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Year : 2012  |  Volume : 4  |  Issue : 3  |  Page : 90-98

Interplay of insulin resistance and the reproductive and metabolic changes in women with polycystic ovary syndrome

1 Departments of Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
2 Departments of Obstetrics & Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Omyma G Ahmed
Departments of Physiology, Faculty of Medicine, Assiut University, Assiut
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1947-489X.210762

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Background: Polycystic ovary syndrome (PCOS) is a complex reproductive, endocrine-metabolic disorder with insulin resistance (IR) as a common feature. Objective: To clarify whether IR and associated hyperinsulinemia play a key role in the pathophysiological changes in PCOS especially, reproductive and metabolic changes, and the efficacy of metformin therapy in these cases. Patients and Methods: Twenty five PCOS patients received metformin 850 mg twice daily for four months and fifteen healthy controls were included in this study. Body mass index (BMI) evaluation followed by ultrasound examination for measurement of antral follicle count (AFC) in both ovaries, oral glucose tolerance test (OGTT), fasting blood glucose, insulin and glucose / insulin ratio (G/I) were measured in addition to serum total testosterone (T), luteinizing hormone (LH) and insulin like growth factor-1 (IGF-1) estimation for all subjects. These parameters were re-evaluated again 4 months after metformin treatment was initiated in PCOS patients. Results: PCOS patients had significantly increased fasting blood glucose levels (P < 0.05), BMI, T, IGF-1 (P < 0.01), LH, insulin levels and AFC (P < 0.001) but G/I ratio was significantly (P < 0.001) lower in comparison to controls. Significant negative correlations between fasting G/I ratio and each of BMI, T, and AFC respectively were evident. Impaired OGTT at baseline was observed in PCOS patients with significant improvement noted after initiation of metformin therapy. Metformin significantly decreased BMI, serum T, LH, IGF-1 levels and AFC and increased the G/I ratio versus pretreatment values. Conclusion: IR plays a vital pathophysiological role in PCOS patients as manifested by causal relationship between insulin resistance and the reproductive and metabolic changes of PCOS. Metformin potentially improves these changes.

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