The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome

Yılmaz, Murat; Bukan, Neslihan; Ayvaz, Göksün; Karakoç, Ayhan; Törüner, Füsun Baloş; Çakır, Nuri; Arslan, Metin

doi:10.1093/humrep/dei258

Cited by 119 publications

(107 citation statements)

References 64 publications

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“…These findings, however, are highly variable and depend on the obesity status, diet and ethnicity of the population studied. Yilmaz et al found no positive impact on serum lipids in their 6 months study of PCOS patients, 9 similar to our study.…”

Section: Resultssupporting

confidence: 92%

Anovulatory Infertility: A Prospective Study

Bhandoria¹,

Rudra²

2013

International Journal of Infertility &Amp; Fetal Medicine

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Section: Resultssupporting

confidence: 92%

Anovulatory Infertility: A Prospective Study

Bhandoria¹,

Rudra²

2013

International Journal of Infertility &Amp; Fetal Medicine

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“…The increase of serum Hcy concentration in the metformin-treated patients was confirmed by a series of observational studies [16][17][18]20,25,[52][53][54][55][56]. These studies indicated that metformin was associated with an elevated concentration of serum Hcy compared with control treatment.…”

Section: Discussionmentioning

confidence: 79%

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang

et al. 2016

Value in Health

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Abstract:The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine (Hcy) with and without simultaneous supplementation of B-group vitamins or folic acid. A literature search was conducted in PubMed, EmBase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials (RCTs) reporting the concentration of serum Hcy in metformin-treated adults. Meta-analysis was applied to assess the association between metformin and the changes of Hcy concentration. Twelve publications were included in this study. In the overall analysis, metformin administration was not statistically associated with the change of Hcy when compared with the control treatment (mean difference (MD), 0.40 µmol/L; 95% confidence interval (CI), −0.07~0.87 µmol/L, p = 0.10). In the subgroup analysis, metformin was significantly associated with an increased concentration of Hcy in the absence of exogenous supplementation of folic acid or B-group vitamins (MD, 2.02 µmol/L; 95% CI, 1.37~2.67 µmol/L, p < 0.00001), but with a decreased concentration of serum Hcy in the presence of these exogenous supplementations (MD, −0.74 µmol/L; 95% CI, −1.19~−0.30 µmol/L, p = 0.001). Therefore, although the overall effect of metformin on the concentration of serum Hcy was neutral, our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given.

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“…The dyslipidemia of PCOS is characterized by elevated plasma levels of cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL), and triglycerides with concomitantly reduced concentrations of high density lipoproteins (HDL) [52][53][54][55] . Homocysteine levels are also higher in women with PCOS compared to controls [56][57][58][59] , and hyperhomocysteinemia represents another independent risk factor for the development of cardiovascular disease 60 . Moderate hyperhomocysteinemia predisposes individuals to endothelial dysfunction via a mechanism involving increased oxidative stress 61 .…”

Section: Cardiovascular Risksmentioning

confidence: 99%

“…Furthermore, antioxidant reserve appears to be compromised in women with PCOS 97 . Even lean women with PCOS exhibit increased oxidative stress, as measured by levels of malonyldialdehyde, a marker of lipid peroxidation, and they have decreased serum total antioxidant levels compared to controls 56 . Recent evidence suggests that inflammatory cytokines and measures of oxidative stress, such as tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) 99,100 , may play a role in the dysregulation of the theca-interstitial compartment, and both of these factors are elevated in PCOS 97,98,101,102 .…”

Section: Pathophysiology Of Pcosmentioning

confidence: 99%

Statins in the Treatment of Polycystic Ovary Syndrome

Kodaman

Dulęba²

2008

Semin Reprod Med

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Many women of reproductive age are affected by polycystic ovary syndrome (PCOS), a heterogeneous endocrinopathy characterized by androgen excess, chronic oligo-anovulation and/or polycystic ovarian morphology. In addition, PCOS is often associated with insulin resistance, systemic inflammation and oxidative stress which, on one hand, lead to endothelial dysfunction and dyslipidemia with subsequent cardiovascular sequelae and, on the other hand, to hyperplasia of the ovarian theca compartment with resultant hyperandrogenism and anovulation. While traditionally statins have been used to treat dyslipidemia by blocking HMG-CoA reductase, the rate limiting step in cholesterol biosynthesis; in fact, they possess pleiotropic actions, resulting in antioxidant, antiinflammatory and anti-proliferative effects. Statins offer a novel therapeutic approach to PCOS in that they address the dyslipidemia associated with the syndrome, as well as hyperandrogenism/ hyperandrogenemia. These actions may be due to an inhibition of the effects of systemic inflammation and insulin resistance/hyperinsulinemia. Evidence to date, both in vitro and in vivo, suggests that statins have potential in the treatment of PCOS; however, further clinical trials are needed before they can be considered a standard of care in the medical management of this common endocrinopathy.

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The effects of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with polycystic ovary syndrome

Cited by 119 publications

References 64 publications

Anovulatory Infertility: A Prospective Study

Anovulatory Infertility: A Prospective Study

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Statins in the Treatment of Polycystic Ovary Syndrome

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