Assessing the Effects of Metformin on Lipid Metabolism in Women with PCOS

Metformin on Lipid Metabolism in PCOS

Authors

  • Sanodia Afridi Department of Obstetrics and Gynaecology, Health Net Hospital, Peshawar, Pakistan
  • Shabina Saifullah Department of Chemical Pathology, Peshawar Medical College, Peshawar, Pakistan
  • Shaikh Fahad Falah Department of Pharmacology, Khyber Girls Medical College, Peshawar, Pakistan
  • Falak Naz Department of Pharmacology, North West School of Medicine, Peshawar, Pakistan
  • Shafiq Ahmad Department of Pharmacology, Khyber Medical University Institute of Dental Sciences, Kohat, Pakistan
  • Asma Shaukat Department of Pharmacology, Women Medical College, Abbottabad, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i5.2980

Keywords:

Polycystic Ovary Syndrome, Metformin, Insulin Resistance, Hormonal Imbalance

Abstract

Polycystic ovary syndrome (PCOS) is a prevalent hormonal imbalance condition that is linked with insulin resistance and abnormal lipid metabolism. Metformin is a common drug given in the management of PCOS; the impact on the lipid profile and the role of adherence to therapy are not established. Objectives: To assess the therapeutic effects of Metformin on lipid profile, hormonal status, and insulin resistance in PCOS while exploring the influence of patient adherence on overall treatment response. Methods: One hundred and ten women with a diagnosis of PCOS in Health Net Hospital, Peshawar, were given Metformin (1500 mg/day) for six months. The assessments for the study included lipid profile, glucose, insulin level, HOMA-IR, and hormonal profiling both at baseline and after the treatment. Treatment adherence was evaluated with pill count and attendance to follow-up visits. Pre- and post-comparisons were done using paired t-tests, while group differences were examined using independent t-tests and chi-square tests. Results: Metformin significantly reduced total cholesterol (199.43 to 167.60 mg/dL, p<0.001), LDL-C (131.71 to 111.20 mg/dL, p<0.001), triglycerides (178.15 to 149.66 mg/dL, p<0.001), and VLDL-C (35.72 to 30.03 mg/dL, ‘p<0.001’), while HDL-C increased (39.70 to 45.24, p<0.001)’. Insulin resistance and androgen levels also improved, with greater benefits observed in adherent participants. Conclusions: It was concluded that metformin positively impacts lipid metabolism, hormonal levels, and insulin responsiveness in patients with PCOS. Adherence significantly enhances therapeutic outcomes, emphasizing the need for strategies that promote consistent medication use.

References

Stener-Victorin E, Teede H, Norman RJ, Legro R, Goodarzi MO, Dokras A et al. Polycystic Ovary Syndrome. Nature Reviews Disease Primers. 2024 Apr; 10(1): 27. doi: 10.1038/s41572-024-00511-3.

Abdalla MA, Shah N, Deshmukh H, Sahebkar A, Östlundh L, Al-Rifai RH et al. Impact of Metformin on the Clinical and Metabolic Parameters of Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Therapeutic Advances in Endocrinology and Metabolism. 2022 Oct; 13: 20420188221127142. doi: 10.1177/20420188221127142.

Soldat-Stanković V, Popović-Pejičić S, Stanković S, Prtina A, Malešević G, Bjekić-Macut J et al. The Effect of Metformin and Myoinositol on Metabolic Outcomes in Women with Polycystic Ovary Syndrome: Role of Body Mass and Adiponectin in A Randomized Controlled Trial. Journal of Endocrinological Investigation. 2022 Mar: 1-3.doi: 10.1007/s40618-021-01691-5.

Bahadur A, Arora H, Ravi AK, Naithani M, Bahurupi Y, Chaturvedi J et al. Comparison of Clinical, Metabolic and Hormonal Effects of Metformin Versus Combined Therapy of Metformin with Myoinositol Plus D-Chiro-Inositol in Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial. Cureus. 2021 Jun; 13(6). doi: 10.7759/cureus.15510.

Peña AS, Witchel SF, Boivin J, Burgert TS, Ee C, Hoeger KM et al. International Evidence-Based Recommendations for Polycystic Ovary Syndrome in Adolescents. BioMed Central Medicine. 2025 Mar; 23(1): 151. doi: 10.1186/s12916-025-03901-w.

Zhu D, Chen Y, Huang J, Deng H, Shen X, Lu D et al. Effects of Metformin on Pregnancy Outcome, Metabolic Profile, and Sex Hormone Levels in Women with Polycystic Ovary Syndrome and Their Offspring: A Systematic Review and Meta-Analysis. Annals of Translational Medicine. 2022 Apr; 10(7): 418. doi: 10.21037/atm-22-909.

Goldberg RB, Orchard TJ, Crandall JP, Boyko EJ, Budoff M, Dabelea D et al. Effects of Long-Term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. Circulation. 2022 May; 145(22): 1632-41. doi: 10.1161/CIRCULATIONAHA.121.056756.

