Body composition in women with polycystic ovary syndrome demonstrating central obesity and insulin resistance improved with metformin, according to research published in The Journal of Clinical Endocrinology & Metabolism.
Patients with normal weight or overweight saw improvements with either metformin therapy alone or in combination with oral contraceptive pills (OCP) compared with OCP alone, Danish researchers discovered.
“Treatment modalities including metformin were superior to OCP regarding weight and regional fat mass deposits without differences in upper to lower fat mass ratio,” the researchers wrote.
Dorte Glintborg, MD, PhD, of the Department of Endocrinology and Metabolism, Odense University Hospital, and colleagues looked at 65 women aged 18 to 39 years meeting Rotterdam criteria for polycystic ovary syndrome (PCOS) in a controlled outpatient setting.
The researchers randomized patients to 12 months of metformin (2 g/day; n=19), metformin plus OCP (150 mg desogestrel plus 30 microgram ethinylestradiol; n=23) or OCP (n=23). Whole body DXA scans, along with clinical and hormonal evaluations, were performed before and after intervention.
Average weight changes seen during 12 months treatment with metformin, metformin plus OCP and OCP were, respectively, -3.0 (95% CI, -10.3; 0.6), -1.9 (95% CI, -4.9; 0.1) and 1.2 (95% CI, -0.8; 3.0) kg (P<.05). Upper to lower fat mass ratio remained unchanged. At study inclusion, body composition changes were predicted by medical intervention and not by BMI. Free testosterone levels decreased more with OCP and metformin plus OCP.
“Our data support that weight loss during metformin treatment in PCOS is not due to initial side effects alone, but the exact mechanism for improved body composition cannot be concluded based on the present study results,” the researchers wrote.
Disclosures: The work was supported by the Jacob Madsen’s and Olga Madsen’s Foundation, Institute of Clinical Research, Odense University Hospital, Kolding Hospital, AP Møller’s
Foundation, Bernhard and Marie Kleins Foundation, The Novo Nordisk Foundation, The Danish Medical Association; contraceptive pills and metformin tablets were sponsored by