Improvement in endothelial structure and function after metformin treatment in young normal-weight women with polycystic ovary syndrome: results of a 6-month study.
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.
Orio
Francesco
F
Department of Molecular, Clinical Endocrinology and Oncology, University Federico II, Via S. Pansini 5, 80131 Naples, Italy. francescoorio@virgilio.it
Palomba
Stefano
S
Cascella
Teresa
T
De Simone
Biagio
B
Manguso
Francesco
F
Savastano
Silvia
S
Russo
Tiziana
T
Tolino
Achille
A
Zullo
Fulvio
F
Lombardi
Gaetano
G
Azziz
Ricardo
R
Colao
Annamaria
A
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
D019332:Endothelin-1; D007004:Hypoglycemic Agents; D008687:Metformin