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Metformin in pcos

Prapti Singh, Ariela Agress, Vanessa Madrigal, Clara Magyar, Nora Ostrzega, Gregorio Daniel Chazenbalk, Daniel Anthony Dumesic
Context: Ovarian hyperandrogenism from polycystic ovarian syndrome (PCOS) and hyperinsulinemia from insulin resistance are modulators of ovarian follicle development. We report a PCOS woman with hyperandrogenism and severe insulin resistance from metabolic syndrome who received long-term GnRH analog therapy preceding bilateral salpingo-oophorectomy for massive ovarian enlargement. Ovarian histological examination showed proliferating granulosa cells within antral follicles coexistent with serous cystadenofibromas, demonstrating a unique link between hyperinsulinemia and granulosa cell mitogenesis...
February 12, 2019: Journal of Clinical Endocrinology and Metabolism
Tao Wang, Jiao Zhang, Min Hu, Yuehui Zhang, Peng Cui, Xin Li, Juan Li, Edvin Vestin, Mats Brännström, Linus R Shao, Håkan Billig
The underlying mechanisms of polycystic ovarian syndrome (PCOS)-induced endometrial dysfunction are not fully understood, and although accumulating evidence shows that the use of metformin has beneficial effects in PCOS patients, the precise regulatory mechanisms of metformin on endometrial function under PCOS conditions have only been partially explored. To address these clinical challenges, this study aimed to assess the protein expression patterns of glycolytic enzymes, estrogen receptor (ER), and androgen receptor (AR) along with differences in mitochondria-dependent apoptosis in PCOS patients with and without endometrial hyperplasia in vivo and to investigate the effects of metformin in PCOS patients with endometrial hyperplasia in vitro ...
2019: International Journal of Biological Sciences
Tang Lingli, Ye Jiangfeng, Shi Yingli, Zhu Xiaoyong
OBJECTIVE: To evaluate the association between CD16++ monocytes in peripheral blood and the clinical features and short-term therapeutic effects of polycystic ovary syndrome (PCOS). METHODS: This prospective cross-sectional study included women diagnosed with PCOS at a university hospital in Shanghai, China, between June 4 and November 28, 2016. Patients received Diane-35, metformin, or both combined for 3 months. We collected anthropometric measures and used flow cytometry to detect CD16++ monocytes...
February 2, 2019: International Journal of Gynaecology and Obstetrics
Xiangyan Ruan, Meng Li, Alfred O Mueck
BACKGROUND: Polycystic ovary syndrome (PCOS) is a frequent female reproductive endocrine disease. It has been associated with numerous severe reproductive and metabolic abnormalities. However, there are still open questions especially regarding the best long-term management. METHODS: We summarized the literature focused on the symptoms and negative long-term consequences of untreated PCOS and the existing options for the treatment. We reviewed the Pubmed and China National Knowledge Infrastructure databases and the relevant literature for the recent 20 years...
January 29, 2019: Current Pharmaceutical Design
Nisha Tiwari, Shikha Pasrija, Sandhya Jain
OBJECTIVES: 1. To study the efficacy of exercise in improving clinical symptoms, anthropometry, glucose tolerance and laboratory profile in women with Polycystic ovarian syndrome. 2. To study the combined efficacy of exercise and metformin on above parameters in women with polycystic ovary syndrome. STUDY DESIGN: A Randomised double blinded placebo controlled trial was performed at a district hospital in New Delhi. Sixty six women were included in the study. Block randomisation was done to divide the women into two groups...
January 4, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Rita Malpique, David Sánchez-Infantes, Cristina Garcia-Beltran, Siri D Taxerås, Abel López-Bermejo, Francis de Zegher, Lourdes Ibáñez
S100A4 is a marker of subcutaneous adipose tissue dysfunction. Polycystic ovary syndrome (PCOS) is often driven by hepato-visceral adiposity. PCOS phenotypes are normalized more by reduction of central fat with spironolactone/pioglitazone/metformin (SPIOMET) than by oral contraceptive (OC) treatment. We studied whether circulating S100A4 concentrations are high in adolescents with PCOS and, if so, whether they normalize more with OC or SPIOMET. Assessments included circulating S100A4, endocrine markers, body composition, abdominal fat partitioning in controls (n = 12) and girls with PCOS (n = 51; age 15...
January 17, 2019: Pediatric Obesity
Djuro Macut, Jelica Bjekić-Macut, Sarantis Livadas, Olivera Stanojlović, Dragan Hrnčić, Aleksandra Rašić-Marković, Danijela Vojnović Milutinović, Violeta Mladenović, Zoran Andrić
Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women during reproductive period. True PCOS phenotype is prone to develop metabolic consequences during life. Obese PCOS women with insulin resistance are carrying risk for development type 2 diabetes, and influencing liver function by generating liver steatosis and nonalcoholic fatty liver disease (NAFLD). Moreover, serum testosterone of over 3 nmol/L is associated with at least two-fold higher risk for the development of NAFLD in PCOS women...
