Behradmanesh et al. flammation with the risk of cardiovascular diseases,21 we sought to investigate the effect of metformin on lowering serum ferritin level in PCOS, obese and non-obese patients. Materials and Methods This is a before-after quasi experimental study on 45 PCOS women. The PCOS subjects were selected based on Homburg criteria and others.12,22 The study was carried out in clinics related to Shiraz University of Medical Sciences, Shiraz Iran, from January 2006 and lasted for six months. Exclusion criteria were pregnancy, diabetes mellitus, psychotic disorders, hypertension, cardiovascular dis- eases, smoking, alcohol drinking and oral contraceptive pill taking, anti-inflammatory drugs and any other medi- cation for hyperlipidemia, hypertension, and glucose intolerance in the past six months were also the exclu- sion criteria. Patients who were also on special diet or on standard sports to lose weight, all were excluded too. The secondary PCOS was also ruled out. All subjects signed the consent forms and the Ethics Committee of the university approved the study. Basic measurements on anthropometric indexes included waist and hip (cm) (waist was calculated by the great- est circumstance between the last rib and iliac crest and the hip was calculated by the greatest circumstance from both greater femoral trochanters),23 height (m), weight (kg), BMI (kg/m2) and WHR. BMI≤25 was considered as normal, 25<BMI<30 overweight and BMI≥30 was considered as obese. WHR>0.8 was considered as a sign of central obesi- ty.24 In addition, fasting insulin was measured with immunotech kit (made in Check by IRMA method), while fasting plasma glucose (FPG), triglycer- ide(Tg), total cholesterol (chol), HDL and LDL [through enzymatic calorimetric method], serum fer- ritin and high sensitive C reactive protein (hsCRP) [by IRMA method] levels that were measured using standard kits. Homeostasis Model Assessment of Insulin Re- sistance (HOMA-IR) was calculated by fasting serum insulin (pmol/L) multiplied by FBS (mmol/L) divided to 22.5.25 Blood pressure was measured by standard method too. In the first week, apo-metformin (Apotex Inc., Toronto, Canada) was prescribed (500 mg/bid) to lower gastrointestinal complications and then reached 500 mg/tid and continued for 12 weeks. The subjects were asked to have a normal diet (30-35 kcal /kg/day) together with ordinary physical activity. At the end of three months (12 weeks), anthropometric indexes were re-measured and recorded. The above- mentioned lab tests were repeated. Insulin resistance was calculated and systolic diastolic BP was re- measured by the same method too. Data were expressed as mean±SD and frequency distribution. Normal distribution of the data was checked with Kolmogrov Smirnov test. Paired t-test and ANOVA by Tukey posthoc were used to investi- gate the changes in variables before and after treat- ment as well as in subgroups. Correlation among some variables was done by Pearson's bivariate corre- lation coefficient test. Data were analyzed by SPSS software (version 13.0, Chicago, IL, USA). A P- value<0.05 was considered significant. Results The age of the subjects was 22.5±4.5 years. Of 45 subjects, 12 (26.7%) had normal BMI, 19 (42.2%) were overweight and 14 (31.1%) were obese. Forty four (97.8%) had central obesity based on WHR. Comparison of the changes in anthropometric indexes before and after three months with metformin showed that hip circumference had a significant decrease while other parameters showed no significant differ- ence (Table 1). Table 2 shows the comparison of metabolic pa- rameters. Serum ferritin level had a significant de- crease (p<0.001, t=4.42). Comparison of basic and after three months treatment of hsCPR, ferritin and HOMA-IR with metformin showed that basic serum ferritin was not different between groups (normal, overweight and obese) (Not Significant). Comparison of serum ferritin , hsCRP and HOMA-IR before and after three months treatment with metformin among mentioned above sub-groups of BMI showed a signif- icant difference of HOMA-IR (p=0.04), serum ferritin (p=0.02) in normal BMI group, while there was not significant difference of hsCRP (p=0.4). In over- weight group, there was only significant difference of serum ferritin (p=0.001). There was not significant difference of parameters before and after treatment in obese sub-group. Data analysis by ANOVA showed no significant difference of CRP (p=0.8), ferritin (p=0.1) and HOMA-IR (p=0.07) among three groups of obese, non-obese and overweight subjects. 488 WWW.ircmj.com Vol 13 July 2011