Abstract
Objective
To evaluate the clinical, endocrine and metabolic effects of metformin and N-acetyl-cysteine
(NAC) in patients with polycystic ovary syndrome (PCOS).
Study design
In this prospective trial, 100 women with PCOS were randomly divided to receive metformin
(500 mg p.o. three times daily) or NAC (600 mg p.o. three times daily) for 24 weeks. Hyperandrogenism, lipid profiles, hirsutism
scores, menstrual irregularity, insulin sensitivity and tumour necrosis factor-α (TNF-α)
levels were measured at baseline and after the treatment period.
Results
Both treatments resulted in a significant decrease in body mass index, hirsutism score,
fasting insulin, HOMA index, free testosterone and menstrual irregularity compared
with baseline values, and both treatments had equal efficacy. NAC led to a significant
decrease in both total cholesterol and low-density lipoprotein levels, whereas metformin
only led to a decrease in total cholesterol level. Although TNF-α levels increased
following treatment for both groups, the difference from baseline was not significant.
Conclusions
Metformin and NAC appear to have comparable effects on hyperandrogenism, hyperinsulinaemia
and menstrual irregularity in women with PCOS. The effects of metformin and NAC on
insulin sensitivity are not associated with TNF-α.
Keywords
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Article info
Publication history
Published online: July 28, 2011
Accepted:
July 11,
2011
Received in revised form:
June 11,
2011
Received:
December 8,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.