Effects of Metformin Treatment on Homocysteine Levels and Metabolic Parameters of Women With Polycystic Ovary Syndrome
,
Abstract
Objective: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. Metformin is a biguanide commonly used to improve PCOS symptoms. Effect of metformin on the levels of serum homocysteine (Hcy) in PCOS women is unclear. The aim of this study is evaluating the effect of metformin administration on serum Hcy levels and metabolic parameters of PCOS patients.
Materials and methods: Thirty three patients with PCOS were enrolled in this study who were selected randomly. All patients received metformin from the fifth day of menstrual cycle at a dose of 850 mg (one tablet daily) for 3 months. Body mass index, Triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar and homocysteine levels were recorded at entry into the study and after 3 months treatment.
Results: BMI, plasma Homocysteine concentrations and fasting blood sugar levels were significantly
(p < 0.05) decreased after the treatment period. No significant changes were observed in the lipid profiles of patients. There was a weak negative correlation between homocysteine and LDL cholesterol serum levels (p = 0.04, r = -0.27).
Conclusion: Treatment with metformin in PCOS women may lead to beneficial effects in terms of BMI, plasma homocysteine concentrations and fasting blood sugar with no remarkable effect on lipid profile.
Gaberšček S, Zaletel K, Schwetz V, Pieber T, Obermayer-Pietsch B, Lerchbaum E. MECHANISMS IN ENDOCRINOLOGY: Thyroid and polycystic ovary syndrome. European Journal of Endocrinology2015;172:R9-21.
Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical epidemiology. 2014;6:1.
Al-Khyat THAT, Al-Jeborry MM, Kadium QM. Serum Homocysteine and Paraoxonase1 Levels in Women with Polycystic Ovary Syndrome Treated with Metformin Versus Metformin and Folic Acid. Global Journal of Science Frontier Research 2013;13:35-40.
Hobbs CA, Cleves MA, Melnyk S, Zhao W, James SJ. Congenital heart defects and abnormal maternal biomarkers of methionine and homocysteine metabolism. The American journal of clinical nutrition 2005;81:
-53.
Takimoto H, Mito N, Umegaki K, Ishiwaki A, Kusama K, Abe S, et al. Relationship between dietary folate intakes, maternal plasma total homocysteine and B-vitamins during pregnancy and fetal growth in Japan. European Journal of nutrition 2007;46:300-6.
Hoque MM, Bulbul T, Mahal M, Ferdausi M. Serum homocysteine in pre-eclampsia and eclampsia. Bangladesh Medical Research Council Bulletin2008;34:16-20.
Setola E, Monti LD, Galluccio E, Palloshi A, Fragasso G, Paroni R, et al. Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia. European journal of endocrinology 2004;151:483-9.
Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. International journal of women's health 2011;3:25-35.
Palomba S, Materazzo C, Falbo A, Orio F, La Sala GB, Sultan C. Metformin, oral contraceptives or both to manage oligo-amenorrhea in adolescents with polycystic ovary syndrome? A clinical review. Gynecological Endocrinology 2014;30:335-40.
Jayasena CN, Franks S. The management of patients with polycystic ovary syndrome. Nature Reviews Endocrinology 2014;10:624-36.
Morin-Papunen L, Rantala AS, Unkila-Kallio L, Tiitinen A, Hippeläinen M, Perheentupa A, et al. Metformin improves pregnancy and live-birth rates in women with polycystic ovary syndrome (PCOS): a multicenter, double-blind, placebo-controlled randomized trial. The Journal of Clinical Endocrinology & Metabolism 2012;97:1492-500.
Kjøtrød S, Carlsen S, Rasmussen P, Holst-Larsen T, Mellembakken J, Thurin-Kjellberg A, et al. Use of metformin before and during assisted reproductive technology in non-obese young infertile women with polycystic ovary syndrome: a prospective, randomized, double-blind, multi-centre study. Human reproduction2011;26:2045-53.
Obeid R. Metformin Causing Vitamin B12 Deficiency: A Guilty Verdict without Sufficient Evidence. Diabetes care 2014;37:e22-3.
Xu L, Huang Z, He X, Wan X, Fang D, Li Y. Adverse effect of Metformin therapy on serum vitamin B12 and folate: Short -term treatment causes disadvantages? Medical Hypotheses 2013;81:149-51.
Palomba S, Falbo A, Giallauria F, Russo T, Tolino A, Zullo F, et al. Effects of metformin with or without supplementation with folate on homocysteine levels and vascular endothelium of women with polycystic ovary syndrome. Diabetes Care 2010;33:246-51.
Schachter M, Raziel A, Strassburger D, Rotem C, Ron-El R, Friedler S. Prospective, randomized trial of metformin and vitamins for the reduction of plasma homocysteine in insulin-resistant polycystic ovary syndrome. Fertility and Sterility 2007;88:227-30.
Sahin Y, Unluhizarci K, Yilmazsoy A, Yikilmaz A, Aygen E, Kelestimur F. The effects of metformin on metabolic and cardiovascular risk factors in nonobese women with polycystic ovary syndrome. Clinical endocrinology 2007;67:904-8.
Yilmaz M, Bukan N, Ayvaz G, Karakoç A, Törüner F, Çakir N, et al. The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome. Human Reproduction 2005;20:3333-40.
Dhanalakshmi G, Sumathi P, Pasupathi P, Kumar K. Lipid profile and Homocysteine level changes in metformin and metformin letrozole therapy with south Indian PCOS women. Int J Cur Biomed Phar Res 2011;1:102-8.
Kilicdag EB, Bagis T, Zeyneloglu HB, Tarim E, Aslan E, Haydardedeoglu B, et al. Homocysteine levels in women with polycystic ovary syndrome treated with metformin versus rosiglitazone: a randomized study. Human reproduction 2005;20:894-9.
Prabhu M, Srinivasan N, Narmadha M, Radha R. Investigation of the Effect of Metformin on the Level of Plasma Homocysteine, Vitamin B 12 and Folic Acid in Type II Diabetes Mellitus Patients. Journal of Pharmacy Research 2014;8:1398.
Kilicdag EB, Bagis T, Tarim E, Aslan E, Erkanli S, Simsek E, et al. Administration of B-group vitamins reduces circulating homocysteine in polycystic ovarian syndrome patients treated with metformin: a randomized trial. Human Reproduction 2005;20:
-8.
Karimzadeh MA, Eftekhar M, Taheripanah R, Tayebi N, Sakhavat L, Zare F. The effect of administration of metformin on lipid profile changes and insulin resistance in patients with polycystic ovary syndrome 2007;12:174-8.
Fleming R, Hopkinson ZE, Wallace AM, Greer IA, Sattar N. Ovarian function and metabolic factors in women with oligomenorrhea treated with metformin in a randomized double blind placebo-controlled trial. The Journal of Clinical Endocrinology & Metabolism 2002;87:569-74
| Files | ||
| Issue | Vol 9, No 4 (December 2015) | |
| Section | Original Articles | |
| Keywords | ||
| Metformin Homocysteine Polycystic Ovary Syndrome Metabolic Parameters | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
