Metformin Effects on Plasminogen Activator Inhibitor-1 in Polycystic Ovarian Women

Abstract

Background: Polycystic ovary syndrome (PCOS) is a widespread complex endocrine disorder of women in the reproductive age group. Plasminogen activator inhibitor-1(PAI-1) has been shown to be associated with the regulation of inflammation and ovulation. Objectives: The aim of this study was to evaluate serum PAI-1 level and to determine the effects of metformin treatment on serum PAI-1 levels in patients with PCOS. Patients and Methods: This study was conducted on sixty women with PCOS, while 30 healthy women matched for age with the PCOS patients were selected as the control group, only 30 patients of them complete the follow up study and they agree to continue on metformin treatment during three months, the duration of the follow up. Study Design: A cross sectional study is done in Salah Al-Deen general hospital/gynecology and obstetrics department in Tikrit city from 1st November 2022-30th January 2023. Patients diagnosed with PCOs depending based on the Rotterdam criteria. Participants were enrolled after all eligibility criteria were confirmed and informed consent completed. The body mass index is determined before and after therapy. Homeostatic model assessment for insulin resistance is determined according to the following formula: (fasting insulin multiplied by fasting glucose) divided by 405. Fasting serum PAI-1 was measured by Enzyme-Linked Immunosorbent Assay method. Data were analyzed using SPSS for Windows 7. Results: Compared with the control group, the levels of PAI1, fasting blood glucose (FBG), Insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) While the levels of follicle stimulating hormone (FSH) were significantly decreased (P<0.05). In the PCOS group were significantly increased (P<0.05). Serum levels of testosterone in PCOS group was significantly increased (P<0.05). In PCOS women treated with metformin for three months, all patients showed significant in decrease in PAI1, and testosterone concentration at p-values 0.05, when compared to pre-treatment. Treatment resulted a significant decrease in in body mass index, Blood glucose, Insulin, HOMA-IR, and LH at p-values 0.05. Conclusion: Plasminogen activator inhibitor-1 level decreased significantly after 3 months of treatment with 850 mg per day with metformin in women with PCOS.