Management of polycystic ovarian syndrome with Diane-35 or Diane-35 plus metformin

In this study, we assessed the efficacy and safe usage of the oral contraceptive, Diane-35, in the treatment of polycystic ovary syndrome (PCOS) when combined with the drug metformin. Eighty-two patients with PCOS were randomly divided into two equal groups: Diane-35 treatment group and Diane-35 plus metformin group. Three treatment cycles were administered. Patients’ biomedical data such as height, weight, waist circumference, hip circumference, body fat percentage, acne score, hirsutism score and serum hormone levels were selected, which were tested between the second and the fifth day of the menstrual cycle and follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), blood glucose, blood lipids and insulin levels(IR) were analyzed. Significant reduction in body mass index (BMI), acne score, LH and T levels were observed in both groups after three months of treatment; on the other hand, high-density lipoprotein cholesterol (HDL) concentration elevated (p?p?相似文献   

The effects of Diane-35 and metformin in treatment of polycystic ovary syndrome: An updated systematic review

Objectives. To systematically evaluate the efficacy and safety of Diane-35 for treating polycystic ovary syndrome (PCOS) and compare it with metformin, either in combination or alone.

Study design. A systematic review and meta-analysis were conducted. Randomized controlled studies applying Diane-35 and metformin for treating PCOS were included. The primary outcome was hirsutism. Authors of primary articles were contacted and methodological quality was evaluated. Subgroups were drawn based on treatment duration and sensitivity analysis was conducted; heterogeneity and bias are discussed.

Results. Twelve studies were included. The effect on improving hirsutism was not different between Diane-35 and metformin. Compared with Diane-35, metformin appeared to protect patients against glucose metabolic abnormality with treatment of at least 6 months. Except for triglycerides, no difference in lipid profile existed between Diane-35 and metformin. The evidence that Diane-35 deteriorates lipid and glucose metabolism was insufficient. Diane-35 could result in hypertension and headache. Methodological quality was still the key problem for studies.

Conclusions. Diane-35 is superior to metformin in reducing androgens, but inferior to metformin in reducing insulin. Whether Diane-35 deteriorates lipid metabolism and insulin resistance is still unclear.     

Effect of orlistat or metformin in overweight and obese polycystic ovary syndrome patients with insulin resistance

The aim of this study was to evaluate the effect of orlistat or metformin combined with Diane-35 on anthropometric, hormonal and metabolic parameters in overweight and obese polycystic ovary syndrome (PCOS) patients with insulin resistance (fasting insulin?>?10?mIU/L). A total of 240 PCOS women were randomly allocated to orlistat plus Diane-35(OD group), metformin plus Diane-35(MD group), orlistat plus metformin plus Diane-35(OMD group) or Diane-35 (D group). Body weight, BMI, waist and hip circumference, blood pressure, endocrine profile, lipid profile and insulin resistance were assessed at baseline and after 3 months. Significant reductions in waist and hip circumference, serum LH, total testosterone and uric acid were observed in all groups compared with baseline. TG and TC significantly decreased in the OD group. Homeostasis model assessment insulin resistance (HOMA-IR) index was reduced in the OD (p?=?.015), MD (p?=?.001) and OMD (p?=?.004) groups. Body weight, BMI, systolic BP and HDL-C significantly changed in the OD and OMD group compared with the D group (p?相似文献   

