Metformin metabolic and vascular effects in normal weight hyperinsulinemic polycystic ovary syndrome patients treated with contraceptive vaginal ring. A pilot study

Abstract

Purpose

The aim of this longitudinal, controlled, and retrospective pilot study was to assess how metformin, associated with a contraceptive vaginal ring, may influence lipid and carbohydrate metabolism, and surrogate markers of arterial function in normal weight polycystic ovary syndrome patients.

Material and Methods

Among 28 lean patients, 15 were treated with vaginal ring plus metformin and 13 women with only vaginal ring. The effects were assessed after six months. The patients were submitted to evaluation of lipid and carbohydrate metabolism; Doppler analysis of ophthalmic artery; brachial artery flow-mediated vasodilatation; and oral glucose tolerance test.

Results

After six months, the fasting insulin, glucose/insulin ratio, and homeostatic model assessment estimates for insulin resistance were significantly improved in metformin group. The ophthalmic artery pulsatility index did not significantly improve in either group. The brachial artery vasodilation was better in metformin treated patients.

Conclusion

Metformin, associated with vaginal ring, improves the insulin and carbohydrate metabolism. This, associated with the significant improvements of surrogate markers of arterial function, may be responsible of a slight possible cardiovascular and cerebrovascular protective effect.

摘要

目的：本项纵向、对照和回顾性初步研究旨在评估二甲双胍与避孕阴道环联合应用对正常体重多囊卵巢综合征患者的脂代谢和碳水化合物代谢以及动脉功能相关指标的影响。

材料与方法：28例瘦多囊卵巢综合征患者中, 15例应用阴道环加二甲双胍治疗, 13例仅应用阴道环治疗。6个月后评估疗效, 对患者进行脂代谢和碳水化合物代谢评估、眼动脉多普勒分析、肱动脉的血管舒张情况和糖耐量试验。

结果：6个月后, 二甲双胍组的空腹胰岛素、血糖/胰岛素比值和稳态模型评估胰岛素抵抗指数均显著改善。两组眼动脉搏动指数均无明显改善。二甲双胍治疗组肱动脉舒张功能较好。

结论：二甲双胍联合阴道环可改善胰岛素和糖类代谢。与动脉功能相关指标的显著改善有关, 可能有轻微的心脑血管保护作用。

Keywords:

• Metformin
• PCOS
• contraception
• insulin
• vascular risk

Disclosure statement

No potential conflict of interest was reported by the author(s).