OBJECTIVE: To determine the effects of different treatment regimens on the hormonal features, metabolic parameters, and hematologic variables in women with polycystic ovary syndrome (PCOS). METHODS:Forty-eight women with PCOS were randomized into four treatment protocols: ethinyl estradiol/cyproterone acetate (EE/CA; n =12), EE/CA-metformin (n = 12), metformin alone (n =12) and EE/CA-spironolactone (n =12). These treatment protocols were given for 3 months and pre- and post-treatment variables were compared. RESULTS:Activated partial thromboplastin time (APTT) and prothrombin time (PT) levels, D-dimer, HOMA-IR, insulin, WBC, MPV as well as androgen levels decreased in all treatment groups. EE/CA-metformin and metformin alone groups resulted in a higher proportional reduction of D-dimer levels than the other protocols, while no significant different proportional reduction was observed in all the four groups for MPV, WBC, APTT, PT values. EE/CA-metformin group showed higher proportional reduction fasting insulin concentrations, HOMA-IR and free testosterone levels than metformin alone and EE/CA-spironolactone groups. DHEAs levels significantly decreased in group EE/CA-metformin than EE/CA alone and EE/CA-spironolactone groups. In multiple stepwise regression analyses, reduction in proportional insulin levels was independently and positively associated with decrease of MPV, D-dimer, free testosterone levels. CONCLUSIONS: In all treatment groups, we observed reduced levels of coagulation parameters, improvement of hormonal, hematological and metabolical variables by most probably reducing insulin levels. Among the treatment groups, EE/CA-metformin may be a more effective therapeutic option than the other protocols and this may be due to the beneficial effect of EE/CA-metformin on insulin resistance.
RCT Entities:
OBJECTIVE: To determine the effects of different treatment regimens on the hormonal features, metabolic parameters, and hematologic variables in women with polycystic ovary syndrome (PCOS). METHODS: Forty-eight women with PCOS were randomized into four treatment protocols: ethinyl estradiol/cyproterone acetate (EE/CA; n =12), EE/CA-metformin (n = 12), metformin alone (n =12) and EE/CA-spironolactone (n =12). These treatment protocols were given for 3 months and pre- and post-treatment variables were compared. RESULTS: Activated partial thromboplastin time (APTT) and prothrombin time (PT) levels, D-dimer, HOMA-IR, insulin, WBC, MPV as well as androgen levels decreased in all treatment groups. EE/CA-metformin and metformin alone groups resulted in a higher proportional reduction of D-dimer levels than the other protocols, while no significant different proportional reduction was observed in all the four groups for MPV, WBC, APTT, PT values. EE/CA-metformin group showed higher proportional reduction fasting insulin concentrations, HOMA-IR and free testosterone levels than metformin alone and EE/CA-spironolactone groups. DHEAs levels significantly decreased in group EE/CA-metformin than EE/CA alone and EE/CA-spironolactone groups. In multiple stepwise regression analyses, reduction in proportional insulin levels was independently and positively associated with decrease of MPV, D-dimer, free testosterone levels. CONCLUSIONS: In all treatment groups, we observed reduced levels of coagulation parameters, improvement of hormonal, hematological and metabolical variables by most probably reducing insulin levels. Among the treatment groups, EE/CA-metformin may be a more effective therapeutic option than the other protocols and this may be due to the beneficial effect of EE/CA-metformin on insulin resistance.
Authors: Eloise Fraison; Elena Kostova; Lisa J Moran; Sophia Bilal; Carolyn C Ee; Christos Venetis; Michael F Costello Journal: Cochrane Database Syst Rev Date: 2020-08-13
Authors: Mohamed Abdel-Maboud; Amr Menshawy; Elfatih A Hasabo; Mohamed Ibrahim Abdelraoof; Mohamed Alshandidy; Muhammad Eid; Esraa Menshawy; Oumaima Outani; Ahmed Menshawy Journal: PLoS One Date: 2021-07-19 Impact factor: 3.240
Authors: Sandra Korol; Fannie Mottet; Sylvie Perreault; William L Baker; Michel White; Simon de Denus Journal: Medicine (Baltimore) Date: 2017-12 Impact factor: 1.817