title: A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To compare N-acetyl cysteine (NAC) and metformin on polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Study was performed as a randomized double-blind clinical trial on women with diagnosis of PCOS without additional complications. In one group, oral NAC 600 mg, three times a day and in the other group, 500 mg oral metformin, three times a day were prescribed. Duration of treatment was 24 weeks, and after finishing this period of treatment, fasting blood glucose (FBS) and insulin, lipid profile and Homeostasis Model Assessment (HOMA) index were measured (all the blood samples were taken while fasting) and were compared in the two groups.
  
  
  RESULTS
  Forty-six women in NAC group and 48 women in metformin group finished the study. The two groups did not show significant difference according to age, body mass index (BMI) of more than 30; mean BMI, AUB, FBS, fasting blood insulin, lipid profile and HOMA index before treatment. After 24 weeks of treatment; BMI >30 [17 (35.4%) versus 7 (15.2%), p = 0.033], mean BMI [(28.36 ± 2.27) versus (27.11 ± 3.55), p = 0.44], number of women with the complain of abnormal uterine bleeding (AUB) [24 (50%) versus 13 (28.3%), p = 0.037], FBS [(90.02 ± 6.24) versus (86.61 ± 7.81), p = 0.021], fasting insulin (10.40 ± 2.64 versus 8.89 ± 2.20, p = 0.004), HOMA Index (2.09 ± 0.69 versus 1.71 ± 0.45, p = 0.001), low density lipoprotein (LDL) (141.83 ± 26.98 versus 127.89 ± 28.70, p = 0.017) were less in NAC group. Triglyceride (TG) and total cholesterol did not show significant difference between the two groups after treatment. High-density lipoprotein (HDL) was higher in NAC group.
  
  
  CONCLUSIONS
  NAC can improve lipid profile and fasting blood sugar (FBS) and fasting blood insulin better than metformin.
authors.affiliation: a Department of Obstetrics & Gynecology , Firoozgar Teaching Hospital, Iran University of Medical Sciences , Tehran , Iran .
authors.forename: Forough
authors.initials: F
authors.lastname: Javanmanesh
authors.affiliation: b Department of Obstetrics & Gynecology , Akbarabadi Teaching Hospital, Iran University of Medical Sciences , Tehran , Iran , and.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kashanian
authors.affiliation: b Department of Obstetrics & Gynecology , Akbarabadi Teaching Hospital, Iran University of Medical Sciences , Tehran , Iran , and.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rahimi
authors.affiliation: c Department of Public Health, Faculty of Medicine , University of Southampton , Southampton , UK.
authors.forename: Narges
authors.initials: N
authors.lastname: Sheikhansari
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D016166:Free Radical Scavengers / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D050356:Lipid Metabolism / Q000187:drug effects; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D016166:Free Radical Scavengers; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D000111:Acetylcysteine
keywords: Abnormal uterine bleeding; BMI; N-acetyl cysteine; fasting blood insulin; fasting blood sugar; insulin resistance; lipid profile; metformin; polycystic ovary syndrome