达英-35联合不同胰岛素增敏剂对PCOS伴IR患者的临床疗效比较

目的:比较吡格列酮和二甲双胍分别配伍达英-35治疗多囊卵巢综合征(P-COS)的内分泌异常以及对卵巢生殖功能恢复的疗效。方法:随机将91例PCOS合并胰岛素抵抗(IR)患者分为两组,吡格列酮配伍组47例口服达英-35和盐酸吡格列酮,二甲双胍配伍组44例口服达英-35和盐酸二甲双胍,两组均于治疗3个月后进行诱导排卵治疗3个周期。检测治疗前后性激素、IR程度、血脂水平以及观察诱导排卵的效果。结果:二甲双胍配伍组治疗后BM I明显降低(P<0.05)。两组治疗后F-G评分均显著降低(P<0.05),卵泡总数及卵巢体积均显著降低(P<0.01),LH、LH/FSH、A2均显著降低(P<0.01)。两组治疗后IR明显改善(P<0.01),吡格列酮配伍组FIN水平降低的更为显著(P<0.05)。吡格列酮配伍组治疗后TC显著下降(P<0.05),TG、LDL-C显著下降(P<0.01),HDL-C显著升高(P<0.05),二甲双胍配伍组治疗前后血脂无明显改变(P>0.05)。两组的周期排卵率、单卵泡发育率、妊娠结局无明显差异(P>0.05)。结论:达英-35与吡格列酮配伍或与二甲双胍联合应用,均能改善PCOS患者的IR和高雄激素症状,对于异常的糖脂代谢,吡格列酮的疗效要优于二甲双胍。     

二甲双胍和噻唑烷二酮类分别与达因-35联用治疗多囊卵巢综合征的疗效比较

目的:比较二甲双胍和噻唑烷二酮类(TZDs)分别与达因-35联用治疗多囊卵巢综合征(PCOS)的临床疗效。方法:随机将53例患者分成两组,A组予以二甲双胍治疗3个月后与达因-35共用3个月,B组予以TZDs治疗3个月后和达因-35共用3个月,总治疗期6个月,比较治疗前后内分泌激素、体重指数、血糖、排卵率等的改变。结果:两组治疗后胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、睾酮(T)及黄体生成素(LH)均明显降低(P<0.05,P<0.01)。A组降低体重优于B组,B组改善胰岛素抵抗优于A组。两组在排卵率和妊娠率方面无显著差异(P>0.05),双胍组4例自发性妊娠,TZDs组也有4例自发性妊娠。随访1年,8例婴儿发育均无异常。结论:二甲双胍和TZDs分别与达因-35联用,均能改善PCOS患者的胰岛素抵抗及内分泌紊乱,肥胖的PCOS患者推荐首选二甲双胍+达因-35,体重正常者或胰岛素抵抗严重者选用TZDs+达因-35。     

Are serum chemerin levels different between obese and non-obese polycystic ovary syndrome women?

The objective of this study is to measure serum chemerin levels in women with polycystic ovary syndrome (PCOS) and assess their relationship with clinical, metabolic, and hormonal parameters. One hundred eighteen PCOS women and 114 healthy women were recruited in this study. Their blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), fasting insulin (FIN), fasting plasma glucose (FPG), blood serum sex hormone, and blood lipid were measured. Serum chemerin, leptin, and adiponectin were measured by ELISA. Serum chemerin was significantly higher in the obese PCOS group (47.62?±?11.27?ng/mL) compared with non-obese PCOS (37.10?±?9.55?ng/mL) and the obese (33.71?±?6.17?ng/mL) and non-obese (25.78?±?6.93?ng/mL) control groups (p?p?相似文献   

Dehydroepiandrosterone sulfate/free androgen index ratio predicts a favorable metabolic profile in patients with polycystic ovary syndrome

Potential effect of hyperandrogenemia on metabolic disturbances in polycystic ovary syndrome (PCOS) has always been a matter of interest. We analyzed the records of 125 patients with PCOS and 54 age-matched healthy women. All participants underwent biochemical and hormonal assessment and a 75?g oral glucose tolerance test was performed. PCOS and control groups were comparable in terms of age. Dehydroepiandrosterone sulfate/free androgen index (DHEAS/FAI) ratio was negatively correlated with body mass index (BMI) (p?<?.001), fasting glucose (p?=?.02), area under the curve (AUC) of glucose (p?=?.03), AUC of insulin (p?=?.001), homeostasis model assessment-estimated insulin resistance (HOMA-IR) (p?<?.001), and triglycerides (TG) (p?=?.009), and positively correlated with insulin sensitivity index (ISI) (p?<?.001) and high-density lipoprotein cholesterol (HDL-C) (p?<?.001) among PCOS patients. In logistic regression analysis, higher DHEAS/FAI ratio levels were associated with lower risk of low HDL-C [RR(95%CI); 0.97(0.95–0.98); p?<?.001] as well as atherogenic dyslipidemia (TG/HDL-C) [RR(95%CI); 0.97(0.94–0.99); p?=?.035] even after adjustment for BMI in the PCOS group. Androgens, DHEAS and FAI act differently on metabolic parameters. Our results demonstrate that high DHEA-S/FAI ratio levels are associated with a more favorable metabolic profile.     

