María Victoria De Diego1, Olga Gómez-Pardo1, Janette Kirk Groar1, Alejandro López-Escobar1, Irene Martín-Estal2, Inma Castilla-Cortázar3,4, Miguel Ángel Rodríguez-Zambrano5. 1. Departments of Ginecology and Pediatry. HM Velazquez Cabinet, Fundación de Investigación HM Hospitales, Hospital "Puerta del Sur", Velazquez 25, 28001, Madrid, Spain. 2. Tecnologico de Monterrey, Escuela de Medicina Y Ciencias de La Salud, Ave. Morones Prieto 3000, 64710, Monterrey, NL, Mexico. 3. Departments of Ginecology and Pediatry. HM Velazquez Cabinet, Fundación de Investigación HM Hospitales, Hospital "Puerta del Sur", Velazquez 25, 28001, Madrid, Spain. iccortazar@gmail.com. 4. Tecnologico de Monterrey, Escuela de Medicina Y Ciencias de La Salud, Ave. Morones Prieto 3000, 64710, Monterrey, NL, Mexico. iccortazar@gmail.com. 5. Departments of Ginecology and Pediatry. HM Velazquez Cabinet, Fundación de Investigación HM Hospitales, Hospital "Puerta del Sur", Velazquez 25, 28001, Madrid, Spain. mrodriguezzambrano@yahoo.es.
Abstract
PURPOSE: To investigate the metabolic impact of currently used therapies in polycystic ovary syndrome (PCOS). METHODS: This is an observational, retrospective and transversal protocol. A small cohort of 133 patients, aged 14-48 years, diagnosed with PCOS was divided into four experimental groups: 1) untreated PCOS patients (n = 51); 2) PCOS patients treated with one of the following therapies (n = 82): a) combined oral contraceptives (COC, n = 35); b) metformin (n = 11); and c) inositols (n = 36). RESULTS: Although only < 10% of patients included in this cohort can be strictly encompassed in the development of metabolic syndrome, approximately 20% had insulin resistance. In PCOS patients, COC treatment modified the hormonal profile and worsened lipid parameters (increasing cholesterol and triglyceride levels) and insulin resistance, whereas inositol therapies improved significantly insulin resistance and glycosylated hemoglobin, reducing cholesterol and triglyceride levels. In these women, obesity was associated with greater alterations in lipid and glycemic metabolism and with higher blood pressure levels. PCOS patients with phenotype A presented vaster alterations in lipid metabolism and higher values of glycosylated hemoglobin as well as blood pressure compared to other PCOS phenotypes. CONCLUSIONS: Results in this paper suggest that inositol therapies (alone or combined with COC) are the most useful therapies with the best benefits against PCOS symptoms. Thus, integrative treatment may become a more efficient long-term choice to control PCOS symptoms. Furthermore, obesity can be considered as an adverse symptom and calorie restriction a key element of combined treatment in PCOS, not only for fertility management but also in long-term metabolic sequelae.
PURPOSE: To investigate the metabolic impact of currently used therapies in polycystic ovary syndrome (PCOS). METHODS: This is an observational, retrospective and transversal protocol. A small cohort of 133 patients, aged 14-48 years, diagnosed with PCOS was divided into four experimental groups: 1) untreated PCOSpatients (n = 51); 2) PCOSpatients treated with one of the following therapies (n = 82): a) combined oral contraceptives (COC, n = 35); b) metformin (n = 11); and c) inositols (n = 36). RESULTS: Although only < 10% of patients included in this cohort can be strictly encompassed in the development of metabolic syndrome, approximately 20% had insulin resistance. In PCOSpatients, COC treatment modified the hormonal profile and worsened lipid parameters (increasing cholesterol and triglyceride levels) and insulin resistance, whereas inositol therapies improved significantly insulin resistance and glycosylated hemoglobin, reducing cholesterol and triglyceride levels. In these women, obesity was associated with greater alterations in lipid and glycemic metabolism and with higher blood pressure levels. PCOSpatients with phenotype A presented vaster alterations in lipid metabolism and higher values of glycosylated hemoglobin as well as blood pressure compared to other PCOS phenotypes. CONCLUSIONS: Results in this paper suggest that inositol therapies (alone or combined with COC) are the most useful therapies with the best benefits against PCOS symptoms. Thus, integrative treatment may become a more efficient long-term choice to control PCOS symptoms. Furthermore, obesity can be considered as an adverse symptom and calorie restriction a key element of combined treatment in PCOS, not only for fertility management but also in long-term metabolic sequelae.
Authors: Daniel A Dumesic; Sharon E Oberfield; Elisabet Stener-Victorin; John C Marshall; Joop S Laven; Richard S Legro Journal: Endocr Rev Date: 2015-10 Impact factor: 19.871
Authors: Wendy A March; Vivienne M Moore; Kristyn J Willson; David I W Phillips; Robert J Norman; Michael J Davies Journal: Hum Reprod Date: 2009-11-12 Impact factor: 6.918