Inflammatory-metabolic parameters in obese and nonobese normoandrogenemic polycystic ovary syndrome during metformin and oral contraceptive treatment

Our aim was to evaluate the optimal treatment strategy addressing cardiovascular risk in obese and nonobese patients with polycystic ovary syndrome (PCOS). We planned a prospect?ve randomized clinical study. Normoandrogenemic and oligoamenorrheic women with PCOS and impaired glucose tolerance (n?=?96) were enrolled in the study. Six months of treatment with metformin HCL or oral contraceptive pills (OCPs) were given to the patients. Group 1 were obese and receiving metformin. Group 2 were obese and receiving OCPs. Group 3 were nonobese and receiving metformin, and Group 4 were nonobese receiving OCPs. ADMA, homocysteine, high sensitive C-reactive protein (hs-CRP) and homeostasis model assessment estimate of insulin resistance (HOMA-IR) were investigated. ADMA, homocysteine, hs-CRP and HOMA-IR were similar in obese and nonobese groups before the treatment. After 6 months of treatment, a significant decrease was observed in ADMA, homocysteine and HOMA-IR levels in Groups 1 and 3. An increase in ADMA and hs-CRP levels was observed in Groups 2 and 4. In this study, metformin treatment leads to improvement in hormonal and metabolic parameters and decreases ADMA and homocysteine levels possibly independent of BMI. However, the use of oral contraceptives in obese and nonobese patients with PCOS with impaired glucose tolerance increases ADMA and hs-CRP levels and creates an increase in the metabolic risk.     

Endometrial injury in the menstrual cycle prior to assisted reproduction techniques to improve reproductive outcomes

Abstract

Objective: Oral contraceptive pills (OCP) are widely used for treating women with polycystic ovary syndrome (PCOS). Metformin has beneficial effects on insulin resistance and endothelial functions. The aim of this study was to investigate the effects of treatment with drospirenone/ethinyl estradiol (EE) alone or in combination with metformin on the flow-mediated vasodilatation (FMD) and carotid intima media thickness (CIMT) in women with PCOS.

Methods: Fifty women with PCOS (mean age 23?±?5) were randomized to oral treatment of OCP alone (n?=?25) or an OCP combination with metformin (n?=?25) for 6 months. FMD from the brachial artery and CIMT were calculated. The hormonal profile, HOMA-IR score, basal insulin and glucose levels were studied in both groups. Before and after 6 months' treatment, echocardiographic measurements and laboratory tests were also obtained.

Results: After 6 months' treatment we observed a small decrease in FMD in the OCP group (14.9?±?9.4 versus 14.4?±?9.9, p?=?0.801) and a slight increase in the combination group (14.5?±?9.1 versus 15.0?±?8.0, p?=?0.715) but neither of them reached significance. CIMT increased in the OCP group (0.048?±?0.011 to 0.050?±?0.010?cm, p?=?0.433) and decreased slightly in the combination group (0.049?±?0.012, 0.048?±?0.011?cm, p?=?0.833).

Conclusion: We demonstrated that adding metformin to OCP treatment may have beneficial effect on FMD and CIMT that represent vascular function in patients with PCOS. These results suggest that adding metformin to OCP treatment for PCOS could preserve the cardiovascular system and improve it.     

二甲双胍对2型糖尿病合并亚临床甲状腺功能异常患者的影响

目的评价二甲双胍对2型糖尿病合并亚临床甲状腺功能异常患者的影响。方法选择2型糖尿病合并亚临床甲状腺功能异常患者81例,按亚临床甲状腺功能减退或亢进分为两组,给予二甲双胍片3次/d,每次0.25 g,观察其对两组患者治疗后血清促甲状腺素含量的影响。结果 81例患者治疗后血糖降低,治疗前后血糖值比较,差异有统计学意义(P<0.05);两组患者的TT3和TT4治疗前后比较差异均无统计学意义(P>0.05);亚临床甲状腺功能亢进组治疗后TSH值降低,治疗前后比较差异有统计学意义(P<0.05)。结论二甲双胍可降低2型糖尿病合并亚临床甲状腺功能异常患者血清促甲状腺素含量,其在治疗2型糖尿病的同时对甲状腺功能无损害。     

二甲双胍治疗抗精神病药所致高催乳素血症患者的初步观察

目的：探讨二甲双胍对抗精神病药所致高催乳素血症（HPRL）的治疗效果。方法：选择抗精神病药治疗过程中出现HPRL的住院精神疾病患者共24例,给予二甲双胍0．75g/d口服,观察12周。分别于治疗前和治疗4周、8周和12周后测定PRL水平。结果：24例患者二甲双胍治疗前PRL水平平均（80．62±56．26）ng/ml,治疗4周后PRL水平降至（62．94±43．49）ng／ml,平均降低（17．69±25．30）ng/ml,治疗前后比较,差异有统计学意义（t=3．424,P〈0．01）。结论：二甲双胍对于抗精神病药所致HPRL可能具有降低PRL的作用。     

二甲双胍对抗精神病药所致精神分裂症患者肥胖及糖脂代谢的影响

目的:观察二甲双胍对抗精神病药所致精神分裂症患者肥胖及糖脂代谢的影响。方法:122例长期服用抗精神病药所致肥胖的精神分裂症患者随机分为研究组62例和对照组60例,两组维持原有抗精神病药治疗不变,研究组加用二甲双胍1.0 g/d,疗程6个月。两组分别于基线及治疗后1、3、6个月测定空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)及体质量指数(BMI)。结果:在治疗后1~3个月,研究组FBG、2 h PBG、TC、TG、LDL、HDL及BMI各项指标均逐步下降,并低于对照组(t=2.03~2.35,P均0.05);治疗6个月,研究组除HDL外,LDL、BMI、FBG、2 h PBG、TC、TG均明显低于对照组(t=2.08~4.47,P0.05或P0.01)。结论:二甲双胍可降低抗精神病药所致肥胖者的血糖、血脂水平及体质量。