title: Effect of lifestyle modification and metformin therapy on emerging cardiovascular risk factors in overweight Indian women with polycystic ovary syndrome.
abstract: BACKGROUND
  Polycystic ovarian syndrome (PCOS) is common among women of reproductive age. Although traditional cardiac risk factors are known to be altered and improved with short-term metformin therapy, not much is known about novel cardiac risk factors.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the effects of lifestyle modification and short-term metformin therapy on the fasting serum lipids, homeostasis model assessment of insulin resistance (HOMA-IR), serum high-sensitivity C-reactive protein (hsCRP), and serum homocysteine.
  
  
  METHODS
  Native overweight [body mass index (BMI) >23 kg/m(2)] Indian women diagnosed with PCOS were evaluated and subjected to an oral glucose tolerance test and determination of insulin, homocysteine, hsCRP, and fasting lipids levels. They were started on maximally tolerated doses of metformin along with lifestyle modification. Following 3 months of therapy, they were resampled.
  
  
  RESULTS
  Out of 36 consecutive patients included, 25 women completed 3 months of metformin treatment and were eligible for repeat evaluation. The age of study group was 22.2 ± 5 years. Twenty-two (61%) women were obese (BMI >25 kg/m(2)). Improvement was seen in body weight, BMI, serum total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), hsCRP, and serum testosterone on metformin therapy. However, no improvement was seen in serum fasting insulin, HOMA-IR, or homocysteine.
  
  
  CONCLUSIONS
  Serum hsCRP improved with lifestyle modification and metformin therapy for 3 months in overweight subjects from India with PCOS, along with serum total cholesterol, triglycerides, and HDL-C. However, markers of insulin resistance and serum homocysteine did not improve.
authors.affiliation: Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati, India.
authors.forename: Gadekal
authors.initials: G
authors.lastname: Rajagopal
authors.forename: Amaresh P
authors.initials: AP
authors.lastname: Reddy
authors.forename: Chittari
authors.initials: C
authors.lastname: Venkata Harinarayan
authors.forename: Vaikkakara
authors.initials: V
authors.lastname: Suresh
authors.forename: Aparna
authors.initials: A
authors.lastname: Bitla
authors.forename: Srinivasa
authors.initials: S
authors.lastname: P V L N Rao
authors.forename: Alok
authors.initials: A
authors.lastname: Sachan
mesh_terms: D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D005260:Female; D006706:Homeostasis; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008019:Life Style; D008055:Lipids / Q000097:blood / Q000737:chemistry; D020714:Maximum Tolerated Dose; D008687:Metformin / Q000627:therapeutic use*; D050177:Overweight / Q000188:drug therapy*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011863:Radioimmunoassay / Q000379:methods; D012307:Risk Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; D006710:Homocysteine; D002097:C-Reactive Protein; D008687:Metformin