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Role of adiponectin and its receptor in prediction of reproductive outcome of metformin treatment in patients with polycystic ovarian syndrome
Author(s) -
Hamed Hossam O.
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12101
Subject(s) - medicine , metformin , adiponectin , insulin resistance , endocrinology , adiponectin receptor 1 , polycystic ovary , ovulation , insulin , hormone
Aims The aim of this study was to examine the effect of metformin on serum adiponectin and adiponectin receptor‐1 ( AdipoR1 ) and evaluate their role in prediction of ovulation in patients with polycystic ovarian syndrome ( PCOS ). Material and Methods The study cohort included 68 PCOS patients with clomiphene citrate resistance (group 1) and 28 healthy women as controls (group 2). Baseline serum adiponectin, AdipoR1 , total testosterone ( T ), and homeostasis model of insulin resistance ( HOMA‐IR ) were measured in all participants. Group 1 received metformin (1500 mg/day) for 6 months followed by second blood sampling. Results Group 1 had significantly lower baseline adiponectin and AdipoR1 ( P = 0.001) compared to group 2. During treatment, metformin resulted in conception in 5/68 (7%), ovulation in 33/68 (48%) and regular cycles in 41/68 (60%) patients. Group 1 showed post‐metformin higher adiponectin and AdipoR1 ( P = 0.01) and lower HOMA‐IR ( P = 0.006) and T ( P = 0.001) compared to pre‐treatment levels. Post‐metformin ovulatory patients had higher adiponectin and AdipoR1 and lower HOMA‐IR and T compared to anovulatory patients. Multivariate regression analysis in group 1 showed that only T and HOMA‐IR were significant independent factors for predicting ovulatory cycles during metformin treatment ( P = 0.04 and P = 0.05, respectively). Conclusions Metformin treatment enhances both adiponectin activity and insulin sensitivity, resulting in a less hyperandrogenic state in patients with PCOS . Serum adiponectin and AdipoR1 are poor predictors of ovulatory outcome during treatment.