title: Ethinyl estradiol-drospirenone vs ethinyl estradiol-drospirenone plus metformin in the treatment of lean women with polycystic ovary syndrome.
abstract: OBJECTIVE
  Oral contraceptive use might be associated with cardiometabolic risk in PCOS. We aimed to compare the effects of ethinyl estradiol-drospirenone (EE/DRSP) alone vs EE/DRSP plus metformin on clinical and cardiometabolic parameters in PCOS.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Forty-five lean patients with PCOS who received EE/DRSP (30 μg/3 mg) (n = 25) or EE/DRSP plus metformin (1700 mg/day) (n = 20) and 45 BMI-matched healthy controls.
  
  
  METHODS
  BMI, waist-to-hip ratio (WHR), hirsutism scores, androgens, lipids, glucose and insulin levels during an OGTT were measured before and after 6 months of treatment in patients and compared to controls.
  
  
  RESULTS
  At baseline, patients with PCOS showed similar glucose, insulin and lipids but increased 2 h glucose values compared to controls. Hirsutism scores and free androgen index decreased in both treatment groups. BMI and WHR did not show any change in the EE/DRSP group, while metformin addition resulted in a decrease in BMI. Lipid levels increased in both groups. Glucose and insulin parameters did not change in any group, but metformin addition compared to EE/DRSP alone significantly decreased waist circumference, fasting insulin and HOMA-IR. After-treatment values for both EE/DRSP alone and in combination with metformin compared to the control group showed increased 2 h glucose and increased lipids in patients with PCOS.
  
  
  CONCLUSIONS
  EE/DRSP alone or in combination with metformin improves clinical and biochemical hyperandrogenism in lean PCOS. Both treatments similarly alter lipid profile. EE/DRSP alone does not affect insulin sensitivity, whereas combining EE/DRSP with metformin might improve it.
authors.affiliation: Endocrinology and Metabolism Unit, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Cinar
authors.forename: Ayla
authors.initials: A
authors.lastname: Harmanci
authors.forename: Miyase
authors.initials: M
authors.lastname: Bayraktar
authors.forename: Bulent O
authors.initials: BO
authors.lastname: Yildiz
mesh_terms: D000736:Androstenes / Q000097:blood / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008687:Metformin / Q000097:blood / Q000627:therapeutic use*; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D013851:Thinness / Q000097:blood
chemical_list: D000736:Androstenes; D004997:Ethinyl Estradiol; D008687:Metformin; C035144:drospirenone