Effect of Metformin on Homocysteine Levels in Lean PCOS Patients

Authors : Ülkü Özmen, Görker Sel, Ayça Görkem Mungan, Anıl Turhan Çakır, Adile Yeşim Akdemir, Mehmet Harma, Müge Harma, Aykut Barut
Pages : 318-325
View : 49 | Download : 182
Publication Date : 2025-12-31
Article Type : Research Paper
Abstract :Aim: Increased levels of homocysteine have been considered as a significant risk factor for cardiovascular disease. Elevated levels have been demonstrated in polycystic ovary syndrome (PCOS) patients, and have been found to be associated with insulin resistance in PCOS. This study aimed to determine the basal homocysteine levels and insulin sensitivity status in previously untreated lean PCOS patients and to evaluate the effect of metformin as a long term treatment modality. Material and Methods: Twenty-five lean (BMI <25kg/m2) patients with PCOS were recruited to the study. Metformin 500mg orally twice daily was administered for 6 months. Before and after initiation of the study, after 12h fasting, homocysteine, insulin, glucose, FSH, LH, estradiol, progesterone, prolactin, free testosterone levels were measured and 75g OGTTs were performed. Normality was assessed with the Shapiro-Wilk test. Paired Student’s t-test or Wilcoxon signed-rank test was used as appropriate, categorical variables were analyzed with the McNemar test, and correlations were evaluated with Spearman analysis (p<0.05). Results: Pre-treatment (pre) and posttreatment (post) homocysteine levels were within normal levels (median (min-max)) (pre:6.1μmol/L (1.2-25.3), post: 6.2μmol/L (2.0-20.0), p=0.59). Metformin treatment significantly reduced fasting blood glucose (pre:93.7±9.6mg/dL; post:84.8±8.8mg/dL, p=0.003), fasting insulin (pre: 18.1±9.5μU/mL; post: 12.3±5.2μU/mL, p=0.02), and logHOMA (pre: 0.59±0.16, post: 0.37±0.17, p<0.001) values. Conclusion: Homocystein levels were within normal range in previously untreated lean PCOS patients. Insulin resistance was present in significant proportion of patients which also decreased after treatment. However, metformin treatment had no significant effect on homocysteine values.
Keywords : Homosistein, Polikistik over sendromu, Metformin, İnsulin direnci

ORIGINAL ARTICLE URL