Shilpa Lingaiah1, Laure Morin-Papunen1, Juha Risteli2, Juha S Tapanainen3. 1. Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital and University of Oulu, Oulu, Finland. 2. Department of Clinical Chemistry, Oulu University Hospital, Oulu, Finland. 3. Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: juha.tapanainen@helsinki.fi.
Abstract
OBJECTIVE: To study the effects of metformin treatment on bone turnover in women with polycystic ovary syndrome (PCOS), as measured by serum concentrations of bone turnover markers. DESIGN: Post hoc study of a previously conducted prospective multicenter, placebo-controlled, randomized study. SETTING:University clinic. PATIENT(S): The study cohort consisted of 74 non-obese women (body mass index < 27 kg/m2) and 44 obese women (body mass index ≥ 27 kg/m2) diagnosed with PCOS, with a mean age of 27.6 ± 4.0 (SD) years. INTERVENTION(S): Randomization to receive metformin or placebo for 3 months. MAIN OUTCOME MEASURE(S): Serum levels of bone formation marker procollagen type I amino-terminal propeptide (PINP) and bone resorption marker carboxy-terminal cross-linking telopeptide of type I collagen (CTX) at baseline and after metformin/placebo treatment. RESULT(S): Serum levels of PINP and CTX were similar between the metformin and placebo groups at baseline in the whole study population. Obese women, when compared with non-obese, had lower baseline levels of PINP and CTX. Levels of PINP and CTX were significantly reduced in the whole study population, as well as in both non-obese and obese women after 3 months of metformin treatment, whereas no significant changes were observed in the placebo group. CONCLUSION(S): Metformin treatment, when compared with placebo, was associated with reduced bone turnover, as suggested by reductions in markers of bone formation and resorption, leading to slower bone remodeling in premenopausal women with PCOS. CLINICAL TRIAL REGISTRATION NUMBER: NCT00994812.
RCT Entities:
OBJECTIVE: To study the effects of metformin treatment on bone turnover in women with polycystic ovary syndrome (PCOS), as measured by serum concentrations of bone turnover markers. DESIGN: Post hoc study of a previously conducted prospective multicenter, placebo-controlled, randomized study. SETTING: University clinic. PATIENT(S): The study cohort consisted of 74 non-obesewomen (body mass index < 27 kg/m2) and 44 obesewomen (body mass index ≥ 27 kg/m2) diagnosed with PCOS, with a mean age of 27.6 ± 4.0 (SD) years. INTERVENTION(S): Randomization to receive metformin or placebo for 3 months. MAIN OUTCOME MEASURE(S): Serum levels of bone formation marker procollagen type I amino-terminal propeptide (PINP) and bone resorption marker carboxy-terminal cross-linking telopeptide of type I collagen (CTX) at baseline and after metformin/placebo treatment. RESULT(S): Serum levels of PINP and CTX were similar between the metformin and placebo groups at baseline in the whole study population. Obesewomen, when compared with non-obese, had lower baseline levels of PINP and CTX. Levels of PINP and CTX were significantly reduced in the whole study population, as well as in both non-obese and obesewomen after 3 months of metformin treatment, whereas no significant changes were observed in the placebo group. CONCLUSION(S): Metformin treatment, when compared with placebo, was associated with reduced bone turnover, as suggested by reductions in markers of bone formation and resorption, leading to slower bone remodeling in premenopausal women with PCOS. CLINICAL TRIAL REGISTRATION NUMBER: NCT00994812.
Keywords:
Bone turnover markers; carboxy-terminal cross-linking telopeptide of type I collagen (CTX); metformin; polycystic ovary syndrome; procollagen type I amino-terminal propeptide (PINP)
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