title: Effects of metformin or an oral contraceptive containing cyproterone acetate on serum c-reactive protein, interleukin-6 and soluble vascular cell adhesion molecule-1 concentrations in women with polycystic ovary syndrome.
abstract: The aim of the present study was to evaluate the effects of commonly used treatment regimens such as metformin (MET) or an oral contraceptive pill (OC) containing ethynyloestradiol and cyproterone acetate (EE-CPA) on surrogate serum CVD risk factors and markers of endothelial dysfunction (CRP, IL-6, sVCAM) in women with PCOS.This study was conducted in a crossover design in order to compare the effects of 2 different treatment regimens in the same subject and has been registered under the number NCT01798875 in the ClinicalTrials.gov registry.42 women with PCOS (age range 18-36 years, median BMI 24.9) were randomly assigned to treatment with MET (850 mg bid) or EE-CPA containing OC for 4 months. After 2 months washout period, treatments were crossed over.Treatment with and OC increased significantly serum CRP concentrations (from 0.77 mg/l [95% CI: 0.70; 2.18] to 1.70 mg/l [95% CI: 1.65; 3.69], P<0.001). Treatment with MET slightly reduced serum CRP levels, but this difference did not reach statistical significance (P=0.08). 4 months treatment with MET or EE-CPA had no effect on serum IL-6 and sVCAM-1 concentrations (P>0.05).Treatment with EE-CPA containing OC for 4 months in women with PCOS significantly raises serum CRP. Since this rise was not accompanied by the increase in serum concentrations of IL-6, which is the most potent and effective stimulant of hepatic CRP production, we can speculate that this effect is caused by the liver first-pass effect of oral oestrogen administration. If this in turn can confer, cardiovascular risk among these women warrants further -studies.
authors.affiliation: Department of Clinical Nutrition, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: J A
authors.initials: JA
authors.lastname: Dardzińska
authors.affiliation: Department of Clinical and Experimental Endocrinology, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Rachoń
authors.affiliation: Department of Clinical and Experimental Endocrinology, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Kuligowska-Jakubowska
authors.affiliation: Department of Clinical Nutrition, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Aleksandrowicz-Wrona
authors.affiliation: Gynaecology and Obstetrics Unit of the Polish Red Cross Maritime Hospital in Gdynia, Gdynia, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Płoszyński
authors.affiliation: Department of Hypertension and Diabetology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Wyrzykowski
authors.affiliation: Faculty of Health Sciences, Powiślański College, Kwidzyn, Poland.
authors.forename: W
authors.initials: W
authors.lastname: Lysiak-Szydłowska
mesh_terms: D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism*; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D003534:Cyproterone / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D015850:Interleukin-6 / Q000097:blood*; D008687:Metformin / Q000008:administration & dosage*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy; D013997:Time Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D000726:Androgen Antagonists; D003276:Contraceptives, Oral; D007004:Hypoglycemic Agents; C508600:IL6 protein, human; D015850:Interleukin-6; D019010:Vascular Cell Adhesion Molecule-1; D002097:C-Reactive Protein; D008687:Metformin; D003534:Cyproterone