January 16, 2019: Current Pharmaceutical Design
Nienke S Weiss, Elena Kostova, Marleen Nahuis, Ben Willem J Mol, Fulco van der Veen, Madelon van Wely
BACKGROUND: Ovulation induction with follicle stimulating hormone (FSH) is a second-line treatment in women with polycystic ovary syndrome (PCOS) who do not ovulate or conceive on clomiphene citrate. OBJECTIVES: To compare the effectiveness and safety of gonadotrophins as a second-line treatment for ovulation induction in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS), and women who do not ovulate or conceive after clomiphene citrate. SEARCH METHODS: In January 2018, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, the World Health Organisation clinical trials register, Clinicaltrials...
January 16, 2019: Cochrane Database of Systematic Reviews
Anisha Agrawal, Reeta Mahey, Garima Kachhawa, Rajesh Khadgawat, Perumal Vanamail, Alka Kriplani
The present study was planned to evaluate the benefit of synergetic effect of Metformin plus Myo-inositol versus Metformin alone in infertile polycystic ovarian syndrome (PCOS) women undergoing ovulation induction. One hundred and twenty infertile PCOS women were randomized: Group I (n = 60) received Metformin (500 mg) plus Myoinositol(600 mg) three times a day; Group II received Metformin 500 mg three times a day. Subjects were advised to try for spontaneous conception. Those who did not conceive after 3 months, were given three cycles of ovulation induction + intrauterine insemination...
January 7, 2019: Gynecological Endocrinology
Fabio Facchinetti, Beatrice Orrù, Giovanni Grandi, Vittorio Unfer
Metformin (MET), the most commonly used insulin sensitizer, is the reference off-label drug for the treatment of polycystic ovary syndrome (PCOS), worldwide. However, its use may be limited mainly by gastrointestinal adverse effects. Myo-inositol (MI), a well-recognized food supplement, also represents an evidence-based treatment for PCOS women, popular in many countries. Our aim is to provide a systematic review of the literature and a meta-analysis which compares these two treatments, for their short-term efficacy and safety in PCOS patients...
January 7, 2019: Gynecological Endocrinology
Elisabet Stener-Victorin, Haolin Zhang, Rong Li, Cecilia Friden, Dong Li, Wei Wang, Haining Wang, Cuiqing Chang, Shi Li, ZeJun Huo, Hua Zhang, Xiaolan Ji, Angelica Linden-Hirschberg, Jie Qiao
INTRODUCTION: Polycystic ovary syndrome (PCOS) is linked to hyperinsulinemia and insulin resistance with dysfunctional glucose metabolism. Pilot studies suggests that acupuncture treatment with combined manual and low-frequency electrical stimulation (electroacupuncture (EA)) of the needles decrease circulating glycated haemoglobulin (HbA1c) and homeostatic model assessment-insulin resistance. Therefore, we here aim to investigate if acupuncture treatment or metformin together with lifestyle or lifestyle management alone improves insulin sensitivity and related symptoms in overweight/obese women with PCOS...
January 4, 2019: BMJ Open
Maryam Shokrpour, Fatemeh Foroozanfard, Faraneh Afshar Ebrahimi, Zahra Vahedpoor, Esmat Aghadavod, Amir Ghaderi, Zatollah Asemi
This investigation was conducted to evaluate comparison of myo-inositol and metformin on glycemic control, lipid profiles, and gene expression related to insulin and lipid metabolism in women with polycystic ovary syndrome (PCOS). This randomized controlled trial was conducted on 53 women with PCOS, aged 18-40 years old. Subjects were randomly allocated into two groups to take either myo-inositol (n = 26) or metformin (n = 27) for 12 weeks. Myo-inositol supplementation, compared with metformin, significantly reduced fasting plasma glucose (FPG) (β -5...
January 4, 2019: Gynecological Endocrinology
Jun Zhai, Gui-Dong Yao, Jing-Yuan Wang, Qing-Ling Yang, Liang Wu, Zi-Yin Chang, Ying-Pu Sun
To some extent, the use of metformin may improve endometrial receptivity and pregnancy outcomes of women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection. However, the mechanism is not well-known. The endometrium of metformin-treated group (metformin-treated patients with PCOS) and the control group (non-metformin-treated patients with PCOS) were analyzed for the expression of homeobox A10 (HOXA10) and integrin beta-3 (ITGB3) and differential micro RNA (miRNA) expression profiles...
