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2 WEIGHT LOSS IS A FEATURE OF PROTRACTED METFORMIN THERAPY IN WOMEN WITH POLYCYSTIC OVARY SYNDROME.
  1. M. Agloria,
  2. M. Winiarska,
  3. G. Luo,
  4. M. Salehi,
  5. L. Sieve,
  6. D. Aregawi,
  7. P. Wang,
  8. C. J. Glueck
  1. Cholesterol Center, Jewish Hospital, Cincinnati, OH

Abstract

In 296 women with polycystic ovary syndrome (PCOS) treated with metformin (MET 2.3 ± 0.4 g/day [Rx]) and diet (1,500 calories/day if BMI < 25, 2,000 calories if BMI $ 25 [protein 26% of calories, carb 44%]) for 1, 2, and 3 years, we assessed whether and to what degree weight loss was a feature of 1, 2, and 3 years of MET-diet Rx in women with PCOS.

 

Despite pretreatment (Pre-Rx) group severe obesity, MET-diet was successful in producing group weight reductions of 5.9% at 1 year, 5.8% at 2 years, and 6.3% at 3 years. Weight loss $ 5% was realized by 55% of women at 1 year, 55% at 2 years, and 58% at 3 years, with 15% or more weight loss in 11% of women at 1 year, 14% at 2 years, and 16% at 3 years. At years 1-3 on Rx, weight fell (p < .05) in BMI groups 25-30 (overweight), 30-40 (obese), and $ 40 (severely obese), and at year 1, in BMI group < 25 (normal). At 1 year follow-up on MET-diet, by stepwise regression, with change in weight as the dependent variable and Pre-Rx weight, age, duration of Rx, and MET dose as the explanatory variables, Pre-Rx weight was a significant positive explanatory variable (p = .017). At 1, 2, and 3 years follow-up on MET-diet, median group HOMA insulin resistance (IR) fell 28% (p < .0001), 42% (p < .0001), and 52% (p < .0001), triglycerides (TG) fell 16% (p = .010), 12% (p = .017), and 19% (p = .011), LDL cholesterol (LDLC) fell 5% (p < .0001), 4% (p = .033), and 8% (p = .014), systolic blood pressure (SBP) fell 4% (p = .0004), 3% (p = .037), and 3% (p = .20), diastolic blood pressure (DBP) fell 6% (p < .0001), 0% (p = .30), and 3% (p = .08). By stepwise regression with explanatory variables age, duration of Rx, MET dose, and weight loss, weight loss was a significant positive explanatory variable for reduction in HOMA IR (year 1 p = .023, year 2 p = .012), was associated with reduction in TG (year 1 p = .005, year 2 p = .007, year 3 p = .043), was associated with reduction in SBP (year 1 p = .0001, year 2 p = .046), and was associated with reduction in DBP (year 1 p = .0001, year 2 p = .016). MET-diet for 1, 2, and 3 years in women with PCOS effectively and safely reduces weight and major atherogenic components of the metabolic syndrome.

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