Titre du document / Document title
Sustainability of 8% weight loss, reduction of insulin resistance, and amelioration of atherogenic-metabolic risk factors over 4 years by metformin-diet in women with polycystic ovary syndrome
Auteur(s) / Author(s)
GLUECK Charles J. (1) ;
AREGAWI Dawit (1) ;
AGLORIA Mahlia (1) ;
WINIARSKA Magdalena (1) ;
SIEVE Luann (1) ;
PING WANG (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Cholesterol Center, Jewish Hospital, Cincinnati, OH 45229, ETATS-UNIS
Résumé / Abstract
In 74 women with polycystic ovary syndrome, treated for 4 years with metformin (MET) and diet, we prospectively assessed whether, and to what degree, weight loss, reduction of insulin resistance, and amelioration of coronary heart disease risk factors could be sustained. We hypothesized that response to MET-diet would not differ by pretreatment body mass index (BMI) classes <25 (normal), >25 to <30 (overweight), ≥30 to <40 (obese), and >40 (extremely obese). Median Percent body weight loss category BMI Weight (kg) % Weight loss 5%-10% 10%-15% 15%-20% > 20% Entry 33.8 90.5 1-y treatment 30.1 81 8.1 32% 21% 14% 4% 2-y treatment 30.2 82 8.5 27% 23% 11% 8% 3-y treatment 30.8 83 7.8 23% 19% 12% 10% 4-y treatment 30.0 83 8.2 16% 18% 15% 8% Metformin-diet was successful in producing stable ∼8% weight reduction for all 4 years (trend P <.0001). Percentage of reductions in weight on MET-diet was significant (P <.05) and did not differ among the 3 highest BMI categories (≥40, ≥ 30 to <40, ≥25 to <30), but were not significant in the normal-weight category (BMI, <25). On MET-diet, median homeostasis model assessment of insulin resistance (HOMA-IR) was 33% lower than entry at 1 year, 50% at 2 years, 51% at 3 years, and 50% at 4 years (trend, P <.0001). On MET-diet, median low-density lipoprotein cholesterol (LDL-C) was 6% lower than entry at year 1, 6% at year 2, 7% at year 3, and 11% at year 4 (trend P <.0001). On MET-diet, median high-density lipoprotein cholesterol (HDL-C) was 3% higher than entry at year 2, 8% higher at year 3, and 11% higher at year 4 (trend P <.0001). Percentage of reductions in HOMA-IR, LDL-C, triglyceride, and systolic blood pressure, and increments in HDL-C did not differ (P >.1) in the 4 BMI categories. By stepwise regression, weight loss was a significant (P ≤.01) positive explanatory variable for reduction in HOMA-IR for all 4 follow-up years. Metformin-diet in women with polycystic ovary syndrome effectively and safely reduces weight and LDL-C while raising HDL-C, and maintains these outcomes stable over 4 years.
Revue / Journal Title
Metabolism, clinical and experimental
ISSN
0026-0495
Source / Source
2006, vol. 55, n
o12, pp. 1582-1589 [8 page(s) (article)] (72 ref.)
Langue / Language
Anglais
Editeur / Publisher
Elsevier, New York, NY, ETATS-UNIS
(1952)
(Revue)
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Localisation / Location
INIST-CNRS, Cote INIST : 6965, 35400014525217.0050
Nº notice refdoc (ud4) : 18408918
