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J Clin Endocrinol Metab. 2014 Jul;99(7):2584-91. doi: 10.1210/jc.2014-1135. Epub 2014 Apr 17.

Body composition is improved during 12 months' treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome.

Author information

1
Departments of Endocrinology and Metabolism (D.G., M.L.A., H.M., A.P.H., M.A.) and Gynecology and Obstetrics (P.R.), Odense University Hospital, 5000 Odense C, Denmark.

Abstract

CONTEXT:

Central obesity in polycystic ovary syndrome (PCOS) is associated with increased inflammatory markers and increased risk for type 2 diabetes.

OBJECTIVE:

The objective of the study was to evaluate whether treatment with metformin (M) or M combined with oral contraceptive pills (OCPs) resulted in a more advantageous body composition than treatment with OCP alone.

SETTING:

The study was conducted at an outpatient clinic.

PATIENTS AND INTERVENTIONS:

This was a randomized, controlled clinical trial. Ninety patients with PCOS were randomized to 12 months' treatment with M (2 g/d), M + OCP (150 mg desogestrel+30 μg ethinylestradiol), or OCP. Whole-body dual-energy x-ray absorptiometry scans and clinical and hormonal evaluations were performed before and after the intervention period. A total of 65 of 90 patients completed the study.

MAIN OUTCOME MEASURES:

Changes in weight at 6 and 12 months and changes in regional fat mass estimates at 12 months were measured.

RESULTS:

Dropout rates between intervention groups were not significantly different. Treatment with M and M+OCP were superior to OCP regarding weight and regional fat mass. The median (quartiles) weight changes during 12 months of M, M+OCP, and OCP treatment were -3.0 (-10.3; 0.6), -1.9 (-4.9; 0.1), and 1.2 (-0.8; 3.0) kg, respectively, P < .05. Upper to lower fat mass ratio was unchanged. Changes in body composition were predicted by the type of medical intervention (M, M+OCP, or OCP) and not by body mass index at study inclusion. OCP and M+OCP were superior to M regarding reduction in free T levels.

CONCLUSIONS:

M treatment alone or in combination with OCP was associated with weight loss and improved body composition compared with OCP, whereas free T levels decreased during M+OCP or OCP. Combined treatment with M+OCP should be considered as an alternative to treatment with OCP alone to avoid weight gain in PCOS.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00451568.

PMID:
24742124
DOI:
10.1210/jc.2014-1135
[Indexed for MEDLINE]

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