Effects of metformin and ethinyl estradiol-cyproterone acetate on clinical,endocrine and metabolic factors in women with polycystic ovary syndrome

Background. Polycystic ovary syndrome (PCOS) is a major endocrine abnormality that affects women of reproductive age. Oral contraceptive pills are usually the first choice of treatment for PCOS when fertility is not desired. Metformin, an insulin-sensitizing drug, has been shown to improve such metabolic abnormality.

Aim. To compare the effects of a contraceptive pill in combination with metformin on the clinical, endocrine and metabolic parameters in obese and non-obese patients with PCOS.

Methods. Sixty PCOS patients (25 obese, 35 non-obese) were enrolled in this prospective clinical study. PCOS was defined according to the Rotterdam criteria. Patients were randomized to oral treatment with Diane35® (35 μg ethinyl estradiol plus 2 mg cyproterone acetate), metformin or a combination of Diane35/metformin for 3 months. Body mass index (BMI), waist-to-hip ratio (WHR), Ferriman–Gallwey (FG) score, leuteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, fasting insulin and glucose/insulin ratio were measured at baseline and at the end of treatment.

Results. Diane35 resulted in a higher reduction of FG score in both obese and non-obese PCOS patients compared with metformin. Menstrual regularity was restored in all PCOS patients treated with Diane35 compared with only 28% of those receiving metformin. Metformin significantly decreased BMI and WHR in obese patients (p < 0.05). Testosterone levels decreased in all three groups. LH levels and LH/FSH ratio decreased with Diane35 and Diane35/metformin in both obese and non-obese patients. Metformin significantly decreased fasting insulin concentrations (p < 0.05 and p < 0.01) and increased the insulin sensitivity (p < 0.05) in both obese and non-obese PCOS patients, while no significant changes were observed in the Diane35 group. In addition, insulin levels also decreased (p < 0.05) in the Diane35/metformin group.

Conclusions. Our data show that a combination of metformin and contraceptive pill may be more effective in suppressing the hyperandrogenemia of obese and non-obese PCOS patients than metformin alone and may reduce insulin levels more than contraceptive pill alone. Hence, combined treatment may become a more effective therapeutic option for PCOS.     

Body mass index and its correlation to metabolic and hormone parameters in postmenopausal Spanish women

Objective.?To assess body weight composition in postmenopausal women and determine correlations with metabolic and hormonal parameters.

Methods.?Medical records of 574 postmenopausal Caucasian Spanish women first time attending a menopause clinic were retrospectively reviewed. Retrieved information included general demographic data, type of menopause, time since menopause onset and baseline hormonal and metabolic parameters. A body mass index (BMI) value of >28.8?kg/m² was used to define obesity. The metabolic syndrome (METS) was diagnosed with three or more criteria: fasting glycemia ≥?100?mg/dL, high density lipoprotein cholesterol (HDL-C)?<50?mg/dL, triglycerides (TG) ≥150?mg/dL, blood pressure ≥130/85?mmHg and obesity (as defined above).

Results.?Mean age of the whole cohort was 49.9?±?6.1 years, with 66% having a natural menopause. A 38.9% and 23.1% of all women were obese or had the METS, respectively. Obese women were older, had a higher parity, smoked less, had more time since menopause onset and a higher rate of surgical menopause as compared to non-obese ones (p?=?0.001). BMI values positively correlated with age, time since menopause, parity, and glucose, TG and systolic blood pressure levels; displaying an inverse correlation with HDL-C and SHBG levels. SHBG levels inversely correlated with glucose, TG, HDL-C and systolic blood pressure levels.

