OC/Metformin Combo Betters Lipids in PCOS


WASHINGTON — A combination of metformin and the oral contraceptive Ortho Tri-Cyclen improves lipid profiles more than does an oral contraceptive alone in patients with polycystic ovary syndrome, according to preliminary data from a small pilot study presented at the annual meeting of the Androgen Excess and PCOS Society.

In this randomized, double-blind, placebo-controlled study, Dr. Pauline Essah of Virginia Commonwealth University, Richmond, and colleagues assigned 17 women with PCOS to an OC plus 500 mg of metformin three times daily or an OC plus a placebo three times daily.

After 3 months, there was no difference between the two groups in weight, BMI, fasting insulin, or fasting glucose measurements. However, the OC-metformin group experienced a trend toward higher HDL cholesterol (55.6 vs. 47.6 mg/dL) and lower triglyceride levels (86.8 vs. 152.7 mg/dL) compared with the group that took OCs alone. The combination group also demonstrated a significant increase in acute insulin response to glucose.

Also, patients in the OC-metformin group “went from 4.7% to 9.4% in flow-mediated dilatation,” a significant improvement, while patients in the OC-alone group did not experience a significant change, Dr. Essah said. “The combination seems to be more beneficial than OC monotherapy because it enhances beta-cell function and endothelial function, and improvements in these factors may attenuate the cardiovascular risks from OCs.” The study was funded by the National Institutes of Health. Dr. Essah said she had no financial conflicts of interest to report.

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