Staff Members - Benha University
Randomized controlled trial of the effects of metformin versus combined oral contraceptives in adolescent PCOS women through a 24 month follow up period
Middle East Fertility Society Journal • 2015
Publication Information
Authors
H.A. El Maghraby a,d, T. Nafee a,c, D. Guiziry b,d, A. Elnashar e,*
Keywords
Adolescent;
Polycystic ovary;
Insulin resistance;
Metformin;
Combined oral contraceptive
Journal
Middle East Fertility Society Journal
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Abstract Objective: To compare metformin and combined oral contraceptive pill (COC) effects
over 24 months in adolescent PCOS. Design: Randomized controlled study. Setting: Alexandria
ICSI centre. Patients: 117 adolescent girls with PCOS, were randomized to: group A (n= 40): metformin,
group B (n= 40): COC, and group C (n= 39): control. Interventions: Group A: received
metformin, group B: received combined oral contraceptives. Main outcome measures: Improvement
in cycle rhythm and hirsutism. Results: In group B a significant decline in serum testosterone
reached the lowest value by the end of the second year (0.7 ± 0.2 versus 1.3± 0.5 lg/ml). By
the end of the study, group A showed a significant decline in fasting (18.6 ± 3.0–
10.0 ± 3.0 lIU/ml) and after-load insulin levels (126± 43–64 ±15 lIU/ml) with a significant rise
in glucose/insulin ratio (GIR) from 4.1 ±0.3 to 4.6± 0.5. Group B showed a significant rise in
fasting and after-load insulin (from 15.0 ±3.0 lIU/ml and 103.0 ±91.0 lIU/ml to 19.0± 4.0
and 187.0 ±22.0 lIU/ml, respectively) and GIR dropped significantly from 4.4± 0.2 to
3.1± 0.3. Metformin was associated with a significant loss of weight from 87.0 ± 6.0 to
72.0 ± 0.5 kg while COC was associated with a non-significant gain in weight (from 84.0± 6.0
to 91.0 ± 9.0 kg). Conclusions: Metformin and COC have comparable therapeutic effectiveness
on cycle regularity and hirsutism. Metformin was associated with a significant improvement in met-abolic syndrome, while COC was associated with a deterioration of metabolic syndrome.
over 24 months in adolescent PCOS. Design: Randomized controlled study. Setting: Alexandria
ICSI centre. Patients: 117 adolescent girls with PCOS, were randomized to: group A (n= 40): metformin,
group B (n= 40): COC, and group C (n= 39): control. Interventions: Group A: received
metformin, group B: received combined oral contraceptives. Main outcome measures: Improvement
in cycle rhythm and hirsutism. Results: In group B a significant decline in serum testosterone
reached the lowest value by the end of the second year (0.7 ± 0.2 versus 1.3± 0.5 lg/ml). By
the end of the study, group A showed a significant decline in fasting (18.6 ± 3.0–
10.0 ± 3.0 lIU/ml) and after-load insulin levels (126± 43–64 ±15 lIU/ml) with a significant rise
in glucose/insulin ratio (GIR) from 4.1 ±0.3 to 4.6± 0.5. Group B showed a significant rise in
fasting and after-load insulin (from 15.0 ±3.0 lIU/ml and 103.0 ±91.0 lIU/ml to 19.0± 4.0
and 187.0 ±22.0 lIU/ml, respectively) and GIR dropped significantly from 4.4± 0.2 to
3.1± 0.3. Metformin was associated with a significant loss of weight from 87.0 ± 6.0 to
72.0 ± 0.5 kg while COC was associated with a non-significant gain in weight (from 84.0± 6.0
to 91.0 ± 9.0 kg). Conclusions: Metformin and COC have comparable therapeutic effectiveness
on cycle regularity and hirsutism. Metformin was associated with a significant improvement in met-abolic syndrome, while COC was associated with a deterioration of metabolic syndrome.