摘要
The effects of metformin treatment on soluble leptin receptor (sOB-R) levels in women with polycystic ovary syndrome (PCOS) were investigated.This prospective and open-label study was conducted by the Department of Obstetrics & Gynecology at Union Hospital,Tongji Medical College of Huazhong University of Science and Technology,China.Fifty-five women with PCOS and insulin resistance (IR) were treated with metformin for 6 months.According to body mass index (BMI),the patients were divided into two groups:lean PCOS group (BMI <23 kg/m^2,n=34) and overweight or obese PCOS group (BMI >23 kg/m^2,n=21).Before and after treatment,serum luteinizing hormone (LH),follicle stimulating hormone (FSH),testosterone (T),androstenedione (A),dehydroepiandrosterone sulfate (DHEAS),insulin and sOB-R levels were determined.Thirty-one BMI-matched ovulatory women served as controls.The results showed:(1) The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR),androgen levels and hirsutism scores were higher,and sOB-R levels were lower in PCOS groups than in control group.A subgroup analysis of lean and overweight or obese PCOS patients revealed there was significant difference in sOB-R level between lean PCOS group and overweight or obese PCOS group.There were no significant differences in anthropometric parameters between lean PCOS patients and BMI-matched controls.However,sOB-R level was significantly lower in lean PCOS women than in controls.(2) There was no correlation between sOB-R level and BMI,waist and hip circumference,total testosterone,androstendione,DHEAS,LH or hirsutism scores in PCOS patients,but there was a significant negative correlation between sOB-R and HOMA-IR.(3) After treatment with metformin for 6 months,serum insulin levels decreased,and sOB-R levels increased significantly (P<0.01).It was suggested that considering low sOB-R levels supposedly compensate diminished leptin action,PCOS per se might cause leptin resistance.It is likely that reduction of hyperinsulinemia produced by metformin effectively improves the sOB-R levels in PCOS.
