TY - JOUR
T1 - Randomized controlled trial evaluating response to metformin versus standard therapy in the treatment of adolescents with polycystic ovary syndrome
AU - Allen, Holley F.
AU - Mazzoni, Cristina
AU - Heptulla, Rubina A.
AU - Murray, Mary A.
AU - Miller, Nancy
AU - Koenigs, Laura
AU - Reiter, Edward O.
PY - 2005/8
Y1 - 2005/8
N2 - Objective: We evaluated the hypothesis that metformin would improve signs and symptoms of polycystic ovary syndrome (PCOS) in adolescents as compared to oral contraceptive pills (OCP) and have a favorable effect on obesity. Study Design: Thirty-five obese, post-menarchal, non-sexually active adolescents aged 12-21 years with PCOS and hyperinsulinism were randomly assigned to receive either OCP or metformin for 6 months. Results: There was a significant decrease in BMI in the two groups over time, from 40.1 to 38.6 in the OCP group, and 37.3 to 36.3 in the metformin group, p = 0.0026, but no significant difference in the degree of change between the two groups. Both groups had decreased free testosterone (OCP: 1.8 pg/ml to 0.96 pg/ml; metformin: 2.1 pg/ml to 1.6 pg/ml), p <0.0001, and improvements in insulin resistance as evidenced by increased glucose/insulin (G/I) ratio (p <0.005) and increased QUICK1 scores (p <0.0005). No significant differences in response to treatment were found between the metformin and OCP groups in outcome variables. Conclusion: Adolescents with PCOS treated with metformin or OCP experienced similar beneficial outcomes including reduction in androgen levels, weight loss, and increased insulin sensitivity. The choice of a treatment agent for long-term use will depend on safety profiles, therapeutic goals and patient adherence.
AB - Objective: We evaluated the hypothesis that metformin would improve signs and symptoms of polycystic ovary syndrome (PCOS) in adolescents as compared to oral contraceptive pills (OCP) and have a favorable effect on obesity. Study Design: Thirty-five obese, post-menarchal, non-sexually active adolescents aged 12-21 years with PCOS and hyperinsulinism were randomly assigned to receive either OCP or metformin for 6 months. Results: There was a significant decrease in BMI in the two groups over time, from 40.1 to 38.6 in the OCP group, and 37.3 to 36.3 in the metformin group, p = 0.0026, but no significant difference in the degree of change between the two groups. Both groups had decreased free testosterone (OCP: 1.8 pg/ml to 0.96 pg/ml; metformin: 2.1 pg/ml to 1.6 pg/ml), p <0.0001, and improvements in insulin resistance as evidenced by increased glucose/insulin (G/I) ratio (p <0.005) and increased QUICK1 scores (p <0.0005). No significant differences in response to treatment were found between the metformin and OCP groups in outcome variables. Conclusion: Adolescents with PCOS treated with metformin or OCP experienced similar beneficial outcomes including reduction in androgen levels, weight loss, and increased insulin sensitivity. The choice of a treatment agent for long-term use will depend on safety profiles, therapeutic goals and patient adherence.
KW - Adolescent
KW - Metformin
KW - Polycystic ovary syndrome
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U2 - 10.1515/JPEM.2005.18.8.761
DO - 10.1515/JPEM.2005.18.8.761
M3 - Article
C2 - 16200842
AN - SCOPUS:24944480071
SN - 0334-018X
VL - 18
SP - 761
EP - 768
JO - Journal of Pediatric Endocrinology and Metabolism
JF - Journal of Pediatric Endocrinology and Metabolism
IS - 8
ER -