Exp Clin Endocrinol Diabetes 2006; 114 - OR3_16
DOI: 10.1055/s-2006-932854

Benefit of metformin on cardiovascular risk factors in women with polycystis ovary syndrome

S Tan 1, S Hahn 1, S Sack 2, S Benson 3, W Bering van Halteren 4, R Kimmig 4, R Erbel 2, K Mann 1, OE Janssen 1
  • 1University Hospital of Essen Medical School, Division of Endocrinology, Department of Medicine, Essen, Germany
  • 2University Hospital of Essen Medical School, Division of Cardiology, Department of Medicine, Essen, Germany
  • 3University Hospital of Essen Medical School, Institute of Medical Psychology, Essen, Germany
  • 4University Hospital of Essen Medical School, Department of Obstetrics and Gynecology, Essen, Germany

Introduction: Polycystic ovary syndrome (PCOS) is characterised by chronic anovulation and hyperandrogenism. It is often associated with insulin resistance and obesity; both harbingers of the metabolic syndrome (MBS). The MBS and possibly also PCOS are associated with an increased risk for diabetes and cardiovascular events. Metformin has been shown to improve both reproductive and metabolic aspects of PCOS.

Objective: To determine the influence of metformin treatment on cardiovascular risk factors (CVR).

Methods: In 127 PCOS-patients (age: 27.2±6.2 years) the effect of six months metformin treatment in a weight adapted dose was prospectively assessed. PCOS was defined by the 2003 Rotterdam criteria. CVR were assessed by physical examination and blood testing. Body fat was measured by dual X-ray absorptionometry. Parameters of insulin resistance were evaluated by 3h glucose tolerance test. MBS was defined by the 2005 IDF criteria.

Main Outcome Measures: BMI, body fat, lipids, blood pressure, high-sensitive CRP (hs-CRP), risk factors of MBS (waist circumference, HDL, TG, fasting glucose, blood pressure)

Results: After 6 months metformin treatment, significant improvements were found for the following parameters: BMI (30.8±8.0 vs. 30.3±10.0kg/m2, p<0.0001), waist circumference (93.8±18.1 vs. 93.6±17.1cm, p<0.0001) and body fat (46.0±8.3 vs. 45.7±8.1%, p=0.0488). There was a significant decrease in systolic blood pressure (125±19 vs. 122±19mmHg, p=0.0273). All cholesterol parameters improved significantly (Chol: 191±34 vs. 185±35mg/dl, p=0.0023), LDL: 120±37 vs. 112±36mg/dl, p=0.0023, HDL: 56.5±16.4 vs. 58.2±15.0mg/dl, p=0.0348), except TG-levels. Metformin therapy improved hs-CRP levels (0.44±0.5 vs. 0.29±0.3mg/dl, p=0.0025). The prevalence of MBS was reduced from 32.3 to 25.2% (-7.1%), but did not reach statistical significance.

Conclusion: Women affected by PCOS profit from metformin therapy concerning their cardiovascular risk profile by improving most of its parameters, but require long term treatment to reduce the prevalence of the MBS.