Hyperandrogenism and menstrual imbalance are the best predictors of metformin response in PCOS patients.
Adult
Biomarkers, Pharmacological
Blood Glucose
/ drug effects
Female
Humans
Hyperandrogenism
/ diagnosis
Hypoglycemic Agents
/ therapeutic use
Insulin Resistance
/ physiology
Italy
Longitudinal Studies
Menstruation Disturbances
/ diagnosis
Metformin
/ therapeutic use
Polycystic Ovary Syndrome
/ complications
Prognosis
Treatment Outcome
Young Adult
Hyperandrogenism
Insulin resistance
Metformin
Oligo-amenorrhea
PCOS
Journal
Reproductive biology and endocrinology : RB&E
ISSN: 1477-7827
Titre abrégé: Reprod Biol Endocrinol
Pays: England
ID NLM: 101153627
Informations de publication
Date de publication:
04 Jan 2022
04 Jan 2022
Historique:
received:
17
10
2021
accepted:
08
12
2021
entrez:
5
1
2022
pubmed:
6
1
2022
medline:
23
3
2022
Statut:
epublish
Résumé
Moving from the correlation between insulin-resistance and PCOS, metformin has been administered in some PCOS women improving ovulatory and metabolic functions and decreasing androgen levels. Inconsistency and unpredictability of response to metformin limit its extensive use. Aim of this study was to identify reliable predictors of response to metformin therapy for weight loss and reduction in plasma androgen levels using ANNs (artificial neural networks). One hundred eight consecutive women with PCOS (ESHRE/ASRM 2003 Rotterdam criteria) treated with metformin 1500 mg/day, at inclusion and every 6 months underwent to a complete clinical, endocrine/metabolic assessment and ultrasonographic evaluation. Therapy outcomes were BMI reduction (≥1 kg/m At 6 months 54 out of 103 (52,4%) obese patients showed BMI reduction and 45 out of 89 (50,6%) hyperandrogenemic women showed FAI decrease. The further response rates at 12 months were 30,6 and 47%, respectively. SCMs showed a clear polarization for both the outcomes with elevated accuracy. Treatment responsiveness resulted strictly related to oligo-amenorrhea and hyperandrogenemia at baseline. In addition, lower serum testosterone levels at baseline were found to be the major predictor of treatment discontinuation. In women with PCOS, menstrual pattern imbalance and ovarian androgens excess are the best predictors of metformin response. They may pave the way for a rethinking of the criteria for evaluating hyperandrogenism in order to better define the large population included in the diagnosis of PCOS. Baseline plasma testosterone level can serve as a sensitive marker to predict treatment compliance.
Sections du résumé
BACKGROUND
BACKGROUND
Moving from the correlation between insulin-resistance and PCOS, metformin has been administered in some PCOS women improving ovulatory and metabolic functions and decreasing androgen levels. Inconsistency and unpredictability of response to metformin limit its extensive use. Aim of this study was to identify reliable predictors of response to metformin therapy for weight loss and reduction in plasma androgen levels using ANNs (artificial neural networks).
METHODS
METHODS
One hundred eight consecutive women with PCOS (ESHRE/ASRM 2003 Rotterdam criteria) treated with metformin 1500 mg/day, at inclusion and every 6 months underwent to a complete clinical, endocrine/metabolic assessment and ultrasonographic evaluation. Therapy outcomes were BMI reduction (≥1 kg/m
RESULTS
RESULTS
At 6 months 54 out of 103 (52,4%) obese patients showed BMI reduction and 45 out of 89 (50,6%) hyperandrogenemic women showed FAI decrease. The further response rates at 12 months were 30,6 and 47%, respectively. SCMs showed a clear polarization for both the outcomes with elevated accuracy. Treatment responsiveness resulted strictly related to oligo-amenorrhea and hyperandrogenemia at baseline. In addition, lower serum testosterone levels at baseline were found to be the major predictor of treatment discontinuation.
CONCLUSIONS
CONCLUSIONS
In women with PCOS, menstrual pattern imbalance and ovarian androgens excess are the best predictors of metformin response. They may pave the way for a rethinking of the criteria for evaluating hyperandrogenism in order to better define the large population included in the diagnosis of PCOS. Baseline plasma testosterone level can serve as a sensitive marker to predict treatment compliance.
Identifiants
pubmed: 34983571
doi: 10.1186/s12958-021-00876-0
pii: 10.1186/s12958-021-00876-0
pmc: PMC8729102
doi:
Substances chimiques
Biomarkers, Pharmacological
0
Blood Glucose
0
Hypoglycemic Agents
0
Metformin
9100L32L2N
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6Informations de copyright
© 2021. The Author(s).
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