ECE2019 Poster Presentations Reproductive Endocrinology 2 (39 abstracts)
The metabolic effects of metformin, cyproterone-acetate and their combination in women with polycystic ovary syndrome
Ivana Bozic-Antic 1 , Dusan Ilic 1 , Tamara Bogavac 1 , Snjezana Erceg 1 , Mirjana Lacmanovic 1 , Bojana Popovic 1 , Tatjana Isailovic 1 , Valentina Elezovic-Kovacevic 1 , Sanja Ognjanovic 1 , Danijela Vojnovic-Milutinovic 2 & Djuro Macut 1
1Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia; 2IBISS, University of Belgrade, Belgrade, Serbia.
Introduction: Metformin and oral contraceptive pills (OCP) are the most commonly prescribed medications among women with polycystic ovary syndrome (PCOS). The aim of this study was to compare effects of pill containing cyproterone-acetate (CPA) and metformin (METF) in women with PCOS during six months of follow-up.
Methods: Group of 60 women with PCOS diagnosed by ESHRE/ASRM criteria were divided into 3 subgroups (20 women each), which were treated with different therapeutic modalities over 6 months: 1)METF (age: 23.5±5.9 years, BMI: 24.8±4.2 kg/m2); 2)CPA (Diane35®) (age:23.7±3.2 years; BMI: 22.6±4.6 kg/m2); 3)METF+CPA (age: 22.3±4.0 years BMI: 25.8±4.8 kg/m2). There were no between-group differences in age and BMI. The fasting glucose (FG), lipids and hormones (FSH, LH, testosterone, SHBG, insulin) were analyzed; menstrual cycles (MC) and hirsutism were monitored. Insulin resistance (IR) was determined by HOMA-IR.
Results: After six months of treatment, there were no significant change in BMI or FG in any group. The CPA group had significantly lower HOMA-IR compared to the METF and METF+CPA groups initially (P=0.040 and P=0.039, respectively). After treatment, HOMA-IR increased only in CPA group (2.7±2.3 vs. 4.3±2.2, P=0.038), and the between-group differences were lost. Initially there were no between-group differences in the lipids. After the therapy, in CPA and METF+CPA groups, total cholesterol rose (P=0.005 and P <0.001, respectively), as well as HDL (P=0.003 and P=0.039, respectively), and triglycerides (P=0.001 and P=0.024, respectively), while LDL did not change. Only in CPA group testosterone significantly decreased (2.6±1.3 vs. 2.0±0.6 nmol/l), while SHBG increased in both CPA (30.9±18.9 vs. 152.9±65.1 nmol/l, P=0.036) and in METF+CPA group (31.9±14.4 vs. 153.2±1.4, P<0.001). In all groups MC frequency significantly increased and hirsutism significantly reduced.
Conclusion: Different therapeutic modalities in women with PCOS may have a similar, clinically favorable response to the hirsutism and frequency of MC. However, it is of clinical importance to know the impact of long-term use of these modalities for the development of potential cardiometabolic comorbidities of this complex syndrome.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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