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 .
Effects of an antiandrogenic oral contraceptive pill compared with metformin on blood coagulation tests and endothelial function in women with the polycystic ovary syndrome: influence of obesity and smoking.
OBJECTIVE To study the blood clotting tests and endothelial function of polycystic ovary syndrome ( PCOS ) patients and non-hyper and rogenic women , and their changes during PCOS treatment , as a function of the presence of obesity and smoking . DESIGN Case-control study followed by a r and omized clinical trial . METHODS Blood clotting and endothelial function were analyzed in 40 PCOS patients and 20 non-hyper and rogenic women . Thirty-four PCOS women were r and omized to an oral contraceptive containing 35 microg ethinyl-estradiol plus 2 mg cyproterone acetate ( Diane(35)Diario ) or metformin ( 850 mg twice daily ) , monitoring the changes on these parameters during 24 weeks of treatment . The influence of obesity and smoking was also analyzed . RESULTS Blood clotting and endothelial function tests were similar among PCOS patients and controls with the exception of a higher platelet count in the former . Obesity increased circulating fibrinogen levels , prothrombin activity and platelet counts , and reduced prothrombin and activated partial thromboplastin times . Smoking increased fibrinogen levels , platelet counts , and prothrombin activity , and reduced prothrombin time , in relation to the larger waist circumference of smokers . Irrespective of the treatment received , PCOS patients showed a decrease in prothrombin time and an increase in prothrombin activity , with a parallel increase in homocysteine levels in metformin users . The activated partial thromboplastin time decreased markedly in the patients treated with Diane(35)Diario . Finally , flow-mediated dilation improved in non-smokers irrespective of the drug received , but worsened in smokers . CONCLUSIONS Oral contraceptives and metformin may exert deleterious effects on blood clotting tests of PCOS women , yet the effects of metformin appear to be milder . Because smoking potentiates some of these effects and deteriorates endothelial function , smoking cessation should be promoted in 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 .