Clinical trial NCT04566718: A Treatment Legacy Effect of Metformin in Obese Women With PCOS
Official title: A Treatment Legacy Effect of Metformin on Metabolic and Endocrine Parameters in Obese Women With Polycystic Ovary Syndrome (PCOS)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: PCOS
Keywords: PCOS
obesity
metformin
Lead sponsor: University Medical Centre Ljubljana
Sponsor class: OTHER
First posted: 2020-09-28
Enrollment: 40
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The investigators conducted 20 obese women with PCOS with normal glucose homeostasis (without known type 1 or type 2 diabetes mellitus) who have been treated with metformin for one year prior to the study and 20 obese women with PCOS with normal glucose homeostasis (without known type 1 or type 2 diabetes mellitus) who have been treated with metformin for at least three years prior to the study.

Brief summary: Metformin has multiple health promoting effects and it may serve as a preventive measure for individuals who are at high risk for metabolic complications.

According to the latest international guidelines it should be considered as an adjunct therapy to lifestyle intervention in all overweight/obese women with PCOS, independently of their glucose homeostasis and menstrual regularity. However, there is no clear answer for how long metformin should be prescribed in this subset of women with PCOS and for how long the beneficial impact would sustain after treatment cessation.

The investigators compared the consequences of metformin withdrawal after long-term therapy as opposed to the consequences of metformin suspension after short term therapy in overweight/obese women with PCOS that had previously responded to metformin by means of moderate weight loss, improved menstrual frequency and sustained normal glucose homeostasis.


Eligibility criteria: Inclusion Criteria:

* PCOS defined by the National Institute of Child Health and Human Development (NICHD) criteria
* obesity with body mass index ≥ 30 kg/m2
* normal glucose homeostasis at metformin treatment

Exclusion Criteria:

* known type 1 or type 2 diabetes mellitus
* heart failure
* renal insufficiency with serum creatinine more than 125 umol/L
* arterial hypertension
* pregnancy
* BMI below 25 kg/m2

Primary outcomes:
measure: The main outcome was change in body weight.
timeFrame: Patient's body weight was measured at the base point and at the endpoint of 6 months of clinical trial.
measure: The main outcome was change in insulin resistance measured with homeostasis model assessment (HOMA IR).
timeFrame: HOMA IR was calculated at the base point and at the endpoint of 6 months of clinical trial.
measure: The main outcome was change in expression of glucose transporter type 4 (GLUT-4) in adipose tissue.
timeFrame: We did adipose tissue needle biopsy at the base point and at the endpoint of 6 months of clinical trial. All samples were frozen and then analysed together after end point of the study.
Secondary outcomes:
Other outcomes:
Locations:
city: Ljubljana
country: Slovenia
facility: University Medical Center Ljubljana
Study officials:
References:
citation: Kravos NA, Janez A, Goricar K, Dolzan V, Jensterle M. Effects of metformin withdrawal after long and short term treatment in PCOS: observational longitudinal study. Diabetol Metab Syndr. 2021 Apr 12;13(1):43. doi: 10.1186/s13098-021-00660-5.