title: Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To evaluate the clinical, endocrine and metabolic effects of metformin and N-acetyl-cysteine (NAC) in patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  In this prospective trial, 100 women with PCOS were randomly divided to receive metformin (500 mg p.o. three times daily) or NAC (600 mg p.o. three times daily) for 24 weeks. Hyperandrogenism, lipid profiles, hirsutism scores, menstrual irregularity, insulin sensitivity and tumour necrosis factor-α (TNF-α) levels were measured at baseline and after the treatment period.
  
  
  RESULTS
  Both treatments resulted in a significant decrease in body mass index, hirsutism score, fasting insulin, HOMA index, free testosterone and menstrual irregularity compared with baseline values, and both treatments had equal efficacy. NAC led to a significant decrease in both total cholesterol and low-density lipoprotein levels, whereas metformin only led to a decrease in total cholesterol level. Although TNF-α levels increased following treatment for both groups, the difference from baseline was not significant.
  
  
  CONCLUSIONS
  Metformin and NAC appear to have comparable effects on hyperandrogenism, hyperinsulinaemia and menstrual irregularity in women with PCOS. The effects of metformin and NAC on insulin sensitivity are not associated with TNF-α.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Erciyes University, 38039 Kayseri, Turkey. onerg@yahoo.com
authors.forename: Gokalp
authors.initials: G
authors.lastname: Oner
authors.forename: Iptisam Ipek
authors.initials: II
authors.lastname: Muderris
mesh_terms: D000111:Acetylcysteine / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000975:Antioxidants / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D005260:Female; D006628:Hirsutism / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology / Q000517:prevention & control; D006937:Hypercholesterolemia / Q000209:etiology / Q000517:prevention & control; D006946:Hyperinsulinism / Q000209:etiology / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007333:Insulin Resistance; D008599:Menstruation Disturbances / Q000209:etiology / Q000517:prevention & control; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D010352:Patient Dropouts; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D000924:Anticholesteremic Agents; D000975:Antioxidants; D007004:Hypoglycemic Agents; D014409:Tumor Necrosis Factor-alpha; D008687:Metformin; D000111:Acetylcysteine