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胡芦巴与二甲双胍对多囊卵巢综合征患者临床及代谢状况影响的比较:一项随机试验

Comparison of the Effect of Fenugreek and Metformin on Clinical and Metabolic Status of Cases with Polycystic Ovary Syndrome: A Randomized Trial.

作者信息

Mirgaloybayat Shahla, Akbari Sene Azadeh, Jayervand Fatemeh, Vazirian Mahdi, Mohazzab Arash, Kazerooni Mitra

机构信息

Endometriosis Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Reprod Infertil. 2024 Apr-Jun;25(2):120-132. doi: 10.18502/jri.v25i2.16040.

Abstract

BACKGROUND

It is hypothesized that fenugreek seeds are a rich source of fiber with anti-diabetic effects, which can help to lower blood glucose in patients with polycystic ovary syndrome (PCOS). In this study, the clinical and metabolic effects of fenugreek were compared to those of metformin in women with PCOS aged 16-40 years.

METHODS

In a randomized, triple-blind, parallel clinical trial, the efficacy of fenugreek 333 (n=55) was compared with metformin 500 (n=55), both administered three times a day in women with PCOS of reproductive age. Changes in some clinical outcomes and metabolic laboratory profile outcomes were evaluated at baseline and two months after the study.

RESULTS

By the end of the intervention period, all investigated factors improved significantly in patients of both groups (p<0.05). Reduction in biometric indices (body mass index and waist-hip ratio), fasting blood sugar (FBS), and insulin resistance was significantly higher after metformin consumption (p<0.001). Metformin also significantly improved irregular menstruation (p=0.02). In contrast, fenugreek significantly improved patients' lipid profiles, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) compared to metformin (p<0.001). Both interventions improved the patient's hair loss and hirsutism.

CONCLUSION

Fenugreek cannot substitute metformin in PCOS treatment. However, regarding its lipid-lowering ability and low frequency of adverse effects, it can be used as an adjuvant treatment in PCOS, especially in PCOS patients with hyper-lipidemia and severe hair loss.

摘要

背景

据推测,胡芦巴籽富含具有抗糖尿病作用的纤维,有助于降低多囊卵巢综合征(PCOS)患者的血糖。在本研究中,对16至40岁PCOS女性患者,比较了胡芦巴与二甲双胍的临床和代谢效应。

方法

在一项随机、三盲、平行临床试验中,将333毫克胡芦巴(n = 55)的疗效与500毫克二甲双胍(n = 55)进行比较,二者均每日给药三次,用于育龄期PCOS女性。在基线和研究两个月后评估一些临床结局和代谢实验室指标的变化。

结果

在干预期结束时,两组患者的所有研究因素均有显著改善(p<0.05)。服用二甲双胍后,生物计量指标(体重指数和腰臀比)、空腹血糖(FBS)和胰岛素抵抗的降低显著更高(p<0.001)。二甲双胍还显著改善了月经不调(p = 0.02)。相比之下,与二甲双胍相比,胡芦巴显著改善了患者的血脂谱,包括低密度脂蛋白(LDL)、高密度脂蛋白(HDL)和甘油三酯(TG)(p<0.001)。两种干预措施均改善了患者的脱发和多毛症。

结论

在PCOS治疗中,胡芦巴不能替代二甲双胍。然而,鉴于其降血脂能力和不良反应发生率低,它可作为PCOS的辅助治疗药物,尤其是对于患有高脂血症和严重脱发的PCOS患者。

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