The Effect of Metaformin Treatment on Insulin Resistance in Women with Polycystic Ovary Syndrome
Article Sidebar
-
Polycystic Ovarian Syndrome, Insulin Resistance, HOMA-IR
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women in reproductive age. It is defined as a syndrome of ovarian dysfunction associated with hyperandrogenism and polycystic ovary morphology, give rise to continuous follicular growth. Insulin resistance (IR) is characterized by impaired glucose response to particular concentration of insulin. The aim of this study was to find if there is an association between PCOS and IR in Sebha region, Libya, and to determine the effect of using metaformin treatment in these women. Samples were collected from a clinic of infertility, Sebha, Libya. Questionnaire was filled for all volunteers including information about treatment by metaformin. A total of 44 women were recruited. 19 healthy women and 25 diagnosed PCOS conditions with matched age and body mass index (BMI). At least two of the following three features were present for PCOS: polycystic ovaries on ultrasound, oligomenorrhea or amenorrhea and clinical or biochemical hyperandrogenism. Age, weight and height were taken. Serum Insulin concentrations were estimated by using ELISA kit and plasma glucose levels was measured spectrophotometrically by glucose oxidase-peroxidase method. Body Mass Index (BMI) and Homeostatic Model Assessment- Insulin Resistance (HOMA-IR) were calculated by their formulas. The results showed PCOS patients had significantly higher values of fasting serum insulin levels and HOMA-IR. No significant difference between fasting plasma glucose which was in the normal range in both groups. Significantly lower insulin concentration and HOMA-IR in group using the metaformin treatment. In conclusion this study illustrated a strong association of PCOS with insulin resistance. The treatment by metaformin has positive effect on hyperinsulinaemia.
Full text article
References
[1]- Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, & Azziz R. Prevalence of the Polycystic Ovary Syndrome in unselected black and white Women of the Southeastern United States: A prospective study 1. The Journal of Clinical Endocrinology & Metabolism 1998; 83: 3078-3082.
[2]- Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, & Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected
population. J Clin Endocrinol Metab 2004; 89: 2745-2749.
[3]- Franks S. Polycystic ovary syndrome. N Engl J Med 1995; 333: 853-861.
[4]- Kyei-Mensah A, Maconochie N, Zaidi J, Pittrof R, Campbell S, & Tan SL (1996). Transvaginal three-dimensional ultrasound: reproducibility of ovarian and endometrial volume measurements. Fertility and sterility 1996; 66: 718-722.
[5]- Chang RJ, Nakamura RM, Judd HL, & Kaplan SA. Insulin resistance in non obese patients with polycystic ovary disease. The endocrine Society 1983; 57: 356-359.
[6]- Dunaif A, Segal KR, & Futterweit W. Profound peripheral insulin resistance independent of obesity in polycystic ovary syndrome. Diabetes 1989; 38: 1165-1174.
[7]- Osei K & Schuster DP. Ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans. Diabetic medicine 1994;11: 755-762.
[8]- Toprak S, Yonem A, çakir B, Guler S, Azal o, Ozata M, & çorakci A. Insulin resistance in nonobese patients with polycystic ovary syndrome. Hormone Research in Paediatrics 2001; 55: 65-70.
[9]- Legro RS, Kunselman A, Dodson WC, & Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999;84: 165-169.
[10]- Welt CK, Arason G, Gudmundsson JA, Adams J, Palsdottir H, Gudlaugsdottir G, Ingadottir G, & Crowley WF. Defining constant versus variable phenotypic features of women with polycystic ovary syndrome using different ethnic groups and populations. The Journal of Clinical Endocrinology & Metabolism 2006; 91: 4361-4368.
[11]- Poretsky L, Cataldo NA, Rosenwaks Z, & Giudice LC. The insulin-related ovarian regulatory system in health and disease. Endocrine reviews 1999; 20: 535-582.
[12]- Dunaif A. Insulin resistance in women with polycystic ovary syndrome. Fertil Steril 2006; 86: Suppl 1, S13-S14.
[13]- Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, & Ghazzi MN. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 2006; 91: 48-53.
[14]- Franks S, Webber LJ, Goh M, Valentine A, Whit DM, Conway GS, Wiltshire S, & McCarthy MI. Ovarian morphology is a marker of heritable biochemical traits in sisters with polycystic ovaries. J Clin Endocrinol Metab 2008; 93: 3396-3402.
