Endocrine Abstracts

C-reactive protein (CRP) is a marker of inflammatory processes which predicts vascular disease, and is raised in the circulation of women with PCOS. Metformin can be used to reduce insulin resistance in women with PCOS, leading to improved ovarian function and circulating lipid profiles. The aim of this study was to determine the effect of protracted metformin treatment on circulating CRP in women with PCOS.

Methods: CRP was assessed in women with PCOS (n=61) before and after 16 weeks treatment with either metformin (850mg bd, n=25) or placebo (n=37). Anthropometric and other cardiovascular risk factors were also assessed at the 2 time points.

Results: Concentrations of CRP were raised in the obese women with PCOS, and a strong correlation was determined between CRP and BMI (r² = 0.49). Significant, but weaker correlations were also determined between CRP and fasting insulin (r2= 0.19), HbA1C, SHBG, leptin, HDL cholesterol, HDL/LDL ratio and triglycerides. No association was determined between CRP and total testosterone.

Metformin treatment resulted in improved ovarian function, significant weight loss, and increased HDL concentrations. Neither the metformin nor the placebo group showed changes in CRP. Furthermore, those patients who lost significant weight (> 1Kg) showed improved HDL concentrations but no change in CRP. The placebo group increased weight and showed no change in any parameter.

Discussion: Although metformin treatment improved many of the underlying features of PCOS, including ovarian function, body mass and HDL, it failed to influence the circulating CRP concentrations.