Preview

Problems of Endocrinology

Advanced search

The use of metformin for polycystic ovary syndrome

https://doi.org/10.14341/probl11302

Abstract

Recently, there is strong evidence that insulin resistance and additive hyperinsulinemia are unique features of the polycystic ovary syndrome (PCOS). Additional studies evaluating the effect of agents affecting hyperinsulinemia are no doubt to be required before making official recommendations on their use in clinical practice. The paper presents data of 12-week metformin therapy in 65 females with PCOS, by analyzing the results of studies of insulinemia and glycemia during oral glucose tolerance tests (OGTT) performed prior to and following the therapy. Insulin resistance and sensitivity, p-cell functions, and a secretory response of insulin to glucose stimulation were evaluated by using mathematical models and by calculating surrogate OGTT indices validated with the reference clamp test. Metformin was found to exert a positive effect on metabolic disorders in females with PCOS via increased insulin sensitivity and a decreased integral secretory response on insulin to oral glucose stimulation, by creating conditions for an adequate response to the stimulus as better insulin-mediated glucose uptake with decreased compensatory hyperinsulinemia. Recovery of adequacy of a secretory response to glucose stimulation promotes a reduction in additive hyperinsulinemia only in PCOSfemales with p-cell dysfunction caused by a predominance of decreased peripheral insulin sensitivity, rather than secretory defect.

About the Authors

T. A. Zykova

Northern State Medical University


Russian Federation


G. A. Mel'nichenko

Endocrinology Research Center RAMS


Russian Federation


A. V. Strelkova

Northern State Medical University


Russian Federation


B. A. Savenko

Northern State Medical University


Russian Federation


E. V. Simonova

Northern State Medical University


Russian Federation


I. I. Dedov

Endocrinology Research Center RAMS


Russian Federation


References

1. Асbау О., Gundorgdu S. // Fertil. and Steril. — 1996. — Vol. 65. - P. 946-949.

2. Albareda M., Rodrigues-Espinosa J., Murugo M. // Diabetologia. - 2000. - Vol. 43. - P. 1507-1511.

3. Bergman R. N., Phillips S. P., Cobelli C. // J. Clin. Invest. — 1981. - Vol. 38. - P. 1512-1527.

4. Cederholm J., Wibell L. // Diabet. Res. Clin. Pract. — 1990. — Vol. 10. - P. 167-175.

5. DeFronzo R., Barzlai N., Sinonson D. // J. Clin. Endocrinol. Metab. - 1991. - Vol. 73. - P. 1294-1301.

6. Diamanti-Kandarakis E., Kouli C., Tsianateli T., Bergiele A. // Eur. J. Endocrinol. - 1998. - Vol. 138. - P. 3269-3274.

7. Drivsholm T., Hansen T., Urhammer S. A. et al. // Diabetologia. — 1999. — Vol. 42. — Suppl. 1. — P. A185.

8. Dunaif A. // Endocrinol. Metab. Clin. N. Am. — 1999. — Vol. 28. - P. 341-359.

9. Ehrmann D. A. // Ibid. - N 2. - P. 423-438.

10. Manninen V., Tenkanen L., Koskinen P. et al. // Circulation.1992. - Vol. 85. - P. 37-45.

11. Matsuda M., DeFronzo R. A. // Diabetes Care. — 1999. — Vol. 22. - P. 1462-1470.

12. Mattews D. R., Hosker J. P., Rudenski A. S. et al. // Diabetologia. - 1985. - Vol. 28. - P. 412-419.


Review

For citations:


Zykova T.A., Mel'nichenko G.A., Strelkova A.V., Savenko B.A., Simonova E.V., Dedov I.I. The use of metformin for polycystic ovary syndrome. Problems of Endocrinology. 2004;50(1):34-40. (In Russ.) https://doi.org/10.14341/probl11302

Views: 27881


ISSN 0375-9660 (Print)
ISSN 2308-1430 (Online)