EFFECT OF CHOLECALCIFEROL AND ITS COMBINATION WITH METFORMIN ON THE LIPID AND CARBOHYDRATE STATUS IN WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

Abstract

Objective. To investigate the effect of therapy with cholecalciferol, metformin and their combination to indicator of carbohydrate and lipid metabolism in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR). Materials and methods. 60 women with PCOS and IR, 30 healthy women similar in age and body weight were examined. Patients were divided into 3 groups: 20 women receiving cholecalciferol at 4000 IU daily; 20 women receiving metformin at 850 mg twice a day; 20 patients taking metformin at 850 mg twice a day and cholecalciferol at 4000 IU daily. Vitamin D, glucose, immunoreactive insulin (IRI), HOMA-IR index, total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), oral glucose tolerance test before and after 12 weeks of therapy were determined. Results. Therapy with cholecalciferol was accompanied by increasing (P < 0.001) in concentrations of vitamin D (158.9 ± 4.7)%, reducing the levels of IRI (P < 0.02), the HOMA-IR indexes (P < 0.001), total cholesterol (P < 0.01) and LDL (P < 0.05), but did not had a significant effect on anthropometric parameters, glucose, TG, and HDL levels. Therapy with metformin was accompanied by decreasing body mass index (BMI) (P < 0.01), basal levels of IRI (24.6 ± 0.4)% (P < 0.001), HOMA-IR index (27.9 ± 0.4)% (P < 0.001), glycemic responses to an oral glucose load (P < 0.001), TG (P < 0.02) and increasing levels of HDL (P < 0.05). No negative dynamics of vitamin D levels was observed. Combination therapy was accompanied by increasing in concentration of vitamin D (P < 0.001), significant decreasing of BMI (P < 0.001), waist-to-hip ratio (P < 0.05), glycemic responses to an oral glucose load (P < 0.001), levels of IRI (P < 0.001) and HOMA-IR indexes (P < 0.001), more significant decreasing in total cholesterol (P < 0.001), TG (P < 0.001), LDL (P < 0.001) and increasing in HDL (P < 0.001). Conclusion. It is expedient to use a combination of cholecalciferol with metformin in the complex of therapeutic measures aimed at the correction of metabolic disorders in women with PCOS.