INFLUENCE OF METFORMIN ON THE FUNCTION OF THE THYROID GL AND IN THE TRE ATMENT OF RESISTANCE TO INSULIN IN PATIENTS WITH POLYCYSTIC OVARIES SYNDROME

Authors

  • Arkhypkina T. L. V. Danilevsky Institute of Endocrine Pathology Problems of NAMS Ukraine
  • Bondarenko V. A. V. Danilevsky Institute of Endocrine Pathology Problems of NAMS Ukraine
  • Goncharova О. А. V. Danilevsky Institute of Endocrine Pathology Problems of NAMS Ukraine
  • Lyubimovа L. P. V. Danilevsky Institute of Endocrine Pathology Problems of NAMS Ukraine

DOI:

https://doi.org/10.21856/j-PEP.2020.2.01

Keywords:

polycystic ovary syndrome, autoimmune thyroiditis, subclinical hypothyroidism, insulin resistance, treatment.

Abstract

The effect of metformin on the hormonal and carbohydrate status of 82 infertile women with polycystic
ovary syndrome (PCOS) and insulin resistance (IR) in combination with autoimmune thyroiditis (AIT) and subclinical hypothyroidism (SCH) was evaluated. Depending on the therapy (monotherapy or combination therapy), the patients were divided into groups. Monotherapy with metformin was received by 20 patients with AIT, 20 women with SCH, 20 with normal thyroid function. Combined therapy was received by 12 women with PCOS and AIT, who after three months of using metformin over the next three months, were additionally prescribed selenium-containing medication and 10 patients with AIT and SCH who were additionally prescribed seleniumcontaining medication in combination with levothyroxine at appropriate therapeutic doses according to existing recommendations.
It was established that anthropometric parameters in patients with PCOS and PCOS in combination with AIT and SCH did not differ significantly. It is proved that AIT and SCH worsen carbohydrate metabolism, help to further reduce the level of sex steroid-binding globulin and increase the free androgen index.
Treatment with metformin for six months in patients with PCOS, IR and SCH resulted in a decrease in the level of thyroid stimulating hormone (TSH) in 35% of cases, but did not change the content of free thyroxine and thyroid peroxidase antibodies (TPO antibodies) in the blood. Three months after the completion of metformin, the level of TSH increased to values that occurred at the start of therapy. The same time, metformin did not affect the indicators of thyroid function in patients with PCOS and euthyroidism and did not change the mean values of TPO antibodies. The use of complex therapy (metformin, levothyroxine and selenium-containing drug) over the past three months has been accompanied by a decrease in hyperandrogenism, a decrease in carbohydrate metabolism disorders, normalization of thyroid status, a decrease TPO antibodies levels in women with PCOS in combination with of AIT and SCH.
At women with PCOS and infertility, it is necessary to screening assessment of thyroid function in order to diagnose of the causes of infertility and timely correction of the revealed thyroid pathology.

References

Ganie MA, Laway BA, Wani TA, et al. Fertil Steril 2011; 95(6): 2039-2043. doi: http://doi.org/10.1016/j.fertnstert.2011.01.149.

Benetti-Pinto CL, Berini Piccolo VR, Garmes HM, Teatin Juliato CR. Fertil Steril 2013; 99(2): 588-592. doi: http://doi.org/10.1016/j.fertnstert.2012.10.006.

Pan’kiv VI. Praktychna tyreoi’dylogija, Donec’k, 2011: 224 p.

Singla R, Gupta Y, Khemani M, Aggarwal S. Indian J Endocrinol Metab 2015; 19(1): 25-29. doi: http://doi.org/10.4103/2230-8210.146860.

Dittrich R, Kajaia N, Cupisti S, et al. Reprod Biomed Online 2009; 19(3): 319-325.

Risk YuQ, Wang JB. Biomed Res Int 2016; 2016: 2067087.doi: http://doi.org/10.1155/2016/2067087.

Cai J, Zhang Y, Wang Y, et al. Front Endocrinol (Lausanne) 2019; 10. doi: http://doi.org/10.3389/fendo.2019.00222 .

Kosova G, Urbanek M. Mol Cell Endocrinol 2013; 373 (1-2): 29-38. doi: http://doi.org/10.1016/j.mce.2012.10.009.

Gaberљиek S, Zaletel K, Pieber T. et al. Eur J Endocrinol 2015; 172: R9-R21.

Mobeen H, Afzal N, Kashif M. Scientifica 2016; 2016: 4071735. doi: http://doi.org/10.1155/2016/4071735.

Janssen OE, Mehlmauer N, Hahn S, et al. Eur J Endocrinol 2004; 150(1): 363-369. doi: http://doi.org/10.1530/eje.0.1500363.

Ott J, Aust S, Kurz C. et al. Fertil Steril 2010; 94(7): 2895-2897.

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Fertil Steril 2004;81(1): 19-25.

