Effect of the insulin sensitizers metformin and pioglitazone on endothelial function in young women with polycystic ovary syndrome: a prospective randomized study
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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DOI：
10.1016/j.fertnstert.2010.06.058
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发表时间：
2011-01-01
影响因子：
6.7
通讯作者：
Michalis, Lampros K.
中科院分区：
文献类型：
--
作者：
Naka, Katerina K.;Kalantaridou, Sophia N.;Michalis, Lampros K.
目的：比较二甲双胍和吡格列酮两种胰岛素增敏剂对多囊卵巢综合征(PCOS)患者血管内皮功能的影响。设计：前瞻性随机研究。地点：大学医院内分泌科门诊。患者(S)：青年PCOS患者(年龄23.3±4.9岁)。干预(S)：随机分为不治疗组(n=14)、二甲双胍850 mg/d(n=15)、吡格列酮30 mg/d(n=14)，疗程6个月。以年龄和体重指数相匹配的健康女性为对照组(n=14)。主要预后指标(S)：在基线和6个月时对肱动脉血流介导的扩张进行研究。结果(S)：与对照组相比，多囊卵巢综合征患者的胰岛素抵抗和高雄激素血症指数更高，血流介导的血管扩张更低。三组患有多囊卵巢综合征的女性在基线上没有差异。在没有接受治疗的女性的随访中没有观察到差异。二甲双胍和吡格列酮改善血流介导的扩张的程度相似，在6个月后恢复到正常值。两种胰岛素增敏剂均可使多囊卵巢综合征患者的胰岛素抵抗和高雄激素指数发生有利的变化。胰岛素增敏剂的治疗和胰岛素抵抗的减少是6个月后血流介导的扩张改善的独立预测因素。结论(S)：在年轻女性多囊卵巢综合征患者中，二甲双胍或吡格列酮治疗6个月对内皮功能有类似的有利作用，这可能部分归因于胰岛素抵抗的改善。需要进一步的研究来调查在患有多囊卵巢综合征的女性中使用胰岛素增敏剂是否也能降低心血管风险。(Fertil Steril(R)2011；95：203-9。(C)2011年，由美国生殖医学会提供。)
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. (Fertil Steril(R) 2011;95:203-9. (C) 2011 by American Society for Reproductive Medicine.)