title: Body composition is improved during 12 months' treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome.
abstract: BACKGROUND
  Central obesity in polycystic ovary syndrome (PCOS) is associated with increased inflammatory markers and increased risk for type 2 diabetes.
  
  
  OBJECTIVE
  The objective of the study was to evaluate whether treatment with metformin (M) or M combined with oral contraceptive pills (OCPs) resulted in a more advantageous body composition than treatment with OCP alone.
  
  
  METHODS
  The study was conducted at an outpatient clinic.
  
  
  METHODS
  This was a randomized, controlled clinical trial. Ninety patients with PCOS were randomized to 12 months' treatment with M (2 g/d), M + OCP (150 mg desogestrel+30 μg ethinylestradiol), or OCP. Whole-body dual-energy x-ray absorptiometry scans and clinical and hormonal evaluations were performed before and after the intervention period. A total of 65 of 90 patients completed the study.
  
  
  METHODS
  Changes in weight at 6 and 12 months and changes in regional fat mass estimates at 12 months were measured.
  
  
  RESULTS
  Dropout rates between intervention groups were not significantly different. Treatment with M and M+OCP were superior to OCP regarding weight and regional fat mass. The median (quartiles) weight changes during 12 months of M, M+OCP, and OCP treatment were -3.0 (-10.3; 0.6), -1.9 (-4.9; 0.1), and 1.2 (-0.8; 3.0) kg, respectively, P < .05. Upper to lower fat mass ratio was unchanged. Changes in body composition were predicted by the type of medical intervention (M, M+OCP, or OCP) and not by body mass index at study inclusion. OCP and M+OCP were superior to M regarding reduction in free T levels.
  
  
  CONCLUSIONS
  M treatment alone or in combination with OCP was associated with weight loss and improved body composition compared with OCP, whereas free T levels decreased during M+OCP or OCP. Combined treatment with M+OCP should be considered as an alternative to treatment with OCP alone to avoid weight gain in PCOS.
authors.affiliation: Departments of Endocrinology and Metabolism (D.G., M.L.A., H.M., A.P.H., M.A.) and Gynecology and Obstetrics (P.R.), Odense University Hospital, 5000 Odense C, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Glintborg
authors.forename: Magda Lambaa
authors.initials: ML
authors.lastname: Altinok
authors.forename: Hanne
authors.initials: H
authors.lastname: Mumm
authors.forename: Anne Pernille
authors.initials: AP
authors.lastname: Hermann
authors.forename: Pernille
authors.initials: P
authors.lastname: Ravn
authors.forename: Marianne
authors.initials: M
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition / Q000187:drug effects*; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D017135:Desogestrel / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects; D008687:Metformin / Q000008:administration & dosage*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003277:Contraceptives, Oral, Combined; D004997:Ethinyl Estradiol; D017135:Desogestrel; D008687:Metformin