Duică F, Dănilă CA, Boboc AE, Antoniadis P, Condrat CE, Onciul S et al. Impact of Increased Oxidative Stress on Cardiovascular Diseases in Women with Polycystic Ovary Syndrome. Frontiers in Endocrinology. 2021 Feb; 12: 614679. doi: 10.3389/fendo.2021.614679.

Trolle B, Flyvbjerg A, Kesmodel U, Lauszus FF. Efficacy of Metformin in Obese and Non-Obese Women with Polycystic Ovary Syndrome: A Randomized, Double-Blinded, Placebo-Controlled Cross-Over Trial. Human Reproduction. 2007 Nov; 22(11): 2967-73. doi: 10.1093/humrep/dem271.

Chow SC, Shao J, Wang H, Lokhnygina Y. Sample Size Calculations in Clinical Research. Chapman and Hall/CRC. 2017 Aug. doi: 10.1201/9781315183084.

Lwanga SK, Lemeshow S, World Health Organization. Sample Size Determination in Health Studies: A Practical Manual/SK Lwanga and S. Leme show. In Sample Size Determination in Health Studies: A Practical Manual/SK Lwanga and S. Lemeshow. 1991.

Joham AE, Norman RJ, Stener-Victorin E, Legro RS, Franks S, Moran LJ et al. Polycystic Ovary Syndrome. The Lancet Diabetes and Endocrinology. 2022 Sep; 10(9): 668-80. doi: 10.1016/S2213-8587(22)00163-2.

Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Endocrine Practice. 2016 Jul; 22: 1-203. doi: 10.4158/EP161365.GL.

Osterberg L and Blaschke T. Adherence to Medication. New England Journal of Medicine. 2005 Aug; 353(5): 487-97. doi: 10.1056/NEJMra050100.

Guan C, Zahid S, Minhas AS, Ouyang P, Vaught A, Baker VL et al. Polycystic Ovary Syndrome: A “Risk-Enhancing” Factor for Cardiovascular Disease. Fertility and Sterility. 2022 May; 117(5): 924-35. doi: 10.1016/j.fertnstert.2022.03.009.

Long DE, Peck BD, Tuggle SC, Villasante Tezanos AG, Windham ST, Bamman MM et al. Associations of Muscle Lipid Content with Physical Function and Resistance Training Outcomes in Older Adults: Altered Responses with Metformin. Geroscience. 2021 Apr; 43: 629-44. doi: 10.1007/s11357-020-00315-9.

Xing C, Zhao H, Zhang J, He B. Effect of Metformin Versus Metformin Plus Liraglutide On Gonadal and Metabolic Profiles in Overweight Patients with Polycystic Ovary Syndrome. Frontiers in Endocrinology. 2022 Aug; 13: 945609. doi: 10.3389/fendo.2022.945609.

Xing C, Zhang J, Zhao H, He B. Effect of Sex Hormone-Binding Globulin on Polycystic Ovary Syndrome: Mechanisms, Manifestations, Genetics, and Treatment. International Journal of Women's Health. 2022 Feb: 91-105. doi: 10.2147/IJWH.S344542.

Aziz M. Investigating The Effects of Metformin and Inositol in the Treatment of Polycystic Ovary Syndrome: A Research Protocol. Undergraduate Research in Natural and Clinical Science and Technology Journal. 2023 Aug; 7: 1-9. doi: 10.26685/urncst.473.

Shpakov AO. Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms. Pharmaceuticals. 2021 Jan; 14(1): 42. doi: 10.3390/ph14010042.

Kravos NA, Janež A, Goričar K, Dolžan V, Jensterle M. Effects of Metformin Withdrawal After Long and Short Term Treatment in PCOS: Observational Longitudinal Study. Diabetology and Metabolic Syndrome. 2021 Dec; 13: 1-9. doi: 10.1186/s13098-021-00660-5.

Mendpara V, Ganampet NR, Afroze S, Gnanasekaran S, Sahu S, Atikah R et al. Long-Term Effects of Treatment Modalities on Metabolic Health, Fertility Outcomes, and Cardiovascular Risks in Lean Women with Polycystic Ovary Syndrome (PCOS): A Systematic Review. 2023. doi: 10.21203/rs.3.rs-3360467/v1.

Downloads

Published

2025-05-31
CITATION
DOI: 10.54393/pjhs.v6i5.2980
Published: 2025-05-31

How to Cite

Afridi, S., Saifullah, S., Falah, S. F., Naz, F., Ahmad, S., & Shaukat, A. (2025). Assessing the Effects of Metformin on Lipid Metabolism in Women with PCOS: Metformin on Lipid Metabolism in PCOS. Pakistan Journal of Health Sciences, 6(5), 104–109. https://doi.org/10.54393/pjhs.v6i5.2980

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)