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

作　　者：叶碧绿 杨海燕 赵军招 林金菊 林文琴 

机构地区：[1]Department of Reproductive Medicine,The First Affiliated Hospital of Wenzhou Medical College,Wenzhou,Zhejiang 325000,China

出　　处：《生殖医学杂志》2003年第z1期24-32,共9页Journal of Reproductive Medicine

摘　　要：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 A1), metformin alone (group A2) or combination of CPA with metformin (groupA3) , respectively by randomizatior. 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 (2.8±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 groupA1(P＜0.001).Conclusions: The PCOS patients treated with metformin in combination with compoundcyproterone acetate may be more effectiveObjective: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 hyperandroge

关 键 词：POLYCYSTIC OVARY syndrome METFORMIN Ethinyl oestradiol/cyprot-erone acetate PILL HYPERINSULINISM 

分 类 号：R69[医药卫生—泌尿科学] R711[医药卫生—外科学]