Conclusion.?In this Spanish postmenopausal population BMI significantly increased with age, time since menopause and parity displaying significant correlations with hormonal and metabolic parameters.     

Comparison of fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome and women with simple obesity

The present study aimed to assess the fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome (PCOS) and to compare them in obese PCOS patients and women with simple obesity. We studied 19 obese women with PCOS (age: 25.1 ± 4.6 years, body mass index (BMI): 34.7 ± 3.9 kg/m²; mean ± standard deviation) and 20 age- and BMI-matched ovulatory controls. We measured blood levels of 17β-estradiol, testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucose and insulin. The following fibrinolytic tests were also performed: euglobulin clot lysis time, plasminogen level, α₂-antiplasmin activity, plasminogen activator inhibitor-1 activity, fibrinogen concentration and estimated fibrinolytic activity. Testosterone and LH levels were significantly higher in obese women with PCOS (p < 0.01 and p < 0.001, respectively). The groups did not differ with regard to 17β-estradiol, prolactin, FSH, DHEAS, TC, TG, HDL-C, LDL-C, glucose and insulin. All of the fibrinolysis parameters with the exception of plasminogen were comparable between the two groups. Serum plasminogen level was lower in obese PCOS patients than in women with simple obesity (p < 0.05). Euglobulin clot lysis time was positively correlated with insulin (r = 0.88, p < 0.05) in both groups. Our results show that fibrinolysis is not suppressed in women with PCOS and that there is no difference in fibrinolytic activity between obese patients with PCOS and women with simple obesity.     

Atherogenic metabolic profile in PCOS patients: role of obesity and hyperandrogenism

Objective. To investigate glyco-lipidic metabolism and androgenic profile in a cohort of women with polycystic ovary syndrome (PCOS) divided according to Rotterdam phenotypes and body mass index (BMI).

Design. A prospective case–control study.

Setting. Gynecology department in a teaching hospital.

Patients. A total of 223 PCOS women and 25 healthy control women were studied.

Methods. Patients and controls were subdivided into three groups according to their BMI: normal weight (18.5?≤?[BMI]?≤24.9?kg/m²), overweight (25.0?≤?BMI?≤29.9?kg/m²), or obese (BMI?≥30.0?kg/m²) and according to Rotterdam criteria of PCOS.

Main outcome measures. Pituitary-gonadal axis assessment including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, PRL, testosterone, androstenedione, DHEA-S, 17-hydroxyprogesterone and inhibin B. Metabolic parameters included cholesterol (Chol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and apolipoproteins (APO) AII and B as well as serum fasting insulin, glucose and HOMA-IR.

Results. Serum fasting insulin, glucose, HOMA-IR, TG and HDL were significantly higher in women with PCOS compared to controls. Additionally, serum levels of Chol, LDL and TG were significantly higher and HDL levels were significantly lower in obese PCOS women compared with overweight/normal PCOS irrespective of Rotterdam phenotypes. Free testosterone index but not androstenedione or total testosterone significantly correlated with TG, HDL and APO B. No significant correlations were detected between gonadotropins, inhibin B or estradiol with metabolic parameters studied.

Conclusions. Obesity but not overweight in PCOS is associated with dyslipidemia. Hyperandrogenic women showed the most atherogenic lipid profiles.     

Plasma visfatin level in lean women with PCOS: relation to proinflammatory markers and insulin resistance

Objectives.?The present study was undertaken to investigate the association between plasma visfatin concentrations and inflammatory markers such as interleukin-6 (IL-6) and high-sensitive C-reactive protein (hsCRP) in company with several metabolic parameters in lean women with polycystic ovary syndrome (PCOS).

Methods.?The study group consisted of 21 lean women with PCOS (BMI 20.74 ± 1.74 kg/m²) and 15 healthy, normally menstruating women (BMI 20.85 ± 2.08 kg/m² control group). PCOS was defined according to the Rotterdam criteria. Visfatin, IL-6, hsCRP, hyperandrogenism markers and metabolic markers were examined in all PCOS and control women.

