Therefore , although the overall effect of metformin on the concentration of serum Hcy was neutral , our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given
The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine ( Hcy ) with and without simultaneous supplementation of B-group vitamins or folic acid .
The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome.
BACKGROUND Oxidative stress and hyperhomocysteinaemia are risk factors for cardiovascular diseases . The aim of this study was to assess the effects of rosiglitazone and metformin on cardiovascular disease risk factors such as insulin resistance , oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome ( PCOS ) . METHODS Fifty lean patients ( BMI < 25 kg/m2 ) with PCOS and 35 healthy subjects were included this study . Serum homocysteine , sex steroids , fasting insulin , fasting glucose and lipid levels were measured . Total antioxidant status ( TAS ; combines concentrations of individual antioxidants ) and malonyldialdehyde concentration ( MDA ) were determined . Insulin resistance was evaluated by using the homeostasis model insulin resistance index ( HOMA-IR ) , quantitative insulin sensitivity check index ( QUICKI ) , Area under the curve insulin ( AUCI ) and the insulin sensitivity index ( ISI ) . Patients were divided into two groups . One group was treated with metformin ( n = 25 ) and the other received rosiglitazone ( n = 25 ) for 12 weeks . All measurements were repeated at the end of 12 weeks . RESULTS Compared with healthy women , those with PCOS had significantly elevated serum MDA , homocysteine , HOMA-IR , AUCI and lipoprotein a levels , and significantly decreased serum TAS , QUICKI and ISI . Serum free testosterone levels showed a significant positive correlation with MDA , AUCI and HOMA-IR , and a negative correlation with TAS , ISI and QUICKI in PCOS patients . HOMA-IR and AUCI significantly decreased , while QUICKI and ISI significantly increased after treatment in both groups . Serum TAS level increased and serum MDA level decreased after the rosiglitazone treatment , but these parameters did not change after the metformin treatment . Serum homocysteine and lipid levels did not change in either group , while serum and rogen levels and LH/FSH ratio significantly decreased after the treatment period in only the rosiglitazone-treated group . CONCLUSION Elevated insulin resistance , oxidative stress and plasma homocysteine levels and changes in serum lipid profile ( risk factors for cardiovascular disease ) were observed in lean PCOS patients .  Rosiglitazone seemed to decrease elevated oxidative stress when compared with metformin treatment in lean PCOS patients
Therefore , although the overall effect of metformin on the concentration of serum Hcy was neutral , our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given
The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine ( Hcy ) with and without simultaneous supplementation of B-group vitamins or folic acid .