Metformin improves clinical and metabolic parameters of women with PCOS

Metformin usage has beneficial effect on polycystic ovary syndrome (PCOS) women by decreasing body weight, total testosterone, BMI, androstenedione, LDL-C, 17-OHP, fasting blood glucose, and raising the chance of pregnancy, says an article published in Therapeutic Advances in Endocrinology and Metabolism by SAGE Journals.

With a frequency of up to 20%, polycystic ovarian syndrome (PCOS) is a diverse endocrine disorder that affects women of reproductive age. Menstrual abnormalities, polycystic ovarian morphology, and excess androgen are biochemical and clinical hallmarks of PCOS. The primary glucose and lipid homeostasis cell regulator AMP-activated protein kinase (AMPK), which is stimulated by metformin, decreases hepatic glucose synthesis. Inhibition of glucose in the hepatocytes is linked to AMPK activation. This research was done by Mohammed Altigani Abdalla and colleagues. to conduct a thorough assessment of the literature on the therapeutic effects of metformin on the clinical and metabolic parameters in PCOS-affected women.

From their origin until April 2020, MEDLINE, PubMed, Scopus, Embase, Cochrane Library, and the Web of Science were searched and chosen sources for grey literature. In June 2022, a new PubMed search was carried out. The review is presented in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

The key findings of this review were:

1. Compared to placebo, metformin significantly reduced body weight by 3.13 kg, body mass index (BMI) by 0.82 kg/m2, fasting blood glucose, low-density lipoprotein cholesterol (LDL-C), total testosterone, androstenedione, and 17-hydroxyprogesterone (17-OHP), and increased the likelihood of clinical pregnancy rate.

2. These effects were seen in 24 eligible randomized controlled trials (RCTs) involving 564 participants who received metformin therapy.

In conclusion, metformin alone considerably lowers mean body weight, BMI, androstenedione, LDL-C, total testosterone, 17-OHP, fasting blood glucose, and dramatically enhances the rate of pregnancy in women with PCOS.

Reference: 

Abdalla, M. A., Shah, N., Deshmukh, H., Sahebkar, A., Östlundh, L., Al-Rifai, R. H., Atkin, S. L., & Sathyapalan, T. (2022). Impact of metformin on the clinical and metabolic parameters of women with polycystic ovary syndrome: a systematic review and meta-analysis of randomised controlled trials. In Therapeutic Advances in Endocrinology and Metabolism. SAGE Publications. https://doi.org/10.1177/20420188221127142