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This Article Accepted manuscript (PDF) All Versions of this Article: EJE-08-0507v1 159/4/399    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Jensterle, M. Articles by Pfeifer, M. PubMed PubMed Citation Articles by Jensterle, M. Articles by Pfeifer, M.

Improvement of endothelial function with metformin and rosiglitazone treatment in women with polycystic ovary syndrome

M Jensterle, Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia
M Sebestjen, Department of Angiology, University Medical Centre, Ljubljana, Slovenia
A Janez, Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia
J Prezelj, Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia
T Kocjan, Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia
I Keber, Department of Angiology, University Medical Centre, Ljubljana, Slovenia
M Pfeifer, Department of Endocrinology, University Medical Centre, Ljubljana, Slovenia

Correspondence: Mojca Jensterle, Email: mojcajensterle{at}yahoo.com

Abstract

Objective: There is evidence of preclinical cardiovascular disease even in young women with polycystic ovary syndrome (PCOS). The aim of our study was to assess and compare the effects of metformin and rosiglitazone on endothelial function in PCOS patients.

Methods: 26 women with PCOS received either metformin or rosiglitazone for 6 months. Blood samples for assessment of androgens, lipids and high sensitive C-reactive protein (hsCRP) were taken at baseline and at endpoint. Endothelium-dependent flow mediated dilation (FMD) and glyceryl trinitrate (GTN)-induced endothelium-independent dilation of brachial artery were studied before and after treatment. Homeostasis model assessment (HOMAIR) calculation was applied as a measure of insulin resistance (IR).

Results: With treatment, FMD of brachial artery improved significantly from 4.2 ± 6.6 to 10.2 ± 5.9 % in metformin group (p=0.036) and from 2.9 ± 3.2 to 7.6 ± 4.9 % in rosiglitazone group (p=0.026), metformin being as effective as rosiglitazone (p=0.70). The endothelium-independent dilation did not change. Additionally, administration of metformin was associated with a significant decrease in HOMAIR (p = 0.003), serum total and free testosterone (p = 0.045 and p = 0.008, respectively) and significantly higher frequencies of menstrual bleeding (p=0.006).

Conclusions: A six-month therapy with insulin sensitizers metformin and rosigitazone resulted in marked improvement of endothelial function in young PCOS patients without clinically evident atherosclerosis who were not severely insulin resistant. Neither drug was superior to the other. We conclude that therapeutic intervention with either insulin sensitizer may reverse the atherosclerotic process in PCOS patients at its early stage.