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Horm Metab Res 2010; 42(11): 815-820
DOI: 10.1055/s-0030-1262855
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Treatment of Polycystic Ovary Syndrome (PCOS) with Metformin Ameliorates Insulin Resistance in Parallel with the Decrease of Serum Interleukin-6 Concentrations

M. Luque-Ramírez1 , H. F. Escobar-Morreale1
  • 1Department of Endocrinology, Hospital Universitario Ramón y Cajal & Universidad de Alcalá & Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain, and Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Spain
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Publication History

received 23.04.2010

accepted 12.07.2010

Publication Date:
20 August 2010 (online)

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Abstract

Low-grade chronic inflammation underlies the pathogenesis of insulin-resistant disorders such as polycystic ovary syndrome (PCOS). We aimed to study if the changes observed in the insulin sensitivity of PCOS patients during treatment with oral contraceptives or metformin associate changes in the serum inflammatory markers interleukin-6 (IL-6) and interleukin-18 (IL-18). In a randomized open-label clinical trial (NLM Identifier NCT00428311), 34 PCOS patients were allocated to receive oral treatment with metformin (850 mg twice daily) or with the Diane35 Diario contraceptive pill (35 μg of ethynylestradiol plus 2 mg of cyproterone acetate) for 24 weeks. Changes in serum IL-6 and IL-18 levels and insulin sensitivity index were monitored throughout the study. Eighteen women without hyperandrogenism served as controls for serum interleukin concentrations. PCOS women treated with metformin showed a decrease in IL-6 levels throughout the study compared with women treated with Diane35 Diario (−33% change vs. +23% change, F=3.709, p=0.048; intention-to-treat analysis: F=5.569, p=0.011). There were no statistically significant changes in IL-18 concentrations with any treatment. The decrease in IL-6 levels in women receiving metformin occurred in parallel to the increase in the insulin sensitivity index (r=−0.579, p=0.048; intention-to-treat analysis, r=−0.687, p=0.001). In conclusion, serum IL-6 levels decreased during treatment with metformin in parallel to amelioration of insulin resistance, whereas oral contraceptives slightly increased circulating IL-6 levels without changing insulin sensitivity. Both drugs had a neutral effect on serum IL-18 concentrations.

Key words

hyperandrogenism - insulin resistance - insulin sensitizers - oral contraceptives - inflammation

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Correspondence

H. F. Escobar-Morreale

Department of Endocrinology

Hospital Universitario

Ramón y Cajal

Carretera de Colmenar km 9.1

28034 Madrid

Spain

Phone: +34/91/336 9029

Fax: +34/91/336 9029

Email: hescobarm.hrc@salud.madrid.org

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