Long-term metformin treatment is able to reduce the prevalence of metabolic syndrome and its hepatic involvement in young hyperinsulinaemic overweight patients with polycystic ovarian syndrome
Long-term metformin treatment is able to reduce the prevalence of metabolic syndrome and its hepatic involvement in young hyperinsulinaemic overweight patients with polycystic ovarian syndrome
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DOI：
10.1111/j.1365-2265.2011.04093.x
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发表时间：
2011-10-01
影响因子：
3.2
通讯作者：
Apa, Rosanna
中科院分区：
文献类型：
--
作者：
Gangale, Maria F.;Miele, Luca;Apa, Rosanna
目的 本研究的目的是确定二甲双胍治疗降低年轻高胰岛素血症超重多囊卵巢综合征 (PCOS) 患者代谢综合征 (MS) 患病率及其肝脏受累的能力。设计临床试验。患者我们招募了 140 名育龄期高胰岛素超重 PCOS 女性。每位患者接受二甲双胍治疗（500 mg x 3/die），为期 12 个月。 测量 主要结果是评估高胰岛素超重 PCOS 患者中非酒精性脂肪性肝病 (NAFLD) 和 MS 的患病率。次要结局是在同一患者中评估二甲双胍治疗对内分泌、代谢和肝脏参数的影响。结果 在基础评估中，140 名 PCOS 患者中，81 名被诊断为 NAFLD（57.85%）； MS 仅出现在 NAFLD 组中（32.09% vs 0%；P < 0.001）。 12 个月后，二甲双胍能够显着降低同一组中 MS 的患病率（28.9% vs 13.5%；P < 0.01）。还观察到肝脏参数的改善和月经稀发的显着减少（85.7% vs 19%，P < 0.001）。 结论 所有高胰岛素血症超重 PCOS 患者，特别是 NAFLD 患者，都需要使用二甲双胍治疗。考虑到它们发生代谢和肝脏并发症的风险增加，这些数据显得更加有趣。
Objective The objective of this study is to determine the ability of metformin treatment in reducing the prevalence of metabolic syndrome (MS) and its hepatic involvement in young hyperinsulinaemic overweight patients with polycystic ovarian syndrome (PCOS).Design Clinical Trial.Patients We recruited 140 hyperinsulinaemic overweight women with PCOS in their reproductive age. Metformin treatment (500 mg x 3/die) was prescribed to each patient for twelve months.Measurements The primary outcome was to evaluate the prevalence of nonalcoholic fatty liver disease (NAFLD) and MS in hyperinsulinaemic overweight patients with PCOS. The secondary outcome was to evaluate, in the same patients, the effects of metformin therapy on endocrine, metabolic and hepatic parameters.Results At basal evaluation, NAFLD was diagnosed in 81 of 140 patients with PCOS (57.85%); MS was present only in the NAFLD group (32.09% vs 0%; P < 0.001). After twelve months, metformin is able to significantly reduce, in the same group, the prevalence of MS (28.9% vs 13.5%; P < 0.01). An improvement of hepatic parameters and a significant decrease in oligomenorrhea (85.7% vs 19%, P < 0.001) were also observed.Conclusions Treatment with metformin is indicated in all hyperinsulinaemic overweight patients with PCOS, especially in those with NAFLD. These data appear even more interesting considering their increased risk to develop metabolic and hepatic complications.