The effect of abnormality family history on therapeutic reaction to metformin and oral contraceptive pill (alone and combined) treatment of patients with polycystic ovary syndrome (PCOS)

Abstract

OBJECTIVE: To study the effect of abnormality family history on curative efficiency of patients with PCOS.DESIGN: Prospective study.MATERIALS AND METHODS: 151 women with PCOS were divided into three groups depending on hyperandrogenemia (39 patients), both hyperandrogenemia with insulin resistance/hyperinsulinemia (67 patients) and insulin resistance/ hyperinsulinemia (45 patients), treated with OCPs alone, combined OCPs and metformin, metformin alone for 3-month respectively. We compared clinical data (BMI, basal follicles number, androgen, HOMA-IR, HOMA-β, ISI, DI, glucose and insulin (fasting, 1hour and 2hour after glucose load), GluAUC, INSAUC and lipid index) of patients who have abnormality family history(The first relatives suffered from diabetes millitus, premature bald, disorder menstruation or hyperandrogenemia) with negative family history in each group before and after treatment. SPSS software was used in statistical analysis.RESULTS: There are more basal follicles, higher LDL (3.11±0.77&2.63±0.80nmol/L) and GluAUC{13.4 (10.8-17.0) & 12.0 (10.3-15.5) nmol/L·min}(P<0.05) meanwhile there is not significant difference in other clinical data in PCOS with positive family history than in negative before any treatment. After 3-month treatment, T level is more easy to step down in OCPs alone group in positive family history than in negative (1.50±0.42 & 2.28±0.53nmol/L) (P<0.05); In combined OCPs and metformin group, T level (1.69±0.84 & 2.61±1.10nmol/L), DI{5.30 (4.58-6.53) & 8.72 (6.86-16.67)} decreased significantly and 1hour Glu (10.43±2.11 & 8.64±1.34mmol/L), GluAUC(17.47±3.27 & 14.59±2.39nmol/L·min) increased significantly (P<0.05) in positive family history compared with in negative, the variation of GluAUC after treatment is lower in positive family history; there is not significant difference in other clinical data in two groups above. There is no any difference with or without family history in metformin alone group.CONCLUSIONS: Abnormality family history not only affect clinical characteristics, but also curative efficiency of PCOS patients. PCOS with positive family history have more basal follicle number, higher LDL level and GluAUC, may increase the risk of cardiovascular disease and diabetes mellitus; they are easier to decrease the serum androgen levels in OCP alone or combined metformin treatment group, but more difficult to improve insulin resistance/hyperinsulinemia and β-cell function, decrease glucose level and GluAUC than with negative family history. OBJECTIVE: To study the effect of abnormality family history on curative efficiency of patients with PCOS. DESIGN: Prospective study. MATERIALS AND METHODS: 151 women with PCOS were divided into three groups depending on hyperandrogenemia (39 patients), both hyperandrogenemia with insulin resistance/hyperinsulinemia (67 patients) and insulin resistance/ hyperinsulinemia (45 patients), treated with OCPs alone, combined OCPs and metformin, metformin alone for 3-month respectively. We compared clinical data (BMI, basal follicles number, androgen, HOMA-IR, HOMA-β, ISI, DI, glucose and insulin (fasting, 1hour and 2hour after glucose load), GluAUC, INSAUC and lipid index) of patients who have abnormality family history(The first relatives suffered from diabetes millitus, premature bald, disorder menstruation or hyperandrogenemia) with negative family history in each group before and after treatment. SPSS software was used in statistical analysis. RESULTS: There are more basal follicles, higher LDL (3.11±0.77&2.63±0.80nmol/L) and GluAUC{13.4 (10.8-17.0) & 12.0 (10.3-15.5) nmol/L·min}(P<0.05) meanwhile there is not significant difference in other clinical data in PCOS with positive family history than in negative before any treatment. After 3-month treatment, T level is more easy to step down in OCPs alone group in positive family history than in negative (1.50±0.42 & 2.28±0.53nmol/L) (P<0.05); In combined OCPs and metformin group, T level (1.69±0.84 & 2.61±1.10nmol/L), DI{5.30 (4.58-6.53) & 8.72 (6.86-16.67)} decreased significantly and 1hour Glu (10.43±2.11 & 8.64±1.34mmol/L), GluAUC(17.47±3.27 & 14.59±2.39nmol/L·min) increased significantly (P<0.05) in positive family history compared with in negative, the variation of GluAUC after treatment is lower in positive family history; there is not significant difference in other clinical data in two groups above. There is no any difference with or without family history in metformin alone group. CONCLUSIONS: Abnormality family history not only affect clinical characteristics, but also curative efficiency of PCOS patients. PCOS with positive family history have more basal follicle number, higher LDL level and GluAUC, may increase the risk of cardiovascular disease and diabetes mellitus; they are easier to decrease the serum androgen levels in OCP alone or combined metformin treatment group, but more difficult to improve insulin resistance/hyperinsulinemia and β-cell function, decrease glucose level and GluAUC than with negative family history.