title: The effect of alfacalcidiol and metformin on phenotype manifestations in women with polycystic ovary syndrome - a preliminary study.
abstract: Aim of this study was to evaluate the effect of vitamin D supplementation in obese, insulin resistant and vitamin D deficient PCOS women on biochemical and clinical hyperandrogenism and menstrual irregularity in comparison to effect of metformin or combined metformin plus vitamin D therapy. Thirty nine PCOS women were randomized into three groups and treated with alfacalcidiol (Group 1), combined alfacalcidiol and metformin therapy (Group 2) and metformin (Group 3) for 6 months. Serum TST, fTST, DHEAS, LH and LH/FSH were measured before and after six months of treatment. Menstrual cycle regularity, hirsutism, acne and pregnancy rate were assessed at the same time. There was a significant decrease in TST levels in the Group 2 and slight but not significant decrease in the Group 3. No significant changes in other parameters (fTST, DHEAS, LH, LH/FSH) have been found after 6 months therapy in all three groups. An improvement of menstrual cycle was detected in 78 % of patients in Group 1 (p<0.04), 80 % in the Group 2 (p<0.03) and in 90 % in the Group 3 (p<0.002), respectively. There was no significant improvement of acne and hirsutism in all three groups (all p not significant). Pregnancy rate was higher in the Group 3 as compared with Groups 1 and 2 (67 % vs. 0 % and 25 %, respectively), however without statistical significance. Vitamin D administration has no significant effect on androgen levels and clinical features of hyperandrogenism in obese vitamin D deficient PCOS women. However, it can potentiate effect of metformin on testosterone levels and LH/FSH ratio but not on clinical hyperandrogenism and pregnancy rate.
authors.affiliation: First Department of Internal Medicine, Medical Faculty of P. J. Šafarik University, Košice, Slovakia. ingrid.dravecka@upjs.sk.
authors.forename: I
authors.initials: I
authors.lastname: Dravecká
authors.forename: J
authors.initials: J
authors.lastname: Figurová
authors.forename: M
authors.initials: M
authors.lastname: Javorský
authors.forename: J
authors.initials: J
authors.lastname: Petríková
authors.forename: M
authors.initials: M
authors.lastname: Vaľková
authors.forename: I
authors.initials: I
authors.lastname: Lazúrová
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000494:pharmacology / Q000627:therapeutic use*; D017588:Hyperandrogenism / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007333:Insulin Resistance; D008597:Menstrual Cycle / Q000187:drug effects*; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use; D009765:Obesity / Q000150:complications; D010641:Phenotype; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D055815:Young Adult
chemical_list: D006887:Hydroxycholecalciferols; D007004:Hypoglycemic Agents; D008687:Metformin; C008088:alfacalcidol