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 .
Homocysteine levels in women with polycystic ovary syndrome treated with metformin versus rosiglitazone: a randomized study.
BACKGROUND Elevated levels of plasma homocysteine ( Hcy ) have been implicated as a significant risk factor for cardiovascular disease . Although long-term treatment with metformin can increase Hcy levels in patients with type II diabetes mellitus or coronary heart disease , it is becoming an increasingly accepted and widespread medication in polycystic ovary syndrome ( PCOS ) . In the literature , only one study has demonstrated that metformin increases Hcy levels in PCOS patients , but the effect of other insulin sensitizers on Hcy levels have not been reported previously in women with PCOS . We aim ed to assess the effects of metformin and rosiglitazone on plasma Hcy levels in patients with PCOS . METHODS Thirty women were r and omized to two groups : 15 women in group 1 received 850 mg of metformin twice daily for 3 months . In group 2 , 15 women received 4 mg of rosiglitazone for 3 months . In both groups , body mass index , menstrual pattern , and plasma total Hcy , insulin , glucose and lipid metabolism parameters were recorded at baseline and at 3 months . RESULTS Hcy levels increased from 8.93+/-0.49 to 11.26+/-0.86 micromol/l ( P = 0.002 ) and from 10.70+/-0.86 to 12.36+/-0.81 micromol/l ( P = 0.01 ) in the metformin and rosiglitazone groups , respectively . Apolipoprotein ( Apo ) A1 levels increased from 127.10+/-6.85 to 145.7+/-7.18 mg/dl ( P = 0.018 ) in the metformin group . Total cholesterol ( total-C ) , high-density lipoprotein cholesterol ( HDL-C ) , low-density lipoprotein cholesterol ( LDL-C ) , lipoprotein ( a ) and Apo B levels decreased in the metformin group , but the change was not significant . Total-C levels decreased from 161.15+/-8.94 to 150.23+/-8.73 mg/dl ( P = 0.026 ) , HDL-C decreased from 43.13+/-2.65 to 39.15+/-2.52 mg/dl ( P = 0.005 ) and LDL-C levels decreased from 93.83+/-6.06 to 80.7+/-2.30 mg/dl ( P = 0.021 ) in the rosiglitazone group . CONCLUSION Treatment with insulin sensitizers in women with PCOS may lead to increases in Hcy levels
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 .