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Cited by 126Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsAcne and Rosacea Treatments and Effects

Randomized Placebo-Controlled Trial of Metformin for Adolescents With Polycystic Ovary Syndrome

Bridger, Tracey, MacDonald, Suzanne, Baltzer, Franziska, Rodd, Celia·2006·Archives of Pediatrics & Adolescent Medicine
DOI 10.1001/archpedi.160.3.241
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Abstract

OBJECTIVE: To determine whether metformin or placebo could, in conjunction with healthy lifestyle counseling, decrease serum testosterone levels and related aberrations in adolescents with hyperandrogenism, hyperinsulinemia, and polycystic ovarian syndrome. DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: Pediatric university teaching hospital. PARTICIPANTS: Twenty-two adolescents aged 13 to 18 years with hyperinsulinemia and polycystic ovarian syndrome. INTERVENTION: Participants were randomly assigned to take a 12-week course of either metformin or placebo. MAIN OUTCOME MEASURES: Pretreatment and posttreatment oral glucose tolerance tests, fasting lipid profiles, and clinical measurements. RESULTS: There was a significant decline in mean serum testosterone concentration with metformin (-38.3 ng/dL) compared with placebo (-0.86 ng/dL) (95% confidence interval, -infinity to -0.29 for the mean difference between groups). At completion, the relative risk of menses was 2.50 times higher in the metformin group compared with the placebo (95% confidence interval, 1.12 to 5.58). Measures of insulin sensitivity, including insulin area under the curve and HOMA (homeostasis model assessment), demonstrated improvement only with metformin, but these did not reach statistical significance. High-density lipoprotein cholesterol levels increased by 6.98 mg/dL with metformin vs a decrease of -2.33 mg/dL with placebo (95% confidence interval, 0.78 to 18.23 for the mean difference between groups). There were no significant changes in body mass index, hirsutism, triglyceride levels, or total and low-density lipoprotein cholesterol levels. CONCLUSION: Metformin significantly lowered total testosterone concentrations, increased the likelihood of menses, and improved high-density lipoprotein cholesterol levels without affecting measures of insulin sensitivity or body weight.

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Crossref · 10.1001/archpedi.160.3.241

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  • Among nonobese Catalan adolescents with a history of premature pubarche, exaggerated adrenarche, and low birth weight, treatment with metformin or rosiglitazone, either before puberty or during adolescence, was reported to attenuate hyperandrogenism.

    “among nonobese Catalan adolescents with a history of premature pubarche, exaggerated adrenarche, and low birth weight, treatment with metformin or rosiglitazone, either prior to puberty or during adolescence, was reported to attenuate hyperandrogenism [138]”

    From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [138]

  • COCPs are associated with improvement in menstrual irregularity and acne according to a meta-analysis of metformin vs oral contraceptives in adolescents with PCOS.

    “Metformin at a dose of 1700 to 2000 mg/d is associated with greater improvement of BMI, and COCPs are associated with improvement in menstrual irregularity and acne according to a meta-analysis of metformin vs oral contraceptives in adolescents with PCOS and including four RCTs (170 adolescents) [164, 180–184].”

    From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [181]

  • COCPs improve menstrual irregularity in adolescents with PCOS.

    “COCPs improve menstrual irregularity in adolescents with PCOS [164, 180–184].”

    From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [181]

  • Metformin at a dose of 1700 to 2000 mg/d is associated with greater improvement of BMI according to a meta-analysis of metformin vs oral contraceptives in adolescents with PCOS and including four RCTs (170 adolescents).

    “Metformin at a dose of 1700 to 2000 mg/d is associated with greater improvement of BMI, and COCPs are associated with improvement in menstrual irregularity and acne according to a meta-analysis of metformin vs oral contraceptives in adolescents with PCOS and including four RCTs (170 adolescents) [164, 180–184].”

    From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [181]

  • Multiple observational studies and six RCTs evaluating the effect of metformin on a total of 275 adolescents with PCOS have demonstrated short-term beneficial effects mostly in adolescents with overweight/obesity.

    “There have been multiple observational studies and six RCTs evaluating the effect of metformin on a total of 275 adolescents with PCOS. These studies have demonstrated short-term beneficial effects mostly in adolescents with overweight/obesity [164, 180–183].”

    From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [181]

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Authors
Bridger, T., MacDonald, S., Baltzer, F., & Rodd, C.
Affiliations
Memorial University of Newfoundland (CA)
ORCID
Rodd, Celia
Venue
Archives of Pediatrics & Adolescent Medicine
Publisher
American Medical Association (AMA)
Published
2006-03-01
Volume
160
Issue
3
Pages
241
ISSN
1072-4710 (ISSN-L)
DOI
10.1001/archpedi.160.3.241
OpenAlex
W2023312836
Cited by
126
References
36
Citations by year
2026: 3 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 2 · 2017: 5 · 2016: 6 · 2015: 12 · 2014: 9 · 2013: 6 · 2012: 6
FWCI
13.37
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
Keywords
metformin, polycystic ovary syndrome, adolescents, hyperinsulinemia, hyperandrogenism, serum testosterone, insulin sensitivity, HOMA, HDL cholesterol, lifestyle counseling, glucose tolerance
MeSH terms
Adolescent, Double-Blind Method, Female, Glucose Tolerance Test, Humans, Hypoglycemic Agents, Insulin Resistance, Cholesterol, HDL, Metformin, Polycystic Ovary Syndrome, Testosterone

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