The effects of long-term metformin treatment on adrenal and ovarian steroidogenesis in women with polycystic ovary syndrome
Abstract
Objective: To evaluate adrenal and ovarian steroidogenesis before and after long-term treatment with metformin in women with polycystic ovary syndrome (PCOS). Design and Methods: Twenty-four women with PCOS were evaluated before and after treatment (27 +/- 4 weeks) with metformin (1000 mg/day) using adrenocorticotrophin (ACTH), GnRH analogue and oral glucose tolerance (oGTT) tests.
For statistical evaluation, ANOVA and Wilcoxon's test were used. Results: In 58% of the women a significant improvement in menstrual cyclicity was observed.
No significant change in basal steroid levels was found. After ACTH stimulation, a significant decrease in the activity of 3 beta -hydroxysteroid dehydrogenase in C-21 steroids (P -hydroxysteroid dehydrogenase (P (4) pathway (P -hydroxysteroid dehydrogenase in C-21 steroids (P cell function) was detected.
In addition, an increase in the levels of C peptide during oGTT was observed (P < 0.01). Conclusions: Long-term metformin treatment reduced various steroid enzymatic activities both in the ovary and the adrenal glands, without apparent changes in basal steroid levels and in insulin sensitivity.