title: Comparison of the effects of metformin, flutamide plus oral contraceptives, and simvastatin on the metabolic consequences of polycystic ovary syndrome.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women of reproductive ages. It is associated with a range of disorders, such as dyslipidemia, hypertension, insulin resistance (IR), compensatory hyperinsulinemia, gestational, and type 2 diabetes, and increased risk of cardiovascular morbidity. There are different treatments available for PCOS. The purpose of this study was to determine and compare the effects of metformin, flutamide plus oral contraceptives (OCs), and simvastatin on the metabolic consequences of PCOS.
  
  
  METHODS
  This study was a single-blind clinical trial. The subjects were selected from a group of patient with PCOS and metabolic syndrome, who were referred to the midwifery clinic of Al-Zahra Hospital and Beheshti Hospital, Isfahan, Iran. A total of 111 subjects were randomly assigned to three groups: metformin, flutamide plus OCs, and simvastatin groups. The measurements were performed at baseline and after 6 months of therapy. Pairedt-test, analysis of variance (ANOVA), and chi-square test were applied in this study.
  
  
  RESULTS
  A total of 102 subjects were analyzed in this study, 34 subjects were allotted in each group. The prevalence of IR was statistically different between three groups (P-value = 0.001). After a 6-month course, metformin showed larger reduction in fasting blood sugar (FBS) level (P-value < 0.001). However, except for metformin, two other treatments reduced C-reactive protein (CRP) level significantly (bothP-values < 0.001). The level of triglycerides (TGs) decreased considerably in all groups (allP-values < 0.001). Both metformin and simvastatin decreased BMI significantly (bothP-values < 0.001). None of the treatments changed high-density lipoprotein (HDL) level (allP-values > 0.05).
  
  
  CONCLUSIONS
  Metformin performed better in FBS reduction. Simvastatin had better performance in terms of reducing TG level and waist circumference.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ferdous
authors.initials: F
authors.lastname: Mehrabian
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hatav
authors.initials: H
authors.lastname: Ghasemi-Tehrani
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mahboobe
authors.initials: M
authors.lastname: Mohamadkhani
authors.affiliation: Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Moeinoddini
authors.affiliation: Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Pooya
authors.initials: P
authors.lastname: Karimzadeh
keywords: Flutamide; metformin; oral contraceptives (OCs); polycystic ovary syndrome (PCOS); simvastatin