title: Acute effects of metformin therapy include improvement of insulin resistance and ovarian morphology.
abstract: OBJECTIVE
  To evaluate the acute effects of metformin therapy on biochemical markers and polycystic ovarian morphology among insulin-resistant (IR) and noninsulin-resistant (NIR) patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Prospective interventional study.
  
  
  METHODS
  Reproductive endocrinology clinic in a university hospital.
  
  
  METHODS
  Five IR and five NIR patients with PCOS. The mean age of patients was 29.5 +/- 4.8 years (range, 23-36 years).
  
  
  METHODS
  Metformin therapy, using 850 mg orally per day for 1 week.
  
  
  METHODS
  Serum levels of T, FSH, and LH, fasting glucose/insulin ratio, levels of anti-Müllerian hormone (AMH) and inhibin B, and antral follicle count.
  
  
  RESULTS
  Levels of AMH and inhibin B were statistically significantly higher in patients with PCOS compared to controls (2.81 +/- 1.79 ng/mL versus 0.95 +/- 1.17 ng/mL, and 56.24 +/- 29.39 pg/mL versus 17.89 +/- 12.87 pg/mL, respectively). Levels of AMH and inhibin B were similar among IR and NIR patients with PCOS (2.77 +/- 1.92 ng/mL versus 2.85 +/- 1.89 ng/mL, and 53.96 +/- 28.58 pg/mL versus 58.51 +/- 33.28 pg/mL, respectively). One week of metformin therapy did not alter either AMH or inhibin B levels. However, there was a statistically significant increase in glucose/insulin ratios (4.59 +/- 1.57 versus 6.35 +/- 3.6), and a significant decrease in the number of antral follicles after 1 week of metformin therapy (38.8 +/- 19.3 versus 23.1 +/- 7.4).
  
  
  CONCLUSIONS
  Levels of AMH and inhibin B are significantly increased in patients with PCOS compared to controls, but are not associated with insulin resistance. Low-dose metformin therapy improves IR and polycystic ovary morphology, even though levels of T, AMH, and inhibin B remain unchanged.
authors.affiliation: Department of Obstetrics and Gynecology, University of Southern California-Keck School of Medicine, Los Angeles, California, USA. Aykutb@aol.com <Aykutb@aol.com>
authors.forename: Aykut
authors.initials: A
authors.lastname: Bayrak
authors.forename: Heather
authors.initials: H
authors.lastname: Terbell
authors.forename: Rebecca
authors.initials: R
authors.lastname: Urwitz-Lane
authors.forename: Eliran
authors.initials: E
authors.lastname: Mor
authors.forename: Frank Z
authors.initials: FZ
authors.lastname: Stanczyk
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Paulson
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D007265:Inhibins / Q000097:blood; D007333:Insulin Resistance; D007986:Luteinizing Hormone / Q000097:blood; D008687:Metformin / Q000627:therapeutic use*; D006080:Ovarian Follicle / Q000502:physiology; D010053:Ovary / Q000187:drug effects* / Q000473:pathology; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies; D013735:Testicular Hormones / Q000097:blood; D013739:Testosterone / Q000097:blood
chemical_list: D006023:Glycoproteins; D007004:Hypoglycemic Agents; D013735:Testicular Hormones; C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D008687:Metformin