Abstract
BackgroundMost women with polycystic ovary syndrome (PCOS) have insulin resistance, hyperinsulinemia, and elevated serum IL-6 levels. These elevated IL-6 levels may have links with insulin resistance and hyperandrogenism. Metformin may have beneficial effects on the chronic low-grade inflammatory background associated with PCOS.MethodsA systematic review was performed via PUBMED, EMBASE, and The Cochrane Library on PCOS studies published through November 30, 2013. Studies were selected that evaluated the effect of metformin on IL-6 levels in PCOS patients. Studies not containing adequate diagnosis information about PCOS or not excluding of other causes of hyperandrogenism were excluded.ResultsFive studies met the inclusion criteria. Of these, one study reported a significant decrease in IL-6 levels after metformin treatment in women with PCOS. Two studies reported that treatment-related reductions in IL-6 levels were significantly correlated with insulin metabolism. In the remaining two studies, plasma IL-6 levels did not change following metformin treatment.ConclusionsSerum IL-6 levels of PCOS patients may be influenced by metformin. Early application of metformin therapy may relieve chronic low-grade inflammation in women with PCOS. However, further investigations with larger samples are needed to better understand the effects of metformin on IL-6 levels and chronic inflammation in PCOS.
Highlights
Most women with polycystic ovary syndrome (PCOS) have insulin resistance, hyperinsulinemia, and elevated serum IL-6 levels
The six remaining studies evaluated the effect of metformin on IL-6 levels in PCOS patients
One study was excluded because it did not meet the objective of the present systematic review; this study by Ibáñez et al [15] evaluated the influence of metformin combined with flutamide to IL-6 levels (Figure 1)
Summary
Most women with polycystic ovary syndrome (PCOS) have insulin resistance, hyperinsulinemia, and elevated serum IL-6 levels. Polycystic ovary syndrome (PCOS) is the most frequently encountered endocrinopathy and affects 5-8% of reproductive-age women [1]. It is characterized by chronic oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism and polycystic ovaries [2,3]. This disorder is associated with an increased risk of hyperinsulinemia, insulin resistance, type 2 diabetes mellitus, dyslipidemia, and cardiovascular diseases. IL-6 has been shown to modulate ovarian development and function [4].
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