Long-term metformin treatment is able to reduce the prevalence of metabolic syndrome and its hepatic involvement in young hyperinsulinaemic overweight patients with polycystic ovarian syndrome

Objective The objective of this study is to determine the ability of metformin treatment in reducing the prevalence of metabolic syndrome (MS) and its hepatic involvement in young hyperinsulinaemic overweight patients with polycystic ovarian syndrome (PCOS). Design Clinical Trial. Patients We recruited 140 hyperinsulinaemic overweight women with PCOS in their reproductive age. Metformin treatment (500 mg x 3/die) was prescribed to each patient for twelve months. Measurements The primary outcome was to evaluate the prevalence of nonalcoholic fatty liver disease (NAFLD) and MS in hyperinsulinaemic overweight patients with PCOS. The secondary outcome was to evaluate, in the same patients, the effects of metformin therapy on endocrine, metabolic and hepatic parameters. Results At basal evaluation, NAFLD was diagnosed in 81 of 140 patients with PCOS (57.85%); MS was present only in the NAFLD group (32.09% vs 0%; P < 0.001). After twelve months, metformin is able to significantly reduce, in the same group, the prevalence of MS (28.9% vs 13.5%; P < 0.01). An improvement of hepatic parameters and a significant decrease in oligomenorrhea (85.7% vs 19%, P < 0.001) were also observed. Conclusions Treatment with metformin is indicated in all hyperinsulinaemic overweight patients with PCOS, especially in those with NAFLD. These data appear even more interesting considering their increased risk to develop metabolic and hepatic complications.