Results.?Plasma visfatin level in the PCOS group was higher than that in the control group. Plasma hsCRP and IL-6 levels in PCOS group were similar with the control group. Plasma visfatin levels were positively associated with total cholesterol, high density lipoprotein, hirsutism score, total testosterone and FAI. Plasma visfatin level was negatively associated with SHBG. However, there were no correlation between plasma visfatin level and IL-6 and hsCRP. In multivariate regression analyses, only FAI and high density lipoprotein-cholesterol (HDL-C) showed a significant association with serum visfatin.

Conclusion. Our data indicates that plasma visfatin levels are associated with HDL-C and markers of hyperandrogenism, but it is not associated with proinflammatory markers and insulin resistance in lean women with PCOS.     

A Randomized Crossover Study of Medroxyprogesterone Acetate and Diane-35 in Adolescent Girls with Polycystic Ovarian Syndrome

ObjectiveTo investigate the effects of 4-month treatment of medroxyprogesterone acetate (MPA) and Diane-35 on the clinical and biochemical features of hyperandrogenism and quality of life of adolescent girls with polycystic ovarian syndrome (PCOS).DesignA prospective, randomized, cross-over study.SettingAn accredited pediatric and adolescent gynecology clinic of a university-affiliated tertiary hospital.Participants76 adolescents girls aged 14 to 19 years old with PCOS were recruited from July 2007 to July 2010.InterventionsGirls were randomized into 2 groups. Group 1 received oral MPA for 4 months, followed by a washout period of 4 months, and then Diane-35 for another 4 months. Group 2 received the same combination but in the reverse order.Main Outcome MeasuresClinical and biochemical features of hyperandrogenism and quality of life were assessed.ResultsThere was no significant difference between the 2 groups at baseline. No significant difference was found in the clinical and biochemical parameters of hyperandrogenism before and after treatment with MPA. Significant reduction of the acne score, LH/FSH ratio, and testosterone level was seen after taking Diane-35. Hirsutism was also improved but it did not reach statistical significant. When comparing post-MPA and post-Diane-35, the post-Diane-35 group had significantly improved acne score and LH/FSH ratio. No significant difference was found on quality of life between both groups after treatment.ConclusionDiane-35 may be a more suitable treatment option in adolescent girls diagnosed with PCOS when compared to MPA.     

达英-35联合二甲双胍预治疗对多囊卵巢综合征患者早期流产的影响

目的:探讨药物预处理对接受IVF-ET的多囊卵巢综合征(PCOS)患者早期流产率的影响。方法:回顾性分析因输卵管因素接受IVF-ET获得临床妊娠的PCOS患者共116例。其中,30例患者进入周期前经达英-35单药治疗(A组),75例患者进入周期前经达英-35联合二甲双胍治疗(B组),均治疗3～6个周期;11例患者进入周期前不用药物治疗(C组)。比较3组患者进行IVF-ET后的早期流产率。结果:B组早期流产率显著低于A组及C组;A组早期胚胎流产率与C组比较无统计学差异。结论:IVF-ET周期前使用二甲双胍预处理能显著降低多囊卵巢综合征患者的早期流产率。     

The quantitative insulin sensitivity check index is not able to detect early metabolic alterations in young patients with polycystic ovarian syndrome

Objective.?To verify whether QUICKY is a suitable method for the identification of metabolic deterioration in normal weight patients affected by polycystic ovarian syndrome (PCOS).

Design.?Prospective clinical study.

Patient(s).?Seventy-nine PCOS normal weight adolescent subjects, 50 eumenorrheic, normal weight, non-hirsute controls matched for age and BMI.

Method(s).?Quantitative insulin sensitivity check index (QUICKY) and integrated secretory area under the curve of insulin values (I-AUC) during oral glucose tolerance test were calculated.

Result(s).?Seventy-nine PCOS and 50 controls were studied. Normal insulin sensitivity was defined as upper control 95th percentile by QUICKY values?<0.31, I-AUC at 180?min?<?16,645. When applying the calculated I-AUC cut-off, 41 PCOS were classified as normoinsulinemic and 38 as hyperinsulinemic, whereas using the calculated QUICKY cut-off, only 19 PCOS could be classified as insulin resistant (IR). Fifteen out of the 60 non-IR PCOS presented hyperinsulinemia; fasting glucose and insulin levels and QUICKY were not sufficient to identify these subjects. Thus, QUICKY displayed a low sensitivity (44%) and specificity (91%) in the diagnosis of the metabolic disorder disclosed by I-AUC.

