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Ethinylestradiol30?g-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome?

ABSTRACT: We are hereby investigating for the first time the effect of the association ethinylestradiol30?g-drospirenone 3mg (DRP/EE30?g) plus metformin and weight loss on endothelial status and C-reactive protein (hsCRP) levels in polycystic ovary syndrome (PCOS).25 young women with PCOS (mean age 22.76?±?0.83 years, body mass index (BMI): 28.44?±?6.23) who completed the study were prospectively evaluated. The oral contraceptive- DRP/EE30?g (21 days/month) and metformin (1700 mg daily) were administered for 6 months to the PCOS group. Additionally, the 15 overweight and obese patients (BMI?>?25 kg/m2) were instructed in a diet of no more than 1500 cal daily. Primary outcome measures were surrogate markers of cardiovascular disease and included endothelial function, i.e. flow-mediated dilatation (FMD) on the brachial artery and endothelin-1 levels, as well as hsCRP concentrations, body composition (measured by whole-body dual-energy X-ray-absorptiometry) and insulin resistance. Variables were assessed at baseline, as well as after our medical intervention.The combination between DRP/EE30?g plus metformin combined with weight loss triggered a significant improvement in the FMD values (FMD-PCOSbasal 3.48?±?1.00 vs FMD-PCOS6 months7.43?±?1.04, p?=?0.033), as well as body composition and insulin insensitivity (p?

SUBMITTER: Ilie IR

PROVIDER: S-EPMC3413550 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Ethinylestradiol30μg-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome?

Ilie Ioana Rada IR Marian Ioan I Mocan Teodora T Ilie Razvan R Mocan Lucian L Duncea Ileana I Pepene Carmen Emanuela CE

BMC endocrine disorders 20120619

<h4>Background</h4>We are hereby investigating for the first time the effect of the association ethinylestradiol30μg-drospirenone 3mg (DRP/EE30μg) plus metformin and weight loss on endothelial status and C-reactive protein (hsCRP) levels in polycystic ovary syndrome (PCOS).<h4>Methods</h4>25 young women with PCOS (mean age 22.76 ± 0.83 years, body mass index (BMI): 28.44 ± 6.23) who completed the study were prospectively evaluated. The oral contraceptive- DRP/EE30μg (21 days/month) and metformin ...[more]

PMID: 22713099

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Project description:Adolescents with polycystic ovary syndrome (PCOS) have insulin resistance and higher rates of the metabolic syndrome.Our objective was to compare the effects of 6 months treatment with drospirenone/ethinyl estradiol (EE) (3 mg/30 ?g) vs. rosiglitazone (4 mg) daily on the hormonal and cardiometabolic profiles of overweight/obese adolescents with PCOS.We conducted a randomized, double-blinded, parallel clinical trial in an academic hospital, with n = 46 patients.The primary outcome measure was insulin sensitivity, hepatic with [6,6-(2)H(2)]glucose and peripheral with a 3-h hyperinsulinemic-euglycemic clamp. Other outcome measures included plasma androgen profile and response to ACTH stimulation, glucose and insulin response to oral glucose tolerance test, insulin secretion with a 2-h hyperglycemic clamp, fasting lipid profile, inflammatory markers, intima media thickness, aortic pulse wave velocity, body composition by dual-energy x-ray absorptiometry, and abdominal adiposity by computed tomography scan.Drospirenone/EE resulted in greater reductions in androgenemia. Neither treatment led to change in weight or body mass index, but rosiglitazone led to a significant decrease in visceral adiposity. Compared with drospirenone/EE, treatment with rosiglitazone improved hepatic and peripheral insulin sensitivity and lowered fasting and stimulated insulin levels during the oral glucose tolerance test. Treatment with drospirenone/EE was associated with elevations in total cholesterol, high-sensitivity C-reactive protein and leptin concentrations, whereas treatment with rosiglitazone led to lower triglycerides and higher adiponectin concentrations. Neither treatment affected intima media thickness or pulse wave velocity.In overweight/obese adolescents with PCOS, 6 months treatment with rosiglitazone was superior to drospirenone/EE in improving the cardiometabolic risk profile, and effective but inferior in attenuating hyperandrogenemia. Additional studies are needed to test insulin sensitizers in the treatment of the reproductive and cardiometabolic aspects of PCOS.

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Ethinylestradiol30?g-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome?

Publications

Ethinylestradiol30μg-drospirenone and metformin: could this combination improve endothelial dysfunction in polycystic ovary syndrome?

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