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Metformin Can Prevent Girls with Insulin Resistance from Developing Polycystic Ovary Syndrome: Presented at ENDO

By Mike Fillon

NEW ORLEANS, LA -- June 21, 2004 -- Early use of metformin in girls with insulin resistance can decrease the progression to polycystic ovary syndrome (PCOS), a common female endocrine disorder.

It is estimated that 5% to 10% of women of reproductive aged suffer from PCOS. Symptoms of this condition, which increases a woman's risk for developing diabetes and cardiovascular disease, include excess hair growth, irregular menstruation and central body obesity.

Results of the study were reported here June 18th in a clinical oral session at the 86th Annual Meeting of The Endocrine Society.

In young girls, early signs of PCOS, which can increase the risk of cardiovascular disease and diabetes as they age, include hyperinsulinemia, exaggerated increase in adrenal gland activity, high cholesterol and upper-body obesity. The new study is the first to show that intervention in young girls can prevent the development of PCOS.

Lead investigator Lourdes Ibanez, MD, Endocrinology Unit, University of Barcelona, Barcelona, Spain, and colleagues randomized 28 nonobese, prepubertal 8-year-old girls who were born with low birthweight and had early signs of PCOS to metformin 425 mg/day before puberty or placebo.

A second group of 24 postpubertal 13-year-old girls who were born with low birthweight and had early signs of PCOS were treated with metformin 850 mg/day for 12 months, and the researchers examined the effects on the girls' metabolism for 6 months after treatment discontinuation.

The results showed that metformin treatment greatly benefits young girls with early insulin resistance. The untreated girls developed more upper body fat and experienced a worsening of endocrine-metabolic markers. Girls who were treated with metformin had a reduction in abdominal fat mass (P <.0001) and in levels of several PCOS markers -- circulating sex hormone-binding globulin, dehydroepiandrosterone sulfate, androstenedione, triglycerides and adiponectin (P <.01). Height gain over 6 months was similar in both groups.

"In the girls who stopped treatment with metformin, all beneficial effects reversed within 6 months," Dr. Ibanez said. "Additionally, girls who began treatment with metformin experienced a rapid improvement in their condition. These results indicate that prepubertal girls can benefit from metformin treatment. At the same time, in both young girls and older adolescents, the discontinuation of metformin treatment can result in a rapid decline in clinical benefits."


[Presentation title: "Towards Prepubertal Prevention of Polycystic Ovary Syndrome (PCOS): Metformin Therapy Reverses Early PCOS Features in Girls (8 y) with Low Birthweight and Precocious Pubarche." Abstract #OR31-1]

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