Metformin in normal-weight hirsute women with polycystic ovary syndrome with normal insulin sensitivity

Fifteen normal-weight (body mass index (BMI) 21.50 +/- 1.65 kg/m(2)) hirsute women with polycystic ovary syndrome and normal insulin sensitivity were treated with 850 mg metformin orally, three times daily, for 4 months. Before and at the end of the treatment, clinical data as well as serum concentrations of sex steroid hormones, gonadotropins, fasting plasma glucose and insulin, insulin resistance - homeostasis model assessment (HOMA-IR), carbohydrate tolerance and the area under the curve for insulin (AUC(insulin)) were analyzed. Three patients withdrew from the study. Seven of the remaining 12 patients presented menstrual pattern improvement, followed by ovulatory cycles at the end of the treatment period. There were no changes in BMI and hirsutism score. A significant (p < 0.05) decrease in luteinizing hormone (LH) (from 8.18 +/- 4.34 to 5.05 +/- 1.53 IU/ml), testosterone (from 104.66 +/- 27.54 to 82.00 +/- 23.05 ng/dl), fasting insulin (from 9.66 +/- 4.79 to 7.83 +/- 3.06 microIU/ml), AUC(insulin) (from 9239 +/- 3285 to 7660 +/- 2565 microUI/ml x min) and HOMA-IR (from 2.15 +/- 1.2 to 1.67 +/- 0.74), and a significant increase in follicle-stimulating hormone (FSH) (from 4.05 +/- 1.53 to 5.96 +/- 2.13 IU/ml), were observed at the end of the treatment period. A higher LH and a lower FSH predicted clinical improvement, while basal insulin and AUC(insulin) showed lower predictive value.