性腺激素水平、基线25-羟基维生素D水平以及胰岛素敏感性的改善相关。A组的随访促性腺激素水平高于其他两组。该药物不影响TSH、催乳素、ACTH、雌二醇、游离甲状腺激素、IGF-1或25-羟基维生素D的循环水平。所得结果表明，绝经后女性中二甲双胍对促性腺激素分泌的影响由维生素D状态决定。
