title: Body weight reduction and metformin: Roles in polycystic ovary syndrome.
abstract: OBJECTIVE
  Polycystic ovary syndrome (PCOS) is a common problem in women at fertile age. A prospective study was conducted to clarify the pathophysiological responses during an application of insulin sensitizer, metformin and weight reduction therapy at the Gynecology Center in Ohud hospital, in AL-Madinah AL-Munawarah, Kingdom of Saudi Arabia.
  
  
  METHODS
  Twenty healthy women served as controls and 180 PCOS women divided into three groups participated in the study. First group was treated with Clomid citrate 100mg/day from the 2nd day of menses to the 6th day plus gonadotrophin from day three to the 13th. Group II was treated as group I plus 850mg metformin twice a day and group III was treated as group I plus weight reduction. Clinical symptoms, menstrual pattern, hirsutism, blood glucose, body mass index, waist-to-hip ratio, insulin, hormonal, and lipid profiles were assessed pre- and post treatment. Insulin resistance was calculated.
  
  
  RESULTS
  PCOS women had significantly higher values than the healthy women in most of the measurements. Metformin and weight reduction therapy resulted in a significant decrease in the fasting insulin, glucose/insulin ratio and HOMA-IR. Metformin and weight reduction therapy resulted in a significant decrease in the lipid parameters, testosterone, LH/FSH ratio, SHBG, and prolactin levels. HOMA-IR was significantly higher in women with PCOS. HOMA-IR was positively correlated with testosterone, estradiol, TG, total cholesterol and LDL-cholesterol parameters, and negatively correlated with HDL-cholesterol and FSH levels.
  
  
  CONCLUSIONS
  Metformin therapy and weight reduction had favorable influences on the basic metabolic and hormonal profiles in women with PCOS and that metformin and lifestyle modification (weight reduction via diet restriction or exercise) resulted in a significantly greater weight loss than hormonal therapy alone. Metformin and weight reduction therapy decreased also hyperandrogenism and insulin resistance.
authors.affiliation: Department of Medicine, College of Medicine, Taibah University, P.O. Box 30001, AL-Madinah AL-Munawarah, Saudi Arabia. Electronic address: alnozhah@hotmail.com.
authors.forename: Omar
authors.initials: O
authors.lastname: Al-Nozha
authors.forename: Fawziah
authors.initials: F
authors.lastname: Habib
authors.forename: Moaz
authors.initials: M
authors.lastname: Mojaddidi
authors.forename: Mohamed Fath
authors.initials: MF
authors.lastname: El-Bab