Endocrine and metabolic effects of metformin in combination with compound cyproterone acetate in women with polycystic ovarian syndrome

【摘要】 <正> Objective:To study the endocrinologic and metabolic effects of metformin in combi-nation with compound cyproterone acetate (CPA) on patients with polycystic ovariansyndrome (PCOS).Methods:A prospective study involved total 65 patients,45 PCOS patients as group Aand 20 non-PCOS infertility patients as control (group B).Complete baseline work-up inclu-ding body mass index (BMI),waist/hip ratio(WHR),Ferriman-Gallwey score(FGS),gona-dotrophin,testosterone(T),sex hormone-binding globulin (SHBG),dehydroepiandrosteronesulfate (DHEAS),and fasting lipid,glucose (FG),insulin (FI) and oral glucose tolerancetest (OGTT),were performed in all patients.Patients in group A were treated with CPA a-lone (group Al),metformin alone (group A2) or combination of CPA with metformin (groupA3),respectively by randomization.At the end of the 12-week therapy,subjects were re-evaluated and above parameters were measured.Results:Women in group A had significant increases in BMI,WHR,FGS,LH,T,FI,insulin resistance (IR),triglycerides(TG),and significant decrease in HDL-C com-paring with the control group (P<0.01).No significant difference among A1,A2 andA3 were found at baseline.LH,T,FT (free testosterone) were significant decreasedfrom (13.9±5.9)IU/L,(2.1±0.8)nmol/L and (2.84±2.3)nmol/L respectively to(5.8±2.2)IU/L,(1.2±0.4)nmol/L and (0.8±0.5)nmol/L respectively and SHBGwas significant increased from (99±42) nmol/L to (187±64) nmol/L in group A3,when compared with LH,T and FT from (13.8±7.6)IU/L,(2.2±1.1) nmol/L and(2.5±1.9) nmol/L respectively to (11.8±6.5)IU/L,(1.8±0.8) nmol/L and (1.7±1.0) nmol/L respectively and SHBG from (99±40) nmol/L to (120±51) nmol/L ingroup A2 (P<0.05,P<0.001).HDL-C was significant increased from (1.5±0.3)mmol/L to (1.8±0.3) mmol/L in group A3 comparing with HDL-C from (1.5±0.4)mmol/L to (1.6±0.4) mmol/L in groupAl(P<0.001).Conclusions.The PCOS patients treated with metformin in combination with compoundcyproterone acetate may be more effective in inhibiting hyperandrogen and hypersecretion ofLH than metfromin alone and more obvious in improving lipid profiles than CPA alone.更多还原

【Abstract】 Objective:To study the endocrinologic and metabolic effects of metformin in combi- nation with compound cyproterone acetate (CPA) on patients with polycystic ovarian syndrome (PCOS). Methods:A prospective study involved total 65 patients,45 PCOS patients as group A and 20 non-PCOS infertility patients as control (group B).Complete baseline work-up inclu- ding body mass index (BMI),waist/hip ratio(WHR),Ferriman-Gallwey score(FGS),gona- dotrophin,testosterone(T),sex hormone-binding globulin (SHBG),dehydroepiandrosterone sulfate (DHEAS),and fasting lipid,glucose (FG),insulin (FI) and oral glucose tolerance test (OGTT),were performed in all patients.Patients in group A were treated with CPA a- lone (group Al),metformin alone (group A2) or combination of CPA with metformin (group A3),respectively by randomization.At the end of the 12-week therapy,subjects were re-eva luated and above parameters were measured. Results:Women in group A had significant increases in BMI,WHR,FGS,LH,T, FI,insulin resistance (IR),triglycerides(TG),and significant decrease in HDL-C com- paring with the control group (P<0.01).No significant difference among A1,A2 and A3 were found at baseline.LH,T,FT (free testosterone) were significant decreased from (13.9±5.9)IU/L,(2.1±0.8)nmol/L and (2.84±2.3)nmol/L respectively to (5.8±2.2)IU/L,(1.2±0.4)nmol/L and (0.8±0.5)nmol/L respectively and SHBG was significant increased from (99±42) nmol/L to (187±64) nmol/L in group A3, when compared with LH,T and FT from (13.8±7.6)IU/L,(2.2±1.1) nmol/L and (2.5±1.9) nmol/L respectively to (11.8±6.5)IU/L,(1.8±0.8) nmol/L and (1.7± 1.0) nmol/L respectively and SHBG from (99±40) nmol/L to (120±51) nmol/L in group A2 (P<0.05,P<0.001).HDL-C was significant increased from (1.5±0.3) mmol/L to (1.8±0.3) mmol/L in group A3 comparing with HDL-C from (1.5±0.4) mmol/L to (1.6±0.4) mmol/L in groupAl(P<0.001). Conclusions.The PCOS patients treated with metformin in combination with compound cyproterone acetate may be more effective in inhibiting hyperandrogen and hypersecretion of LH than metfromin alone and more obvious in improving lipid profiles than CPA alone.更多还原