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Metformin and/or clomiphene do not adversely affect liver or renal function in women with polycystic ovary syndrome.

AbstractCONTEXT:
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.
AuthorsMira Aubuchon, Allen R Kunselman, William D Schlaff, Michael P Diamond, Christos Coutifaris, Sandra A Carson, Michael P Steinkampf, Bruce R Carr, Peter G McGovern, Nicholas A Cataldo, Gabriella G Gosman, John E Nestler, Evan R Myers, Richard S Legro,
JournalThe Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 96 Issue 10 Pg. E1645-9 (Oct 2011) ISSN: 1945-7197 [Electronic] United States
PMID21832111 (Publication Type: Journal Article, Meta-Analysis, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
Chemical References
  • Fertility Agents, Female
  • Hypoglycemic Agents
  • Clomiphene
  • Metformin
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Bilirubin
Topics
  • Adult
  • Alanine Transaminase (blood)
  • Aspartate Aminotransferases (blood)
  • Bilirubin (blood)
  • Clomiphene (adverse effects, therapeutic use)
  • Double-Blind Method
  • Female
  • Fertility Agents, Female (adverse effects, therapeutic use)
  • Humans
  • Hypoglycemic Agents (adverse effects, therapeutic use)
  • Infertility, Female (drug therapy)
  • Kidney (drug effects)
  • Kidney Function Tests
  • Liver (drug effects)
  • Liver Function Tests
  • Metformin (adverse effects, therapeutic use)
  • Polycystic Ovary Syndrome (metabolism)

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