Journals / İstanbul Medical Journal / 2020 / Cilt: 21 - Sayı: 1

The Effects of Metformin, Ethinyl Estradiol/Cyproterone Acetate, and Metformin Ethinyl Estradiol/Cyproterone Acetate Combination Therapy on Carotid Artery Intima-media Thickness in Patients with Polycystic Ovary Syndrome

Polikistik Over Sendromlu Olgularda Metformin, Etinil Estradiol/Siproteron Asetat ve Metformin-etinil Estradiol/Siproteron Asetat Kombinasyonu Tedavisinin Karotis Arter İntima Media Kalınlığı Üzerine Etkileri

Pages
47–52
Publication Date
2022-10-19
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

There was no statistically significantchange in carotid IMT value in all treatment groups (p>0.05).Conclusion: According to these results, we can say that womenwith PCOS have subclinical atherosclerosis and that metformintreatment has a positive effect on subclinical atherosclerosis.

📌 3 Key Takeaways

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Objective & Hypothesis:Introduction: Patients with polycystic ovary syndrome(PCOS) are in the risk group for early-onset cardiovasculardisease.
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Key Findings & Data:Our studyaimed to measure carotid intima-media thickness (IMT) inPCOS cases and to assess the effects of metformin, ethinylestradiol/cyproterone acetate (EE/CA) and metformin + EE/CA combination therapy on carotid IMT, insulin resistance,C-reactive protein (CRP), apelin and adiponectin.Methods: Basal carotid IMT, insulin resistance [Homeostasismodel assessment insulin resistance (HOMA-IR)], apelin,adiponectin, and CRP values were evaluated in 60 women withPCOS and 43 healthy volunteers between the ages of 18 and 45.After baseline evaluation, patients were divided into metformin(n=20), EE/CA (n=20) and metformin + EE/CA (n=20) treatmentgroups.
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Conclusion & Impact:There was no statistically significantchange in carotid IMT value in all treatment groups (p>0.05).Conclusion: According to these results, we can say that womenwith PCOS have subclinical atherosclerosis and that metformintreatment has a positive effect on subclinical atherosclerosis.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Introduction: Patients with polycystic ovary syndrome(PCOS) are in the risk group for early-onset cardiovasculardisease. There are few studies evaluating physiological andinflammatory cardiovascular risk factors in PCOS. Our studyaimed to measure carotid intima-media thickness (IMT) inPCOS cases and to assess the effects of metformin, ethinylestradiol/cyproterone acetate (EE/CA) and metformin + EE/CA combination therapy on carotid IMT, insulin resistance,C-reactive protein (CRP), apelin and adiponectin.Methods: Basal carotid IMT, insulin resistance [Homeostasismodel assessment insulin resistance (HOMA-IR)], apelin,adiponectin, and CRP values were evaluated in 60 women withPCOS and 43 healthy volunteers between the ages of 18 and 45.After baseline evaluation, patients were divided into metformin(n=20), EE/CA (n=20) and metformin + EE/CA (n=20) treatmentgroups. Treatment regimens were administered for six months.At the end of the treatment, the same parameters were reevaluated.Results: Compared with the control group, CRP (p=0.003),HOMA-IR (p=0.004) and IMT (p=0.049) were significantlyhigher, and adiponectin (p=0.002) and apelin (p=0.031) levelswere significantly lower in patients with PCOS. At the end of thesix-month treatment, the adiponectin level in the metformin(p=0.012) and metformin + EE/CA groups (p=0.012), and theapelin level in the metformin (p=0.024), EE/CA (p=0.024) andmetformin + EE/CA groups (p=0.024) were significantly higher.There was no statistically significant change in CRP level in all treatment groups (p>0.05). There was no statistically significantchange in carotid IMT value in all treatment groups (p>0.05).Conclusion: According to these results, we can say that womenwith PCOS have subclinical atherosclerosis and that metformintreatment has a positive effect on subclinical atherosclerosis.

Özet

Amaç: Polikistik over sendromu (PKOS) erken dönemde ortaya çıkan kardiyovasküler hastalık için risk grubundadır. PKOS’de, fizyolojik ve enflamatuvar kardiyovasküler risk faktörlerini değerlendiren az sayıda çalışma vardır. Çalışmamızın amacı, PKOS olgularında karotis intima media kalınlığını (İMK) ve ayrıca metformin, etinil estradiol/siproteron asetat (EE/SA) ve metformin + EE/SA kombinasyon tedavisinin karotis İMK, insülin direnci, C-reaktif protein (CRP), apelin ve adiponektin üzerine etkilerini değerlendirmektir. Yöntemler: Çalışmamıza katılan 18-45 yaş arasındaki 60 PKOS’li kadında ve 43 sağlıklı gönüllü kadında bazal karotis İMK, insülin direnci [Homeostasis model assessment insulin resistance (HOMA-IR)], apelin, adiponektin ve CRP değerlendirmeleri yapıldı. Bazal değerlendirmeden sonra, hastalar metformin (n=20), EE/SA (n=20) ve metformin + EE/SA (n=20) tedavi gruplarına ayrıldı. Tedavi rejimleri 6 ay boyunca uygulandı. Tedavi sonunda aynı parametreler tekrar değerlendirildi. Bulgular: Kontrol grubuyla karşılaştırıldığında PKOS’li olguların CRP (p=0,003), HOMA-IR (p=0,004), İMK (p=0,049) değerleri istatistiksel olarak anlamlı derecede daha yüksek, adiponektin (p=0,002), apelin (p=0,031) düzeyleri kontrol grubundan istatistiksel olarak daha düşük saptandı. Altı aylık tedavinin sonunda adiponektin seviyesi metformin (p=0,012) ve metformin + EE/SA grubunda (p=0,012), apelin seviyesi ise metformin grubu (p=0,024), EE/SA grubu (p=0,024), ve metformin + EE/SA grubunda (p=0,024) anlamlı olarak yüksek saptandı. Üç tedavi grubunda da CRP seviyesinde istatistiksel olarak anlamlı değişim yoktu (p>0,05). Üç tedavi grubunda da karotis İMK değerinde istatistiksel olarak anlamlı değişim yoktu (p>0,05). Sonuç: Bu sonuçlara göre PKOS’de subklinik aterosklerozun varlığını ve metformin tedavisinin subklinik ateroskleroz üzerine olumlu etki gösterdiğini söyleyebiliriz.

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Cite This Article

KISA, Ü., YILMAZ, M., GÜLİTER, S., DEMİRCİ, H., TULMAÇ, M., ÜNAL, D. (2022). The Effects of Metformin, Ethinyl Estradiol/Cyproterone Acetate, and Metformin Ethinyl Estradiol/Cyproterone Acetate Combination Therapy on Carotid Artery Intima-media Thickness in Patients with Polycystic Ovary Syndrome. İstanbul Medical Journal, Cilt: 21 - Sayı: 1, 47–52. https://ajindex.com/articles/551817

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