[15]- Norman RJ, Masters S, & Hague W. Hyperinsulinemia is common in family members of women with polycystic ovary syndrome. Fertility and sterility 1996; 66, 942-947.
[16]- Nestler JE, Jakubowicz DJ, Evans WS, & Pasquali R. Effects of metformin on spontaneous and clomiphene-induced ovulation in the polycystic ovary syndrome. New England Journal of Medicine 1998; 338: 1876-1880.
[17]- Kolodziejczyk B, Duleba AJ, Spaczynski RZ, & Pawelczyk L. Metformin therapy decreases hyperandrogenism and hyperinsulinemia in women with polycystic ovary syndrome. Fertility and sterility 2000; 73: 1149-1154.
[18]- Nawrocka J & Starczewski A. Effects of metformin treatment in women with polycystic ovary syndrome depends on insulin resistance. Gynecological Endocrinology 2007; 23: 231-237.
[19]- Velazquez EM, Mendoza S, Hamer T, Sosa F, & Glueck CJ. Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while facilitating normal menses and pregnancy. Metabolism 1994; 43: 647-654.
[20]- Gupta S, Chen D, O.G. Brien KO, Chandra A, Metterle L, Kesavan S, & Agarwal A. Adolescent polycystic ovary syndrome: pathophysiology and implications of the disease. Arch MedSci 2009; 5: S115-S131.
[21]- Gupta MM, Chari S, Chandankhede M, & Ghike S. Insulin Resistance and Homocysteine Levels in Patients with Polycystic Ovarian Syndrome. Journal of South Asian Federation of Obstetrics and Gynaecology 2013; 5: 49-51.
[22]- Agarwal N, Gangopadhyay S, Koch N, Gupta A, Batra A, & Kabi BC. Polycystic ovarian syndrome and insulin resistance: a North Indian study. International Journal of Research in Medical Sciences 2015; 5 Jun;3(6):1321-1324
[23]- Huang J, Ni R, Chen X, Huang L, Mo Y, & Yang D. Metabolic abnormalities in adolescents with polycystic ovary syndrome in south China. Reproductive Biology and Endocrinology 2010; 8: 1.
[24]- Holte J, Bergh T, Berne C, Wide L, & Lithell H. Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 1995; 80: 2586-2593.
[25]- Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997; 18: 774-800.
[26]- Esfahanian F, Zamani MM, & Heshmat R. Effect of Metformin compared with hypocaloric diet on serum C_reactive protein level and insulin resistance in obese and overweight women with polycystic ovary syndrome. Journal of Obstetrics and Gynaecology Research 2013; 39: 806-813.
[27]- Nawrocka-Rutkowska J, Ciecwiez S, Marciniak A, Brodowska A, Wisniewska B,
Kotlega D, & Starczewski A. Insulin resistance assessment in patients with polycystic ovary syndrome using different diagnostic criteriaG_ôImpact of metformin treatment. Annals of Agricultural and Environmental Medicine 2013; 20.
[28]- Tang T, Lord JM, Norman RJ, Yasmin E, & Balen AH. Insulin - sensitising drugs (metformin, rosiglitazone, pioglitazone, Dchiro inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. The Cochrane Library Cochrane Database Syst Rev. 2012; May 16;(5),DOI 10.1002
[29]- Diamanti-Kandarakis E, Kouli C, Tsianateli T, & Bergiele A. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. European Journal of Endocrinology 1989; 138: 269-274.
[30]- Eshre TT & Group A-SPCW (2008). Consensus on infertility treatment related to polycystic ovary syndrome. Fertility and sterility 2008; 89: 505-522.
Authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
In a brief statement, the rights relate to the publication and distribution of research published in the journal of the University of Sebha where authors who have published their articles in the journal of the university of Sebha should how they can use or distribute their articles. They reserve all their rights to the published works, such as (but not limited to) the following rights:
- Copyright and other property rights related to the article, such as patent rights.
- Research published in the journal of the University of Sebha and used in its future works, including lectures and books, the right to reproduce articles for their own purposes, and the right to self-archive their articles.
- The right to enter a separate article, or for a non-exclusive distribution of their article with an acknowledgment of its initial publication in the journal of Sebha University.
Privacy Statement The names and e-mail addresses entered on the Sabha University Journal site will be used for the aforementioned purposes only and for which they were used.