Early Metformin Therapy Prevents, Delays PCOS in Girls

Girls with low birth weight and precocious puberty have improved outcomes with early metformin

MONDAY, July 11 (HealthDay News) -- Early metformin therapy in girls with low birth weight and precocious puberty (LBW-PP) prevents or delays the development of hirsutism, androgen excess, oligomenorrhea, and polycystic ovary syndrome (PCOS), according to a study published online June 1 in the Journal of Clinical Endocrinology & Metabolism.

Lourdes Ibáñez, M.D., Ph.D., from the University of Barcelona in Spain, and colleagues compared the efficacy of early versus late metformin treatment in preventing adolescent PCOS in 38 LBW-PP girls, followed up for seven years. The participants were randomly assigned to four years of no treatment (19 girls) or to early metformin (19 girls, aged 8 to 12 years). No participant received treatment in the fifth year. Those who received early metformin remained untreated in the sixth and seventh years. Others (aged 13 to 14 years) received metformin in the sixth year, and were followed up for one year without intervention. Height, weight, hirsutism score, menstrual cycle, C-reactive protein, abdominal fat partitioning, absorptiometry ovarian morphology, and PCOS were measured after the seventh year.

The investigators found that the girls treated with early-metformin were 4 cm taller, in a less pro-inflammatory state, and had less central fat distribution than late-treated metformin girls. Late-treated metformin girls had a two- to eight-fold higher prevalence of hirsutism, androgen excess, oligomenorrhea, and PCOS than early metformin girls. In girls with PCOS at age 15 the first variable to diverge at age 8 to 10 years was abdominal adiposity, compared to girls without PCOS.

"In LBW-PP girls, early metformin therapy was found to prevent or delay the development of hirsutism, androgen excess, oligomenorrhea, and PCOS more effectively than late metformin," the authors write.

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