Lipids in polycystic ovary syndrome: Role of hyperinsulinemia and effects of metformin

Objective Patients with polycystic ovary syndrome frequently suffer from hyperinsulinemia and adverse lipid profile. This study evaluated effects of metformin on lipid profile. Study design Lipid profiles in hyperinsulinemic (n = 43) and normoinsulinemic (n = 45) subjects were compared. Hyperinsulinemic subjects were treated with metformin (500 mg po tid) and lipid profiles were reevaluated at 3 and 6 months of treatment. Results The hyperinsulinemic group had significantly lower high-density lipoprotein (HDL) (by 11%), higher total cholesterol to HDL ratio (by 23%), and greater triglycerides (by 57%) than the normoinsulinemic group. Six-month metformin therapy in hyperinsulinemic women was associated with a significant decrease of insulin level (by 35%), total cholesterol (by 11%), low-density lipoprotein (LDL) (by 12%), and triglycerides (by 33%). Levels of lipids in hyperinsulinemic women after metformin therapy were comparable to levels observed in normoinsulinemic subjects. Conclusion The present study supports the notion that metformin may be considered as a prophylactic therapy lowering cardiovascular risk factors in hyperinsulinemic women with polycystic ovary syndrome.