The Relationship of Insulin Resistance and Polycystic Ovary Syndrome: Effects of Metformin Therapy and ovarian Drilling | ||
| Bulletin of Egyptian Society for Physiological Sciences | ||
| Article 1, Volume 29, Issue 2, December 2009, Pages 1-14 PDF (200.67 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/besps.2009.36348 | ||
| Authors | ||
| Asmaa Hassan* 1; Omyma Ahmed1; Marwa Ahmed1; Hosam Hamed2 | ||
| 1Department of Physiology , Faculty of Medicine, Assiut University | ||
| 2Department of Obstetrics & Gynecology, Faculty of Medicine, Assiut University | ||
| Abstract | ||
| Background: Polycystic ovary syndrome (PCOS) is a complex reproductive endocrine-metabolic disorder and insulin resistance (IR) is a common feature of it. Objective: To clarify the pathophysiological mechanisms of POCS, highlight its basic relationship with IR and to investigate the efficacy of metformin therapy and ovarian drilling in these cases. Patients and Methods: Thirty two PCOS patients (sixteen received metformin 850 mg twice daily for four months[group 1] and sixteen underwent laparoscopic ovarian drilling [group 2]) and fifteen healthy controls were included in this study. Body mass index (BMI) evaluation followed by ultrasound examination for measurement of antral follicles count (AFC) in both ovaries, oral glucose tolerance curve, fasting blood glucose, insulin and glucose / insulin ratio (G/I) were measured in addition to serum total testosterone (T), leutinizing hormone (LH) and insulin like growth factor-1 (IGF-1) for all subjects. These parameters were reevaluated again 4 months after either types of treatment. Results: PCOS patients had significant increase BMI, T, LH, IGF-1, fasting blood glucose, insulin level and AFC but G/I ratio was significantly lower. Significant negative correlations between fasting G/I ratio and either of BMI, T, and AFC respectively were evident. Impaired fasting glucose level at baseline was observed in PCOS patients while after metformin and laparoscopic drilling it was significantly improved. Metformin significantly decreased BMI, serum T, LH levels, IGF-1 and AFC and increased the G/I ratio versus pretreatment values. Also, ovarian drilling has similar but less obvious effects. Conclusion: IR plays a vital pathophysiological role in PCOS patients as manifested by causal relationship between insulin resistance and metabolic and reproductive changes of PCOS. Metformin and ovarian drilling potentially improve these changes. | ||
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