De-Medeiros SF, Yamamoto MMW, de-Medeiros MAS, et al. J Reprod Infertil 2017; 18(2): 242-250.

Behboudi-Gandevani S, Ramezani Tehrani F, Rostami Dovom M, et al. Gynecol Endocrinol 2016; 32(5): 343-353. doi: http://doi.org/10.3109/09513590.2015.1117069.

Victor VM, Rovira-Llopis S, Baсuls C, et al. PLoS One 2016; 23(11): e0151960. doi: 10.1371/journal.pone.0151960.

Rezzonico J, Rezzonico M, Pusiol E, et al. Thyroid 2008; 18(4): 461-464. doi: 10.1089/thy.2007.0223.

Kimura T, Van Keymeulen A, Golstein J, et al. Endocr Rev 2001; 22(5): 631-656.

Diamanti-Kandarakis E, Economou F, Palimeri S, Christakou C. Ann N Y Acad Sci 2010; 1205: 192-198.

Vigersky RA, Filmore-Nassar A, Glass AR. J Clin Endocrinol Metab 2006; 91(1): 225-227.

Cappelli C, Rotondi M, Pirola I, et al. Eur J Endocrinol 2012; 167(2): 261-265. doi: 10.1530/EJE-12-0225.

Anil C, Kut A, Atesagaoglu B, et al. Med Princ Pract 2016; 25(3): 233-236. doi: http://doi.org/10.1159/000442821.

Enzevaei A, Salehpour S, Tohidi M, Saharkhiz N. Iran J Reprod Med 2014; 12(7): 481-486.

Al Sayed A, Al Ali N, Bo Abbas Y, Alfadhli E. Endocr J 2006; 53(5): 653-657.

Ezeh U, Pall M, Mathur R, Azziz R. Hum Reprod 2014; 29(7): 1508-1517. doi: http://doi.org/10.1093/humrep/deu096.

Duckworth W, Abraira C, Moritz T, et al. N Engl J Med 2009; 360(2): 129-139.

Nikolaev DV, Smirnov AV, Bobrinskaja IG i dr. Bioimpedansnyj analiz sostava tela cheloveka, Moskva, 2009: 392 p.

Ferriman D, Gallwey J. J Clin Endocrinol Metab 1961; 21: 1440-1447.

Morley JE, Patrics P, Perry HM. Metab Clin Experim 2002; 51(5): 554-559.

Members TF, Rydйn L, Grant PJ, et al. Eur Heart J 2013; 34(39): 3035-3087, available at: https://doi.org/10.1093/eurheartj/eht108.

Manuhin IB, Gevorkjan MA, Chagaj NB. Anovuljacija i insulinorezistentnost’, Moskva, 2006: 416 p.

Cassar S, Misso ML, Hopkins WG, et al. Hum Reprod 2016; 31(11): 2619-2631.

Gevorkjan MA, Manuhin IB, Studenaja LB, et al. ZhROAG 2008;4: 35-48.

Morgante G, Musacchio MC, Orvieto R, et al. Gynecol Endocrinol 2013; 29(11): 967-969. doi: http://doi.org/10.3109/09513590.2013.829445.

Lуpez M, Varela L, Vбzquez MJ, et al. Nat Med 2010; 16(9): 1001-1008. doi: http://doi.org/10.1038/nm.2207.

Krysiak R, Okopien B. Clin. Endocrinol (Oxf.) 2011; 75(3): 404-406. doi: http://doi.org/10.1111/j.1365-2265.2011.04058.x.

Duntas LH, Biondi B. Thyroid 2013; 23(6): 646-653. doi: http://doi.org/10.1089/thy.2011.0499.

Anil C, Kut A, Atesagaoglu B, et al. Med Princ Pract2016; 25: 233-236.

Cappelli C, Rotondi M, Pirola I, et al. Eur J Endocrinol2012; 167(2): 261-265. doi: http://doi.org/10.1530/EJE-12-0225.

Dowling RJ, Goodwin PJ, Stambolic V. BMC Med 2011;6(9): 33. doi: http://doi.org/10.1186/1741-7015-9-33.

Denver RJ. Gen Comp Endocrinol 1988; 72(3): 383-393.

Flood DE, Fernandino JI, Langlois VS. Gen Comp Endocrinol 2013; 192: 2-14. doi: http://doi.org/10.1016/j.ygcen.2013.02.038.

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Published

2021-06-30

How to Cite

Arkhypkina, T. L., Bondarenko, V. A., Goncharova О. А., & Lyubimovа L. P. (2021). INFLUENCE OF METFORMIN ON THE FUNCTION OF THE THYROID GL AND IN THE TRE ATMENT OF RESISTANCE TO INSULIN IN PATIENTS WITH POLYCYSTIC OVARIES SYNDROME. Problems of Endocrine Pathology, 72(2), 7-15. https://doi.org/10.21856/j-PEP.2020.2.01

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Section

CLINICAL ENDOCRINOLOGY

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