Metformin may reverse PCOS in some girls.(Gynecology)

NEW ORLEANS -- Metformin appeared to reverse the features of polycystic ovary syndrome when given to prepubertal girls with a history of low birth weight and precocious puberty in two small randomized studies.

When metformin was withdrawn from these girls after puberty, however, the beneficial changes were reversed within 6 months, Lourdes Ibanez, M.D., said at the annual meeting of the Endocrine Society.

Dr. Ibanez of the University of Barcelona, Spain, reported on two small randomized studies of metformin treatment in girls with a combined history of low birth weight and precocious puberty. The first study randomized 33 prepubertal girls to either no therapy or to 425 mg of metformin daily for 6 months. The second was a randomized crossover trial: 24 postpubertal girls received either no therapy or 850 mg metformin daily for 12 months, after which the groups switched treatments for 6 months.

In the first study, all girls were 8 years old and prepubertal. Birth weight averaged 2.4 kg and BMI, 18.5. All had precocious puberty secondary to exaggerated adrenarche, high circulating levels of interleukin-6 and dehydroepiandrosterone sulfate (DHEAS), and low adiponectin.

In untreated girls, these parameters continued to diverge from normal levels during the 6-month study, Dr. Ibanez said. Their DHEAS levels rose from about 105 [micro]g/dL to 115 [micro]g/dL; interleukin-6 rose from about 1,050 femtogram/mL to 1,100 fg/mL, and adiponectin decreased from about 10.5 [micro]g/mL to 9 [micro]g/mL. The girls continued to increase their abdominal fat over the 6 months, gaining an average of about 300 g.

All these parameters improved in the treated girls. In this group, the DHEAS levels remained stable, the interleukin-6 level dropped from about 1,000 fg/mL to abut 800 fg/mL, and the adiponectin increased from about 10 [micro]g/mL to about 11 [micro]g/mL. Abdominal fat decreased in these girls by an average of 300 g.

The crossover trial contained 24 girls who were 6-12 months beyond menarche at the study outset. These girls were also low birth weight (average 2.4 kg). Their average age was 12 years and their ...