Improvement of endothelial function with metformin and rosiglitazone treatment in women with polycystic ovary syndrome
Improvement of endothelial function with metformin and rosiglitazone treatment in women with polycystic ovary syndrome
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DOI：
10.1530/eje-08-0507
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发表时间：
2008-10-01
影响因子：
5.8
通讯作者：
Pfeifer, Marija
中科院分区：
文献类型：
--
作者：
Jensterle, Mojca;Sebestjen, Miran;Pfeifer, Marija
目的：多囊卵巢综合征（PCOS）的年轻女性也存在临床前心血管疾病。本研究的目的是评估和比较二甲双胍（MET）和罗格列酮（ROSI）对PCOS患者血管内皮功能的影响。方法：26例PCOS患者接受6个月的MET或ROSI治疗。在基线和终点时采集用于评估雄激素、血脂和高敏C反应蛋白的血液样本。观察治疗前后肱动脉内皮依赖性血流介导的舒张功能（FMD）和硝酸甘油诱导的非内皮依赖性舒张功能。应用稳态模型评估（HOMA（IR））计算作为胰岛素抵抗（IR）的量度。经治疗，MET组肱动脉FMD从4.2 +/-6.6%显著改善至10.2 +/- 5.9%（P = 0.036），ROSI组从2.9 +/-3.2%显著改善至7.6 +/- 4.9%（P = 0.026）。MET与ROSI同样有效（P = 0.70）。非内皮依赖性血管舒张功能无变化。此外，MET的施用与HOMA（IR）（P = 0.003）、血清总睾酮和血清游离睾酮（分别为P = 0.045和P = 0.008）的显著降低以及月经出血频率的显著增加（P = 0.006）相关。MET和ROST可显著改善年轻PCOS患者的内皮功能，这些患者临床上没有明显的动脉粥样硬化，也没有严重的胰岛素抵抗。两种药物均不优于另一种药物上级。我们的结论是，治疗性干预与胰岛素增敏剂可以扭转动脉粥样硬化过程中的PCOS患者在其早期阶段。
Objective: There is evidence of preclinical cardiovascular disease even in young women with polycystic ovary syndrome (PCOS). The aim of our study was to assess and compare the effects of metformin (MET) and rosiglitazone (ROSI) on endothelial function in PCOS patients.Methods: For 6 months, 26 women with PCOS received either MET or ROSI. Blood samples for assessment of androgens, lipids and high-sensitive C-reactive protein were taken at baseline and at endpoint. Endothelium-dependent flow-mediated dilation (FMD) and glyceryl trinitrate-induced endothelium-independent dilation of brachial artery were studied before and after treatment. Homeostasis model assessment (HOMA(IR)) calculation was applied as a measure of insulin resistance (IR).Results: With treatment, FMD of brachial artery improved significantly from 4.2 +/- 6.6 to 10.2 +/- 5.9% in MET group (P = 0.036) and from 2.9 +/- 3.2 to 7.6 +/- 4.9% in ROSI group (P = 0.026). MET being as effective as ROSI (P = 0.70). The endothelium-independent dilation did not change. Additionally, administration of MET was associated with a significant decrease in HOMA(IR) (P = 0.003), serum total and serum-free testosterone (P = 0.045 and P = 0.008 respectively) and significantly higher frequencies of menstrual bleeding (P = 0.006).Conclusion: A 6-month therapy with insulin sensitizers. MET and ROST, resulted in marked improvement of endothelial function in young PCOS patients without clinically evident atherosclerosis who were not severely insulin resistant. Neither drug was superior to the other. We conclude that therapeutic intervention with either insulin sensitizer may reverse the atherosclerotic process in PCOS patients at its early stage.