C-reactive protein in obese PCOS women and the effect of metformin therapy.

Elevated C-reactive protein (CRP) in association with hyperinsulinemia is a significant risk factor for cardiovascular diseases and that plays a key role in the development of the PCOS. We evaluated serum CRP level, before and after metformin therapy in obese women with polycystic ovarian syndrome (PCOS). Thirty five obese women with PCOS [BMI=28,2+/-1,84 kg/m2, aged 20-35 years] were studied. Patients received metformin orally the dose of 850 mg per day. The patients were carefully interviewed, clinically examined, and laboratory tested to eliminate conditions, probable to provoke an inflammatory response which was an exclusion criterion. Subjects were excluded if there was clinical or electrocardiographic evidence of coronary artery disease, a family history of coronary artery disease, a history of smoking, or concurrent oestrogen, antihypertensive, or lipid lowering medication. At all patients we determined CRP, insulin, C-peptide, luteinising hormone, follicle stimulating hormone, oestradiol, testosterone, prolactin, TSh, T3, T4, glucose, fibrinogen and lipid profile, before and after metformin treatment. Mean serum C-RP levels significantly decreased after metformin treatment ((6,37+/-1,72 vs. 1,67+/-0,73 mg/l; p<0,05). Level of insulin reduced for 37% after metformin treatment (234+/-68 vs. 148+/-39 pmol/l). Total cholesterol and low-density lipoprotein cholesterol levels decreased as well. Mean total testosterone levels decreased after metformin treatment too (3,21+/-0,91, vs. 2,31+/-0,72 nmol/l). Elevated serum CRP level significantly correlated to the hyperinsulinaemia (r=0,54). Metformin therapy in PCOS women reduces CRP level, hyperinsulinaemia and cardiovascular risk.