The effect of alfacalcidiol and metformin on metabolic disturbances in women with polycystic ovary syndrome.
BACKGROUND
The aim of this randomized clinical trial (RCT) was to evaluate the effect of vitamin D supplementation in obese, insulin-resistant (IR) and vitamin D-deficient polycystic ovary syndrome (PCOS) women on metabolic abnormalities in comparison to the effect of metformin or combined metformin plus vitamin D therapy.


METHODS
Thirty-nine PCOS women who fulfilled the inclusion criteria were randomized into three groups and treated with alfacalcidiol, combined alfacalcidiol and metformin therapy and metformin for 6 months. Body weight, body mass index (BMI), waist circumference, total body fat and fat distribution were measured before and after 6 months of treatment. Plasma fasting glucose, insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and lipid profiles were measured at the same time.


RESULTS
There was a significant decrease in body weight, BMI, waist circumference, total body fat and serum glucose levels in the metformin group (p<0.05), whereas PCOS women treated with alfacalcidiol did not significantly change their anthropometric and metabolic parameters. A significant decrease in waist circumference (p<0.05) in the group treated with metformin and alfacalcidiol was detected without other significant metabolic changes (all p>0.05). There were no significant changes in metabolic parameters (p>0.05) after vitamin D therapy except for a slight but non-significant trend towards higher high-density lipoprotein (HDL) cholesterol levels (p=0.087).


CONCLUSIONS
We conclude that vitamin D supplementation has no significant effect on anthropometric and metabolic parameters in PCOS women. Metformin has been still the most effective modality for the treatment of metabolic changes in PCOS.
Jana
J
Figurová
Ingrid
I
Dravecká
Jana
J
Petríková
Martin
M
Javorský
Ivica
I
Lazúrová
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D050071:Bone Density Conservation Agents / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006887:Hydroxycholecalciferols / Q000494:pharmacology*; D007004:Hypoglycemic Agents / Q000494:pharmacology; D007333:Insulin Resistance; D008055:Lipids / Q000032:analysis; D008297:Male; D008687:Metformin / Q000494:pharmacology*; D009765:Obesity / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D014807:Vitamin D / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage
D015415:Biomarkers; D001786:Blood Glucose; D050071:Bone Density Conservation Agents; D006887:Hydroxycholecalciferols; D007004:Hypoglycemic Agents; D008055:Lipids; D014815:Vitamins; D014807:Vitamin D; D008687:Metformin; C008088:alfacalcidol