Effect of metformin on reproductive endocrine and glucose and lipid metabolism of polycystic ovary syndrome patients with or without central obesity

Abstract

Objective To explore the therapeutic status of metformin in central obesity and non-central obesity polycystic ovary syndrome (PCOS) patients. Methods Totally 113 PCOS patients of Obstetrics and Gynecology Hospital, Fudan University from January 2016 to April 2018 were divided into central obesity group (waist circumstance≥80 cm) and non-central obesity group (waist circumstance<80 cm) according to waist circumstance. They were treated with metformin (1.5 g/d) for 3 months. The height, weight, waist circumference and menstrual cycle were recorded before and after treatment. Peripheral blood was taken to measure reproductive endocrine and glucose and lipid metabolism indexes before and after treatment. Results After treatment, the ovulation rates of central obese and non-central obesity groups were 59.7% and 56.1%, respectively, and there was no statistical difference between the two groups (P>0.05). The improvement rates of menstrual cycle in central obese and non-central obesity groups were 83.8% and 84.2%, respectively, with no statistical difference between the two groups (P>0.05). After treatment, luteinizing hormone (LH), total testosterone (TT), and free androgen index (FAI) decreased significantly in central obese and non-central obesity groups (P<0.05). Fasting plasma glucose (FPG), fast insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) in both groups significantly decreased (P<0.05), but only insulin area under the curve (IAUC) in central obesity group significantly decreased (P<0.05). Body mass index (BMI) and waist circumstance decreased in the two groups(P<0.05). However, only apolipoprotein A (APO-A) in central obese group increased significantly (P<0.05). Conclusion Metformin is not only suitable for central obese PCOS patients, but also for non-central obese PCOS patients. Key words: Polycystic ovary syndrome; Metformin; Central obesity; Menstrual cycle; Glucose and lipid metabolism