Sustained Metabolic Improvements with Low-Dose Metformin Combined with Oral Contraceptives in Female Adolescents with PCOS: A Single-Center Retrospective Cohort Study
Abstract
INTRODUCTION: This study aimed to evaluate metformin treatment's immediate and long-term efficacy in adolescent patients with polycystic ovary syndrome (PCOS) and hyperinsulinemia and the subsequent metabolic evolution post-treatment discontinuation.
METHODS: This single-center, retrospective cohort study included 168 adolescent girls (12-17 years) diagnosed with PCOS between December 2018 and August 2024. All participants underwent an oral glucose tolerance test to evaluate insulin sensitivity and were stratified into two groups: patients with normal insulinemia (n = 21) and patients with hyperinsulinemia (n = 147). Patients with hyperinsulinemia were offered low-dose metformin (500 mg twice daily); 80 accepted and formed the treatment arm, while 53 declined and served as controls. Simultaneously, every subject received a continuous regimen of combined oral contraceptives (COCs) (30 µg ethinyl estradiol/3 mg drospirenone). Clinical, biochemical, and ultrasound assessments were conducted at baseline, at regular intervals during therapy, at the end of treatment, and at least 24 months after metformin discontinuation to evaluate immediate and long-term outcomes.
RESULTS: Metformin therapy yielded favorable body mass index, insulin sensitivity, and androgenic profile outcomes. Remarkably, these benefits persisted beyond the cessation of treatment. Metformin responders showed a ≥ 20% decrease in the insulin area under the curve values post-treatment. Our investigation revealed a…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 147 participants or records.
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