[Clinical, hormonal and biochemical changes after treatment with metformin and weight reduction in women with polycystic ovary syndrome]

Abstract

Aim of the study: to compare the clinical, hormonal and biochemical changes after the application of the two ways of influence upon insulin resistance in women with PCOS - reduction of weight and application of metformin.

Materials and methods: It is an open, 6 months, prospective study, including 60 women with PCOS, divided in two groups. The first group (n=35) received 1700 mg metformin (M) per day. The second group (n =25) was put on a low caloric diet (1200-1400 kcal) for reduction of weight. The following anthropological and clinical parameters have been checked in the beginning and at the end of the study - weight, BMI, frequency of menstruation, waist to hip ratio, hirsutismus, defined by the Ferriman-Gallwey index. The following hormonal parameters have been studied as well - testosterone, SHBG, insulin, DHEAS, LH and FSH. FAI and HOMAIR have also been determined.

Results: A considerable improvement in the frequency of menstruation has been noticed in both groups, while hirsutism has been influenced positively mostly in the group, where M is applied. In group 2 the clinical improvement is directly connected with the percent of weight reduction. In group 1 the clinical changes depend on the degree of influence over insulin resistance.

Conclusion: The higher BMI is, the more likely to expect is an effect over the menstruation cycle, due to weight reduction, than to M application or to the increase dosage of the drug. In cases of women with expressed hirsutism, it is more appropriate to apply M as a monotherapy or in combination with programs for body-weight reduction.