scholarly journals Responses of Serum Androgen and Insulin Resistance to Metformin and Pioglitazone in Obese, Insulin-Resistant Women with Polycystic Ovary Syndrome

2005 ◽  
Vol 90 (3) ◽  
pp. 1360-1365 ◽  
Author(s):  
C. Ortega-González ◽  
S. Luna ◽  
L. Hernández ◽  
G. Crespo ◽  
P. Aguayo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Weight ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Waist To Hip Ratio

Severe insulin resistance is a key abnormality in obese women with polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate whether pioglitazone decreases insulin resistance (IR) and hyperandrogenism to the same extent as metformin in obese women with PCOS who have not received any previous treatment. Fifty-two women with PCOS were randomly allocated to receive either pioglitazone (30 mg/d, n = 25) or metformin (850 mg three times daily, n = 27) and were assessed before and after 6 months. Body weight, body mass index, and waist to hip ratio increased significantly (P ≤ 0.05) after pioglitazone treatment but not after metformin treatment. Fasting serum insulin concentration (P < 0.001 for both drugs) and the area under the insulin curve during a 2-h oral glucose tolerance test decreased after pioglitazone (P < 0.002) or metformin (P < 0.05) treatment. IR (homeostasis model of assessment-IR index) decreased and insulin sensitivity (elevation of the quantitative insulin sensitivity check index and the fasting glucose to insulin ratio) increased (P ≤ 0.008) after treatment with either drug. Hirsutism (P < 0.05) and serum concentrations of free testosterone (P < 0.02) and androstenedione (P < 0.01) declined to a similar extent after treatment with the drugs. Treatment with pioglitazone or metformin was associated with the occurrence of pregnancy (n = 5 and n = 3, respectively). These results suggest that pioglitazone is as effective as metformin in improving insulin sensitivity and hyperandrogenism, despite an increase in body weight, body mass index, and the waist to hip ratio associated with pioglitazone.

Metformin treatment with or without life style changes in patients with polycystic ovary syndrome

2011 ◽  
Vol 152 (16) ◽  
pp. 628-632 ◽  
Author(s):  
Gyula Petrányi ◽  
Mária Zaoura-Petrányi
Keyword(s):  
Body Mass Index ◽  
Polycystic Ovary Syndrome ◽  
Treatment Period ◽  
Body Mass ◽  
Life Style ◽  
Polycystic Ovary ◽  
Glycaemic Index ◽  
Ovary Syndrome ◽  
Waist To Hip Ratio ◽  
Life Style Changes

Treatment with metformin three times 500 mg daily had been advised since 2002, to patients suffering from the polycystic ovary syndrome diagnosed by the Rotterdam criteria and who did not want to take contraceptive pills. More recently, life style changes have also been introduced to treatment recommendation: increased physical activity, low glycaemic index diet; also with calorie restriction for the obese patients. Aim: To assess the efficacy of the two treatment forms on clinical symptoms of the disease. Method: The metformin only historical control group (metformin monotherapy) consisted of 27 patients between the ages from 18 to 39 years (mean 29 years); to which was the age-matched metformin and life style changes group (triple basal therapy) of 29 patients compared. The following parameters were registered at the beginning and the end of a six-month treatment period: global acne score, Ferriman-Gallwey hirsutism score, body mass index, waist-to-hip circumference ratio, and menstrual cycles. Results: By the end of the treatment period, both acne and hirsutism scores improved significantly in both treatment groups (P<0.001); the improvements did not differ between them: acne 8.6±5.7 vs. 9.2±5.9 (P = 0.70); hirsutism 2.5±2.0 vs. 2.6±1.6 (P = 0.83). Body mass index and waist-to-hip ratio remained practically unchanged in the metformin only group: 0.26±1.0 kg/m2 (P = 0.21) and 0.001±0.02 (P = 0.71). Body mass index decreased in the triple therapy group by 0.91±1.1 kg/m2 (P<0.001); and waist-to-hip ratio by 0.019±0.03 (P<0.001). The decrease of the body mass index was more remarkable in overweight patients: 1.10±1.26 kg/m2 (P = 0.002) vs. 0.64±0.88 kg/m2 (P = 0.03) in lean patients. Recommendation on life style changes with metformin did not show further improvement of hyperandrogenic symptoms in comparison to metformin alone but the combined therapy diminished body size indexes. Conclusion: Authors recommend the triple basal treatment consisting of metformin, physical exercise and low glycaemic index diet to their patients with polycystic ovary syndrome for assessment of its long-term efficacy. Orv. Hetil., 2011, 152, 628–632.

scholarly journals Hyperandrogenism and Insulin Resistance, Not Changes in Body Weight, Mediate the Development of Endothelial Dysfunction in a Female Rat Model of Polycystic Ovary Syndrome (PCOS)

Endocrinology ◽  
2015 ◽  
Vol 156 (11) ◽  
pp. 4071-4080 ◽  
Author(s):  
Amanda Hurliman ◽  
Jennifer Keller Brown ◽  
Nicole Maille ◽  
Maurizio Mandala ◽  
Peter Casson ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Weight ◽  
Weight Gain ◽  
Insulin Sensitivity ◽  
Endothelial Dysfunction ◽  
Polycystic Ovary Syndrome ◽  
Rat Model ◽  
Polycystic Ovary ◽  
Phase 1 ◽  
Ovary Syndrome