Conclusions.?In young normal weight patients with PCOS the prevalence of early alterations of insulin metabolism are not detectable by QUICKY studies.     

Prevalence of the metabolic syndrome in Asian women with polycystic ovary syndrome: Using the International Diabetes Federation criteria

Background. Since insulin resistance and compensatory hyperinsulinemia are the major causes of the metabolic syndrome (MS) and are also the main pathophysiology of polycystic ovary syndrome (PCOS), PCOS women are at risk of MS. The aim of the present cross-sectional study was to determine the prevalence of MS in Asian women with PCOS using the International Diabetes Federation (IDF) criteria and to define the risk factors.

Methods. One hundred and seventy women with PCOS were enrolled in the study from September 3, 2002 to June 14, 2005. A 75-g oral glucose tolerance test with plasma glucose and serum insulin levels was performed. Also, blood samples were examined for fasting triglycerides, high-density lipoprotein cholesterol and adiponectin levels.

Results. The mean (±standard deviation) age, body mass index (BMI) and waist-to-hip ratio were 28.8±5.9 years, 27.1 ± 7.0 kg/m² and 0.85±0.06, respectively. The prevalence of MS was 35.3%. Age, BMI, waist circumference and all metabolic parameters were higher in PCOS women with MS than in those without MS. MS prevalence increased with age, BMI and insulin resistance as determined by homeostasis model assessment (HOMA-IR), but not with adiponectin after BMI adjustment.

Conclusions. According to the IDF criteria, one-third of the PCOS women had MS. This study also showed that age, BMI and HOMA-IR are important risk factors for MS.     

达英-35治疗PCOS患者体外受精-胚胎移植后早期妊娠流产因素分析

目的:回顾分析达英-35治疗后接受体外受精-胚胎移植(IVF-ET)的多囊卵巢综合征(PCOS)患者早期妊娠流产的内分泌因素及胚胎因素。方法:选择2003年1月～2007年9月因PCOS予达英-35预处理,且因输卵管因素在中山大学第一附属医院生殖医学中心接受IVF-ET辅助生殖后妊娠患者35例,其中早期流产15例,分娩20例。选择同期因单纯输卵管因素在本中心行IVF-ET的非PCOS早期流产患者20例为对照。对所有入组患者的基础代谢情况(BMI、空腹血糖、空腹胰岛素水平、HOMA-IR)、达英-35治疗前后及IVF-ET周期中的内分泌水平(启动日的FSH、LH、E2水平,及注射HCG日的LH、E2、P水平)、获卵数、受精率、优质胚胎率、胚胎种植率和废弃胚胎率等胚胎情况进行回顾性的统计学分析。结果:PCOS患者接受达英-35治疗后,LH、T水平均显著下降,且PCOS流产组LH水平及LH/FSH比值显著低于PCOS分娩组。PCOS流产组和PCOS分娩组患者的肥胖程度、代谢水平、基础内分泌水平及卵子、胚胎情况均无统计学差异。PCOS流产组与非PCOS流产组的内分泌及胚胎因素无统计学差异。结论:用达英-35预处理的P-COS患者接受IVF-ET后早期自然流产的发生与基础代谢、内分泌、卵子及胚胎情况无关。使用达英-35能降低PCOS患者的基础LH水平及基础T水平,但激素情况改善并非降低流产率的关键环节。     

Comparison of myo-inositol and metformin on glycemic control,lipid profiles,and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome: a randomized controlled clinical trial

