title: Effect of metformin compared with hypocaloric diet on serum C-reactive protein level and insulin resistance in obese and overweight women with polycystic ovary syndrome.
abstract: OBJECTIVE
  The aim of the present study was to investigate the efficacy of Metformin compared with a hypocaloric diet on C-reactive protein (CRP) level and markers of insulin resistance in obese and overweight women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Forty women with body mass index ≥ 27 and PCOS were randomly allocated to receive either Metformin or hypocaloric diet and were assessed before and after a treatment period of 12 weeks. High-sensitivity CRP (hs-CRP) and markers of insulin resistance (IR), homeostasis model assessment-IR, quantitative insulin-sensitivity check index and fasting glucose to insulin ratio were evaluated in each patient.
  
  
  RESULTS
  A total of 10 subjects did not complete the trial (three patients in the Metformin group and seven patients in the diet group) and a total of 30 subjects completed the trial (17 subjects in the Metformin group and 13 subjects in the diet group). Serum concentration of hs-CRP significantly decreased in both the Metformin (5.29 ± 2.50 vs 3.81 ± 1.99, P = 0.008) and diet groups (6.08 ± 2.14 vs 4.27 ± 1.60, P = 0.004). There were no significant differences in mean hs-CRP decrement between the two groups. Decrease in hs-CRP levels was significantly correlated with waist circumference in the diet group (r = 0.8, P < 0.001). The effect of a hypocaloric diet with 5-10% weight reduction on markers of insulin resistance (homeostasis model assessment-IR, fasting glucose to insulin ratio, quantitative insulin-sensitivity check index) was better than Metformin therapy (P = 0.001).
  
  
  CONCLUSIONS
  Although weight reduction has equal efficacy with Metformin in decreasing serum hs-CRP levels, it was significantly more effective in improving insulin resistance in obese and overweight PCOS women.
authors.affiliation: Endocrinology and Metabolism Research Center, Internal Medicine Department, Vali-Asr Hospital, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Esfahanian
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Zamani
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Moini nia
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy*; D015431:Weight Loss; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D002097:C-Reactive Protein; D008687:Metformin