Key result
Metformin fails to alter follistatin or oxyntomodulin levels vs placebo in women with PCOS.
Why the study?
Whether treatment with metformin affects circulating levels of oxyntomodulin in patients with PCOS was not known.
Does metformin alter follistatin and oxyntomodulin levels in patients with PCOS?
RCT (n=45)
Double-blind
Parallel
Yes
Does metformin alter follistatin and oxyntomodulin levels in patients with PCOS?
Absolute Event Rate: 0.04% vs 0.02%
p-value: p=0.497
Metformin treatment for 60 days does not significantly alter follistatin and oxyntomodulin levels in patients with PCOS.
Metformin does not alter follistatin or oxyntomodulin in PCOS; challenges mediation via these pathways and directs research to alternatives.
Background: An abnormal secretion of incretins, specially Glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and oxyntomodulin (OXM), have been described in subjects with Type 2 diabetes mellitus and PCOS. OXM has important actions in the metabolism including the ability to reduce food intake and improve insulin secretion reducing the liver fat accumulation. Metformin is an insulin-sensitizing hypoglycemic drug and is widely used in the treatment of PCOS. Whether treatment with metformin may affect circulating levels of OXM is not known and is the subject of this study. Design: a secondary analysis, randomized double-blind clinical trial. Methods: Forty-five patients with PCOS were recruited, divided into one group that received metformin (n=21) and one group who received placebo (n=24) to evaluate the levels of follistatin and oxyntomodulin before and after the use of metformin (1500mg/day). Blood levels of oxyntomodulin and follistatin were evaluated by ELISA tests. Results: At the end of the study, 20 patients were evaluated, 5 (25%) from the group using metformin and 15 (75%) from the placebo group. There was no significant difference in the variation in follistatin and oxyntomodulin levels between the metformin and placebo groups. There was a significant difference in follistatin levels among participants with hyperandrogenic and non-hyperandrogenic phenotype. There was no significant difference in oxyntomodulin levels in the different phenotypes. Conclusion: The use of metformin for 60 days did not alter follistatin and oxyntomodulin levels, and there was a significant difference between the follistatin values in hyperandrogenic and non-hyperandrogenic phenotypes. Trial registration: Brazilian Registration Platform for Clinical Studies - REBEC -ID RBR-47tvky / Brazilian Health Ministry- ID 17127713.2.0000.5149.
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Damasceno et al. (2023) conducted an RCT in Polycystic Ovary Syndrome (PCOS) (n=45). Metformin vs. Placebo was evaluated on Variation in follistatin levels (p=0.497). Metformin treatment for 60 days did not significantly alter follistatin or oxyntomodulin levels compared to placebo in women with Polycystic Ovary Syndrome.
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