Endocrine Abstracts

Background: Central obesity in polycystic ovary syndrome (PCOS) is associated with increased inflammatory markers and increased risk for type 2 diabetes.

Aim: To evaluate the long-term effects of metformin (M) and/or oral contraceptives (OC) on fat mass.

Research design: Randomized, controlled study.

Setting: Outpatient clinic.

Methods: 90 patients with PCOS were randomized to 12 months M (2 g/day) or OC (150 mg desogestrel+30 μg ethinylestradiol) or M+OC. Clinical and hormonal evaluations, oral glucose tolerance tests, and whole-body DXA scans were performed before and after the intervention period.

Main outcome measures: BMI, fat mass measures evaluated by DXA scans.

Results: A total of 65/90 patients completed the study (dropout rates between intervention groups, NS). M and M+OC were superior to OC regarding fat mass, body composition and insulin sensitivity. The median (quartiles) weight changes during 12 months M, OC, and M+OC treatment were −3.0 (−10.3; 0.6), 1.2 (−0.8; 3.0), and −1.9 (−4.9; 0.1) kg, respectively, P<0.05. During multiple regression analyses, changes in body composition during study intervention were predicted by type of medical intervention and not by BMI at study inclusion. Changes in total testosterone were comparable during the three different interventions, but OC and M+OC was superior to M regarding increased SHBG and decreased free testosterone levels.

Conclusions: M treatment is associated with improved body composition compared to OC, whereas OC is associated with decreased testosterone levels. Combined treatment with M+OC should be considered in patients with hyperandrogenism and obesity.