Metformin and/or clomiphene do not adversely affect liver or renal function in
women with polycystic ovary syndrome.
Author(s): Aubuchon M, Kunselman AR, Schlaff WD, Diamond MP, Coutifaris C, Carson SA,
Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER,
Legro RS; Reproductive Medicine Network.
Collaborators: Barnhart K Jr, Mastroianni L, Martino L, Timbers K, Lambe L,
DeWire R, Yang H, Bodine C, Mark D, Puscheck E, Ginsburg K, Collins K, Leach R,
Yelian F, Perez M, Buster J, Amato P, Torres M, Dodson W, Gnatuk C, Ober J,
Demers L, Heller D, Colon J, Weiss G, Solnica A, Gatlin K, Hahn S, Roark M,
Blackwell R, Willis V, Love L, Laychak K, Nazmy M, Stovall D, Evans W, Turner K,
Giudice L, Chang J, Malcolm P, Coddington C, Faber K, Leppert P, Casson P, Zhang
H.
Affiliation(s): Department of Obstetrics, University of Missouri School of Medicine, Columbia,
Missouri 65212, USA.
Publication date & source: 2011, J Clin Endocrinol Metab. , 96(10):E1645-9
CONTEXT: Nonalcoholic fatty liver disease is common to insulin-resistant states
such as polycystic ovary syndrome (PCOS). Metformin (MET) is often used to treat
PCOS but information is limited as to its effects on liver function.
OBJECTIVE: We sought to determine the effects of MET on serum hepatic parameters
in PCOS patients.
DESIGN: This was a secondary analysis of a randomized, doubled-blind trial from
2002-2004.
SETTING: This multi-center clinical trial was conducted in academic centers.
PATIENTS: Six hundred twenty-six infertile women with PCOS with serum liver
function parameters less than twice the upper limit of normal were included.
INTERVENTIONS: Clomiphene citrate (n = 209), MET (n = 208), or combined (n = 209)
were given for up to 6 months.
MAIN OUTCOME MEASURE: The percent change from baseline in renal and liver
function between- and within-treatment arms was assessed.
RESULTS: Renal function improved in all treatment arms with significant decreases
in serum blood urea nitrogen levels (range, -14.7 to -21.3%) as well as
creatinine (-4.2 to -6.9%). There were similar decreases in liver transaminase
levels in the clomiphene citrate and combined arms (-10% in bilirubin, -9 to -11%
in transaminases) without significant changes in the MET arm. When categorizing
baseline bilirubin, aspartate aminotransferase, and alanine aminotransferase into
tertiles, there were significant within-treatment arm differences between the
tertiles with the highest tertile having the largest decrease from baseline
regardless of treatment arm.
CONCLUSION: Women with PCOS can safely use metformin and clomiphene even in the
setting of mildly abnormal liver function parameters, and both result in improved
renal function.
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