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Contraceptives plus lifestyle control effective against PCOS effects on glucose, lipid metabolism

27 Jun 2019

Use of oral contraceptive agents in combination with metformin or lifestyle changes appears to effectively reduce the adverse impact of polycystic ovary syndrome (PCOS) on glucose and lipid metabolism in overweight women, according to the results of a network meta-analysis.

The study included 20 trials involving 12 kinds of interventions, as follows: metformin, 2-mg cyproterone acetate plus 0.05-mg ethinylestradiol (EE/CA), 0.15-mg desogestrel plus 0.03-mg ethinylestradiol (EE/DSG), and 3-mg drospirenone plus 0.03-mg ethinylestradiol (EE/DRSP), lifestyle, exercise, diet, metformin + lifestyle, metformin + diet, EE/CA + lifestyle, metformin + EE/CA, and EE/DRSP + lifestyle.

Pooled data showed that some of the interventions produced significant reductions in total cholesterol (TC) levels compared with placebo: metformin + lifestyle (mean difference [MD], –2.04, 95 percent CrI, –3.64 to –0.41), EE/CA + lifestyle (MD, –2.23, –4.11 to –0.35) and EE/DRSP + lifestyle (MD, –2.59, –4.66 to –0.50). On the other hand, the following led to improvements in low-density lipoprotein cholesterol (LDL-C) levels: metformin + lifestyle (MD, –1.82, –2.88 to –0.79), EE/CA + lifestyle (MD, –2.25, –3.58 to –1.08) or EE/DRSP + lifestyle (MD, –2.29, –3.69 to –1.07).

In terms of homeostasis model assessment of insulin resistance (HOMA-IR) and total triglycerides (TG), none of the interventions significantly differed with placebo. However, the surface cumulative rank curve revealed that metformin + lifestyle might be the best intervention with respect to improving HOMA-IR, while EE/DRSP + lifestyle proved to be the most effective for reducing TC and LDL-C. Finally, the metformin + diet intervention trumped all the other interventions for reducing TG levels.

According to the researchers, the present data should provide clinical guidance for the treatment of PCOS. Therefore, large-scale clinical trials are warranted to examine the appropriate dosage of metformin, exercise volume and dietary control.

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Most Read Articles
13 Jul 2019
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Pearl Toh, 4 days ago
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
13 Jul 2019
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.
4 days ago
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.