Abstract
BackgroundFew studies have assessed whether the amelioration of the clinical signs of polycystic ovary syndrome (PCOS) achieved by treatment leads to improvement in the health-related quality of life (HRQoL) of patients. This study was aimed to examine the HRQoL of ethnic Chinese women with PCOS who received metformin treatment.MethodsThis prospective study was conducted at a medical center in Taiwan. Study participants aged 18–45 years were diagnosed as having PCOS according to the Rotterdam criteria, and all received metformin treatment. Their HRQoL was assessed using generic (WHOQOL-Bref) and PCOS-specific (Chi-PCOSQ) instruments. Mixed effect models were used to examine the effects of metformin on repeatedly measured HRQoL. Additional analyses using stratified patients characteristics (overweight vs. normal; hyperandrogenism vs. non-hyperandrogenism) were done.ResultsWe recruited 109 participants (56 % were overweight, 80 % had hyperandrogenism). Among the domain scores of WHOQOL-Bref, the psychological domain score was the lowest one (12.64 ± 2.2, range 4–20). Weight (3.25 ± 1.59, range 1–7) and infertility (3.38 ± 1.93, range 1–7) domain scores were relatively low among the domain scores of Chi-PCOSQ. Overweight and hyperandrogenic patients had significantly lower HRQoL as compared with those of normal weight and non-hyperandrogenic patients, respectively. Metformin significantly improved the physical domain of WHOQOL-Bref (p = 0.01), and the infertility (p = 0.043) and acne and hair loss aspects (p = 0.008) of PCOS-specific HRQoL. In the subgroup analysis, significantly improved HRQoL following metformin treatment appeared for only overweight and hyperandrogenism subgroups.ConclusionsMetformin might improve health-related quality of life of polycystic ovary syndrome women by ameliorating psychological disturbances due to acne, hair loss and infertility problems, especially for overweight and hyperandrogenic patients.
Highlights
Few studies have assessed whether the amelioration of the clinical signs of polycystic ovary syndrome (PCOS) achieved by treatment leads to improvement in the health-related quality of life (HRQoL) of patients
PCOS patients had the lowest score in the psychological aspect of HRQoL, with similar trends found within subgroups
Repeated measures analysis of variance (ANOVA) indicated that the changes in psychological and social domain scores along with treatment duration between overweight and normal weight subgroups were significantly different
Summary
Few studies have assessed whether the amelioration of the clinical signs of polycystic ovary syndrome (PCOS) achieved by treatment leads to improvement in the health-related quality of life (HRQoL) of patients. Health-related quality of life (HRQoL) is generally defined as the functional effect of a clinical condition and/or its treatments upon a patient, which is subjective and multidimensional, including physical function, psychological state, and social interactions [1]. In addition to traditional measures of health (e.g., survival), HRQoL is an important indicator that captures the burden of illness. Assessing HRQoL helps healthcare providers understand whether patients are satisfied with their health and associated treatments. HRQoL is important to consider when evaluating various symptom management plans [3] and disease treatments [4], especially when they provide similar effects on life expectancy. According to U.S Food and Drug Administration’s guidance for industry, HRQoL can be used as a clinical outcome to claim the effect of treatment [5]
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