Effect of Metformin and Vitamin D Supplementation on Metabolic and Hormonal Profiles in Polycystic Ovary Syndrome Women: A Follow-Up Study

Abstract

Background: Insulin resistance in association with obesity is implicated in the pathogenesis of polycystic ovarian syndrome and its primary characteristic of hyperandrogenism. Metformin at a dose of (1700-2000) mg/day, with and without lifestyle, is associated with a beneficial enhancement in BMI and menstrual cycles. We aimed to determine the role of free testosterone: dihydrotestosterone ratio, and sex hormone binding globulin in the evaluation of the efficacy of metformin and vitamin D in the treatment of polycystic ovary syndrome. Methods: This cross-sectional study included 50 infertile women who were diagnosed with PCOS with an age range of (18-40 years). They were classified into Group I: Twenty-five women treated with metformin 850 mg/twice daily and followed for 8 weeks; Group II: Twenty-five women treated with vitamin D3 50.000 IU/wk for the same period. Serum investigations included measurements of prolactin, 25 hydroxyvitamin D, LH, FSH, free testosterone, DHT and SHBG by ELISA technique. Results: This study revealed that the mean values of BMI, HOMA-IR, prolactin and free testosterone: dihydrotestosterone ratio were significantly improved (by lowering) after treatment with metformin and vitamin D. Moreover, Polycystic Ovary Syndrome women treated with metformin revealed significant negative association between HOMA-IR with SHBG (r= -0.593, p=0.009), also significant positive association between HOMA-IR with BMI (r= 0.631, p=0.003). Conclusion: Serum measurements of free testosterone: dihydrotestosterone ratio, along with SHBG, are good biochemical markers that reflect the enhancement of insulin resistance and BMI in Polycystic Ovary Syndrome women post metformin treatment or vitamin D supplementation.