Metformin therapy improves coronary microvascular function in patients with polycystic ovary syndrome and insulin resistance.
BACKGROUND
Women with polycystic ovary syndrome (PCOS) are thought to have increased cardiovascular risk. Metformin therapy reduces whole-body insulin resistance (IR) in patients with type-2 diabetes mellitus (DM).


OBJECTIVE
As insulin resistance accompanying PCOS may be reversed by metformin therapy, we hypothesized that metformin therapy might improve coronary microvascular functions in women with PCOS and IR.


METHODS
We treated 16 women with PCOS and IR with metformin, and measured coronary flow reserve (CFR) at the beginning and after 6 months of metformin therapy using transthoracic second-harmonic Doppler echocardiography.


RESULTS
At the end of the 6 months of metformin therapy, baseline coronary diastolic peak flow velocity (DPFV) did not change significantly (from 24.6 +/- 4.3 to 23.0 +/- 3.1, P = 0.106); however, hyperaemic coronary DPFV (from 68.2 +/- 12.7 to 74.5 +/- 9.7, P = 0.08), and CFR (from 2.75 +/- 0.48 to 3.3 +/- 0.5, P = 0.016) was significantly improved by metformin therapy.


CONCLUSIONS
In women with PCOS, coronary microvascular function and CFR are significantly improved by 6 months of therapy with metformin.
Topcu
Semra
S
Department of Cardiology, Baskent University, Konya Teaching and Medical Research Centre, Konya, Turkey.
Tok
Derya
D
Caliskan
Mustafa
M
Ozcimen
Emel Ebru
EE
Gullu
Hakan
H
Uckuyu
Ayla
A
Erdogan
Dogan
D
Zeyneloglu
Hulusi
H
Muderrisoglu
Haldun
H
D000328:Adult; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003326:Coronary Circulation / Q000187:drug effects*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D008833:Microcirculation / Q000187:drug effects; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D012039:Regional Blood Flow; D018709:Statistics, Nonparametric; D013997:Time Factors
D007004:Hypoglycemic Agents; D008687:Metformin