This study was designed to differentiate the contributions of hyperandrogenism, insulin resistance (IR), and body weight to the development of endothelial dysfunction in polycystic ovary syndrome and determine the effectiveness of insulin sensitization and antiandrogenic therapy after the establishment of vascular and metabolic dysfunction using a rat model of polycystic ovary syndrome. We hypothesized that the observed endothelial dysfunction was a direct steroidal effect, as opposed to changes in insulin sensitivity or body weight. Prepubertal female rats were randomized to the implantation of a pellet containing DHT or sham procedure. In phase 1, DHT-exposed animals were randomized to pair feeding to prevent weight gain or metformin, an insulin-sensitizing agent, from 5 to 14 weeks. In phase 2, DHT-exposed animals were randomized to treatment with metformin or flutamide, a nonsteroidal androgen receptor blocker from 12 to 16 weeks. Endothelial function was assessed by the vasodilatory response of preconstricted arteries to acetylcholine. Serum steroid levels were analyzed in phase 1 animals. Fasting blood glucose and plasma insulin were analyzed and homeostasis model assessment index calculated in all animals. Our data confirm the presence of endothelial dysfunction as well as increased body weight, hypertension, hyperinsulinemia, and greater IR among DHT-treated animals. Even when normal weight was maintained through pair feeding, endothelial dysfunction, hyperinsulinemia, and IR still developed. Furthermore, despite weight gain, treatment with metformin and flutamide improved insulin sensitivity and blood pressure and restored normal endothelial function. Therefore, the observed endothelial dysfunction is most likely a direct result of hyperandrogenism-induced reductions in insulin sensitivity, as opposed to weight gain.

scholarly journals Effect of Metformin Therapy on Clinical and Hormonal Indices of Patients with Polycystic Ovary Syndrome

2021 ◽  
Vol 15 (5) ◽  
pp. 1522-1525
Author(s):  
S. Inayat ◽  
H. F. Khattak ◽  
M. G. Muhammad ◽  
K. Robeen ◽  
A. Inayat ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Weight ◽  
Polycystic Ovary Syndrome ◽  
Blood Sugar ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Fasting Blood Sugar ◽  
Ovary Syndrome ◽  
Group Ii

Objective: The main objective of this study is to determine the efficacy of metformin therapy on clinical and hormonal indices of patients with polycystic ovary syndrome. Study Design: Randomized control trial Place and Duration: Study was conducted at Obstetrics & Gynaecology department of Northwest General Hospital and Research Center, Peshawar and Mian Rashid Hussain Shaheed Memorial Hospital, Pabbi for duration of nine months from March 2020 to November 2020. Methods: Total 100 patients of polycystic ovary syndrome were presented in this study. Patients were aged between 18 to 45years. Patients detailed demographics including age, body mass index and socio-economicstatus were recorded after taking informed written consent. Patients were divided into 2-groups, group I had 50 patients and received metformin (500 mg) three times a day and group II had 50 patients and received pioglitazone (30 mg) three times a day for 3months.Clinical (body weight, blood pressure (BP), and body mass index) and indices fasting blood sugar (FBS), serum triglyceride (TG), cholesterol, low-density lipoprotein, high-density lipoprotein, insulin, testosterone, and dehydroepiandrosterone (DHEA) were measured before and after therapy. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients in group I was 29.18 ± 2.25 years with mean BMI 26.14 ± 8.86 kg/m2 and in group II mean age was 29.8 ± 2.52 years with mean BMI 27.64 ± 7.68 kg/m2.Significantly decrease in blood pressure (systolic 105.41±8.57, diastolic 67.19±8.9), hair loss 20 (40%),oligomenorrhea 23 (46%), body weight 74.45±9.72, waist circumference and dehydroepiandrosterone (DHEA) 2.35±0.67 and as compared to group II. Only triglycerides gave results of reduction in group II 115.39±64.11. Among both groups serum insulin, acne, menstrual disturbance and fasting blood sugar were controlled after treatment. Conclusion: We concluded in this study that use of metformin in patients with polycystic ovary syndrome resulted in to decrease clinical body weight, blood pressure (BP), body mass index and hormonal indices with reduction of serum insulin, acne, menstrual disturbance and fasting blood sugar but pioglitazone was an alternative effective and reliable method in PCOS patients. Keywords: Polycystic ovary syndrome, Insulin resistance, Metformin, Pioglitazone

scholarly journals Insulin resistance in relation to clinical, endocrine and metabolic profile of infertile women with polycystic ovary syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. 1-6
Author(s):  
Shakeela Ishrat ◽  
Marufa Hossain ◽  
Subrata Kumar Biswas
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Polycystic Ovary Syndrome ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Significant Difference

The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to the clinical, endocrine and metabolic factors in the infertile women with polycystic ovary syndrome. This study was conducted on 121 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit from January 2017 to December 2017. They were divided into two groups: insulin resistant and insulin sensitive. There was significant difference in body mass index and waist circumference between the two groups. Serum lipids were not associated with insulin resistance. Hyperinsulinemia was significantly associated with metabolic syndrome. Reducing body mass index and waist circumference may improve insulin resistance in infertile women with polycystic ovary syndrome. Screening the infertile women with polycystic ovary syndrome for hyperinsulinemia and insulin resistance and subsequent counseling is recommended to address the long-term risks of metabolic syndrome.

scholarly journals Association of PPARG Pro12Ala polymorphism with insulin sensitivity and body mass index in patients with polycystic ovary syndrome

2013 ◽  
Vol 2 (2) ◽  
pp. 199-206 ◽  
Author(s):  
DINKA PAVICIC BALDANI ◽  
LANA SKRGATIC ◽  
JASMINA Z. CERNE ◽  
POLONCA FERK ◽  
VELIMIR SIMUNIC ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Pro12ala Polymorphism ◽  
Ovary Syndrome
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