This article is more than 5 years old. Information may no longer be current.
Metformin improves clinical outcomes in PCOS, not metabolic, endocrine outcomes
Click Here to Manage Email Alerts
Women with polycystic ovary syndrome assigned metformin therapy saw improved clinical outcomes, including reduced BMI, waist-to-hip ratio and blood pressure, compared with those assigned a placebo, but the drug did not affect metabolic or endocrine outcomes, according to findings published in Current Medical Research and Opinion.
In a meta-analysis, Roshni Patel, MPharm, of the K.B. Institute of Pharmaceutical Education and Research in Gandhinagar, and Gaurang B. Shah, MPharm, PhD, of the L.M. College of Pharmacy in Ahmedabad, both in Gujarat, India, analyzed 14 randomized controlled trials conducted through May 2016 in Brazil, Denmark, Germany, Iran, Italy, Turkey, the United Kingdom, the United States and Venezuela that evaluated the efficacy of metformin in women with PCOS. To determine the total effect of metformin therapy, results from each study were presented as mean values and standard deviation for each group.
Researchers analyzed the effects of metformin on BMI in 11 studies (n = 336) and waist-to-hip ratio in seven studies (n = 297). Compared with placebo, metformin reduced BMI with a mean difference of –1.18 (95% CI, –2 to –0.36) and waist-to-hip ratio with a mean difference of –0.02 (95% CI, –0.03 to 0); however, researchers noted substantial heterogeneities for BMI (I² = 60%) and waist-to-hip ratio (I2 = 87%). Systolic BP was assessed across eight studies (n = 360) and diastolic BP across seven studies (n = 277); researchers found metformin therapy reduced systolic BP with a mean difference of –4.92 (95% CI, –7.51 to –2.33) and diastolic BP with a mean difference of –1.51 (95% CI, –2.23 to –0.79) compared with placebo. There was no observable effect of metformin therapy on Ferriman-Gallwey score.
Researchers also observed a decrease in triglyceride levels among women assigned metformin vs. placebo (mean difference, –10.74; 95% CI, –17.93 to –3.56), but the decrease did not improve total cholesterol, LDL or HDL levels, they noted.
“These results are in accordance with earlier meta-analyses, also reporting no improvement in triglycerides and total cholesterol levels,” the researchers wrote. “However, heterogeneity was moderate to high in both studies.”
For endocrine outcomes, researchers observed improvement in serum total testosterone (mean difference, –14.32; 95% CI, –26.8 to –1.85), but not in sex hormone-binding globulin or other measures.
“The other outcomes, such as free testosterone level, free androgen index, SHBG level, [dehydroepiandrosterone sulfate] level, [luteinizing hormone] level, [follicle-stimulating hormone] level, [luteinizing hormone]/[follicle-stimulating hormone] ratio, estradiol level and progesterone level, were not significantly improved by metformin treatment,” the researchers wrote. “Since heterogeneity was high in both meta-analyses for all parameters, the reliability of results remains poor.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts