title: Improvement in endothelial structure and function after metformin treatment in young normal-weight women with polycystic ovary syndrome: results of a 6-month study.
abstract: BACKGROUND
  Recent data indicate that women affected by the polycystic ovary syndrome (PCOS) are at greater risk for cardiovascular disease and that metformin may improve the metabolic alterations in these patients.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the effects of 6 months of metformin administration on endothelial structure and function in women with PCOS.
  
  
  METHODS
  This was a prospective, baseline-controlled, clinical study.
  
  
  METHODS
  The study was performed at University Federico II (Naples, Italy).
  
  
  METHODS
  Thirty young normal-weight women with PCOS without additional metabolic or cardiovascular diseases were studied.
  
  
  METHODS
  Metformin (850 mg daily) was administered for 6 months.
  
  
  METHODS
  The main outcome measures were complete hormonal profile, including total testosterone, SHBG, dehydroepiandrosterone sulfate, prolactin, and gonadotropin levels; serum insulin and glucose levels during a 75-g 2-h oral glucose tolerance test; plasma endothelin-1 concentrations (picomoles per liter +/- sd); serum lipid profile; brachial artery baseline diameter (millimeters +/- sd), diameter after reactive hyperemia (millimeters +/- sd), and flow-mediated dilation (percentage +/- sd); and the intima media thickness (millimeters +/- sd) on both common carotid arteries.
  
  
  RESULTS
  After treatment, SHBG levels and the free androgen index changed significantly (P < 0.001). High-density lipoproteins and the area under curve for glucose/area under curve for insulin ratio also significantly (P < 0.001) increased, whereas low-density lipoproteins and plasma endothelin-1 levels were significantly (P < 0.001) reduced. No other change was found in any of the biochemical parameters evaluated. A significant difference was observed in brachial artery baseline diameter (3.24 +/- 0.30 vs. 3.0 +/- 0.30), flow-mediated dilation (14.30 +/- 1.90 vs. 15.70 +/- 1.50) (P < 0.01, each), diameter after reactive hyperemia (3.70 +/- 0.30 vs. 3.55 +/- 0.10) (P < 0.05), and intima media thickness (0.53 +/- 0.09 vs. 0.40 +/- 0.07) (P < 0.001) after metformin treatment in comparison with baseline values.
  
  
  CONCLUSIONS
  A 6-month course of metformin improves endothelial structure and function in young, normal-weight women with PCOS.
authors.affiliation: Department of Molecular, Clinical Endocrinology and Oncology, University Federico II, Via S. Pansini 5, 80131 Naples, Italy. francescoorio@virgilio.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Teresa
authors.initials: T
authors.lastname: Cascella
authors.forename: Biagio
authors.initials: B
authors.lastname: De Simone
authors.forename: Francesco
authors.initials: F
authors.lastname: Manguso
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastano
authors.forename: Tiziana
authors.initials: T
authors.lastname: Russo
authors.forename: Achille
authors.initials: A
authors.lastname: Tolino
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
authors.forename: Ricardo
authors.initials: R
authors.lastname: Azziz
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D019540:Area Under Curve; D002318:Cardiovascular Diseases / Q000209:etiology; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies
chemical_list: D019332:Endothelin-1; D007004:Hypoglycemic Agents; D008687:Metformin