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Fertil Steril. 2011 Jan;95(1):203-9. doi: 10.1016/j.fertnstert.2010.06.058. Epub 2010 Aug 4.

Effect of the insulin sensitizers metformin and pioglitazone on endothelial function in young women with polycystic ovary syndrome: a prospective randomized study.

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1
Michaelidion Cardiac Center, Department of Cardiology, University of Ioannina, Ioannina, Greece.

Abstract

OBJECTIVE:

To compare the effect of two different insulin sensitizers, metformin and pioglitazone, on endothelial function in women with polycystic ovary syndrome (PCOS).

DESIGN:

Prospective randomized study.

SETTING:

University Hospital endocrinology outpatient clinic.

PATIENT(S):

Young women with PCOS (aged 23.3±4.9 years).

INTERVENTION(S):

Patients were assigned randomly to no treatment (n=14), metformin 850 mg two times per day (n=15), and pioglitazone 30 mg daily (n=14) for 6 months. Healthy age- and body mass index-matched women served as controls (n=14).

MAIN OUTCOME MEASURE(S):

Brachial artery flow-mediated dilation was studied at baseline and 6 months.

RESULT(S):

Women with PCOS had higher insulin resistance and hyperandrogenism indices and lower flow-mediated dilation compared with controls. The three groups of women with PCOS did not differ at baseline. No differences were observed at follow-up in women who received no treatment. Metformin and pioglitazone improved flow-mediated dilation to a similar extent, restoring it to normal values at 6 months. Both insulin sensitizers induced favorable changes in insulin resistance and hyperandrogenism indices in women with PCOS. Independent predictors of flow-mediated dilation improvement at 6 months were treatment with insulin sensitizers and reduction in insulin resistance.

CONCLUSION(S):

In young women with PCOS, treatment with metformin or pioglitazone for 6 months induces a similar beneficial effect on endothelial function; this may be partially attributed to an improvement in insulin resistance. Further research is needed to investigate whether treatment with insulin sensitizers in women with PCOS also reduces cardiovascular risk.

[Indexed for MEDLINE]

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