January 1, 2019: Reproductive Sciences
Claudio D Gonzalez, Jorge Alvariñas, Maria Florencia Gonzalez Bagnes, Guillermo Di Girolamo
BACKGROUND: Metformin is sometimes used as an alternative to insulin in gestational diabetes mellitus (GDM). It is also used to achieve ovulation in polycystic ovary syndrome (PCOS). Pre-natal exposure to metformin results from its continuation after a successful ovulation in women with PCOS, its maintenance in women with pre-gestational diabetes or the installation of metformin in GDM. Few is known about the potential consequences of metformin exposure on pregnancy outcomes and offspring development...
December 24, 2018: Current Clinical Pharmacology
Marian G Showell, Rebecca Mackenzie-Proctor, Vanessa Jordan, Ruth Hodgson, Cindy Farquhar
BACKGROUND: Subfertile women are highly motivated to try different adjunctive therapies to have a baby, and the widespread perception is that dietary supplements such as myo-inositol (MI) and D-chiro-insoitol (DCI) are associated with only benefit, and not with harm. Many fertility clinicians currently prescribe MI for subfertile women with polycystic ovary syndrome (PCOS) as pre-treatment to in vitro fertilisation (IVF) or for ovulation induction; however no high-quality evidence is available to support this practice...
December 20, 2018: Cochrane Database of Systematic Reviews
Fang Xiong, Juxia Xiao, Yinyang Bai, Yun Zhang, Qiuping Li, Xu Lishuang
BACKGROUND: Polycystic ovary syndrome (PCOS) is a serious threat for reproductive-aged women. Metformin has been used for the treatment of PCOS. However, its molecular mechanism in decidualization process of PCOS has not been well featured. METHODS: RT-qPCR analysis was used to detect expression patterns of progesterone receptor (PGR), estradiol receptor alpha (ERα), Cytokeratin 8 and Vimentin in endometrial tissues of PCOS and non-PCOS patients. RT-qPCR assay was also employed to determine mRNA expression of prolactin, Insulin-like growth factor-binding protein 1 (IGFBP-1), matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP9)...
January 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Meng-Fei Li, Xiao-Meng Zhou, Xue-Lian Li
Purpose: To evaluate the effect of berberine (BBR) on polycystic ovary syndrome (PCOS) patients with insulin resistance (IR). Methods: PubMed (in English), Medline (in English), Embase (in English), CNKI (in Chinese), WanFang DATA (in Chinese), and VIP (in Chinese) were searched for randomized controlled trials in human beings with the search terms including "polycystic ovary syndrome /PCOS" and "berberine/BBR/Huang liansu (in Chinese)/ Xiao bojian (in Chinese)" till July 2018...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Melanie Faure, Michael J Bertoldo, Rita Khoueiry, Alice Bongrani, François Brion, Cecilia Giulivi, Joelle Dupont, Pascal Froment
Initially produced in Europe in 1958, metformin is still one of the most widely prescribed drugs to treat type II diabetes and other comorbidities associated with insulin resistance. Metformin has been shown to improve fertility outcomes in females with insulin resistance associated with polycystic ovary syndrome (PCOS) and in obese males with reduced fertility. Metformin treatment reinstates menstrual cyclicity, decreases the incidence of cesareans, and limits the number of premature births. Notably, metformin reduces steroid levels in conditions associated with hyperandrogenism (e...
2018: Frontiers in Endocrinology
Chan-Young Kwon, Boram Lee, Kyoung Sun Park
BACKGROUND: Polycystic ovary syndrome (PCOS) is one of the most common disorders of reproductive endocrinology in women of reproductive age. Lifestyle intervention and oral contraceptives are the first-line treatments for PCOS. Recent studies have suggested that complementary and alternative medicine (CAM) therapies including acupuncture, herbal medicine, and mind-body therapy have the potential to alleviate the symptoms and/or pathology of PCOS and to improve the quality of life of women with PCOS...
October 2018: Medicine (Baltimore)
Moiz Artani, Mohammad Faisal Iftikhar, Shehroz Khan
Background Metformin is a highly preferred drug that is used to treat the symptoms of polycystic ovarian syndrome among women. Pakistan is facing a continuous rise in the prevalence of polycystic ovarian syndrome. Therefore, the determination of the effectiveness of the drug in this condition is considered ideal as per the presenting situation. Objective The aim of the study was to determine the effects of metformin in patients with polycystic ovarian syndrome. Methods This cross-sectional study has investigated the influence of metformin on the ability to conceive, body weight, mood swings, energy levels, menstrual irregularities, and acne and hirsutism...
August 25, 2018: Curēus
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