Abstract

This investigation was conducted to evaluate comparison of myo-inositol and metformin on glycemic control, lipid profiles, and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome (PCOS). This randomized controlled trial was conducted on 53 women with PCOS, aged 18–40 years old. Subjects were randomly allocated into two groups to take either myo-inositol (n?=?26) or metformin (n?=?27) for 12 weeks. Myo-inositol supplementation, compared with metformin, significantly reduced fasting plasma glucose (FPG) (β ?5.12?mg/dL; 95% CI, ?8.09, ?2.16; p=.001), serum insulin levels (β ?1.49 µIU/mL; 95% CI, ?2.28, ?0.70; p<.001), homeostasis model of assessment-insulin resistance (β ?0.36; 95% CI, ?0.55, ?0.17; p<.001), serum triglycerides (β 12.42?mg/dL; 95% CI, ?20.47, ?4.37; p=.003) and VLDL-cholesterol levels (β ?2.48?mg/dL; 95% CI, ?4.09, ?0.87; p=.003), and significantly increased the quantitative insulin sensitivity check index (β 0.006; 95% CI, 0.002, 0.01; p=.006) compared with metformin. Moreover, myo-inositol supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (p=.002) compared with metformin. Overall, taking myo-inositol, compared with metformin, for 12 weeks by women with PCOS had beneficial effects on glycemic control, triglycerides and VLDL-cholesterol levels, and gene expression of PPAR-γ.     

The platelet activating factor acetyl hydrolase,oxidized low-density lipoprotein,paraoxonase 1 and arylesterase levels in treated and untreated patients with polycystic ovary syndrome

Purpose

To evaluate the platelet activating factor acetyl hydrolyze (PAF-AH), oxidized low-density lipoprotein (ox-LDL), paraoxonase 1 (PON1), arylesterase (ARE) levels and the effects of metformin and Diane-35 (ethinyl oestradiol + cyproterone acetate) therapies on these parameters and to determine the PON1 polymorphisms among PCOS patients.

Methods

Ninety patients with PCOS, age 30, and body mass index-matched healthy controls were included in the study. Patients were divided into three groups: metformin treatment, Diane-35 treatment and no medication groups. The treatment with metformin or Diane-35 was continued for 6 months and all subjects were evaluated with clinical and biochemical parameters 6 months later. One-way Anova test, t test and non-parametric Mann–Whitney U tests were used for statistical analysis.

Results

PAF-AH and ox-LDL levels were statistically significantly higher in untreated PCOS patients than controls, and they were statistically significantly lower in patients treated with metformin or Diane-35 than untreated PCOS patients. In contrast, there were lower PON1 (not statistically significant) and ARE (statistically significant) levels in untreated PCOS patients than the control group and they significantly increased after metformin and Diane-35 treatments. In PCOS patients serum PON1 levels for QQ, QR and RR phenotypes were statistically significantly lower than the control group.

Conclusion

In patients with PCOS, proatherogenic markers increase. The treatment of PCOS with metformin or Diane-35 had positive effects on lipid profile, increased PON1 level, which is a protector from atherosclerosis and decreased the proatherogenic PAF-AH and ox-LDL levels.     

The prevalence of metabolic syndrome in premenopausal and postmenopausal women in Southern Thailand

Objective: To assess the prevalence of metabolic syndrome (MetS) in premenopausal and postmenopausal women in Southern Thailand.

Methods: A cross-sectional study was conducted with 361 healthy women (218 premenopausal women and 143 postmenopausal women) in Southern Thailand. Blood pressure, anthropometric indices, fasting plasma glucose and serum lipid levels were measured. MetS was defined according to criteria of the “National Cholesterol Education Program Adult Panel Treatment III” (NCEP ATPIII). Logistic regression analysis was used to evaluate factors associated with MetS.

Results: Waist circumference, systolic blood pressure, diastolic blood pressure, and levels of total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were significantly higher in postmenopausal women, when compared with premenopausal women (p?p?=?0.005). The most frequent component of MetS in postmenopausal women was central obesity (58.74%), followed by hypertension (58.04%), high triglyceride (27.97%), low HDL-C (23.08%), and high FPG (11.19%). Multivariate analysis revealed that age and higher body mass index (BMI) increased the risk of developing MetS.

Conclusion: The prevalence of MetS is higher in postmenopausal women than in premenopausal women, and its significant predictors include age and BMI.