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


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.


CONCLUSIONS
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.
Pekhlivanov
B
B
Mitkov
M
M
Kavŭrdzhikova
S
S
D000293:Adolescent; D000328:Adult; D031204:Caloric Restriction; D015444:Exercise; D005260:Female; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008598:Menstruation / Q000502:physiology*; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000178:diet therapy / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
D006728:Hormones; D007004:Hypoglycemic Agents; D008687:Metformin