The Effect of Ethinylestradiol (EE)/Cyproterone Acetate (CA) and EE/CA Plus Metformin Treatment on Adhesion Molecules in Cases with Polycystic Ovary Syndrome (PCOS)
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Objective To determine if EE/CA and EE/CA plus metformin treatment have any effect on adhesion molecules in cases with PCOS. Methods Among 40 patients diagnosed with PCOS, one study arm was administered EE/CA (n=20, cyproterone acetate 2 mg, ethinylestradiol 35 μg) and the other was administered metformin (1,700 mg) combined with EE/CA (n=20, cyproterone acetate 2 mg, ethinylestradiol 35 μg). Soluble intercellular adhesion molecule-1 (sICAM-1), soluble endothelial leukocyte adhesion molecule-1 (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble leukocyte endothelial cell adhesion molecule-3 (sP-selectin), lipid profile, androgens, insulin, and HOMA-IR values were assessed prior to treatment and after 3 months of therapy. Results The comparison of the groups receiving EE/CA and EE/CA+metformin revealed a significant reduction in sVCAM (1,445±614 vs 1,167±482, p<0.05) and sICAM (442±141 vs 345±118, p<0.05) values relative to pre-treatment values while no significant changes were detected in sE-selectin and sP-selectin levels relative to pre-treatment levels in the EE/CA+metformin group (p>0.05). In the post-treatment period, sVCAM, sICAM, sE-selectin values did not significantly change compared to the pre-treatment values in EE/CA group (p>0.05). sP-selectin levels were also decreased but missed the significance in EE/CA group (229.4±68.0 vs 189.6±65.0, p=0.08). Conclusion These results demonstrate that EE/CA+metformin treatment reduced inflammation markers in cases with PCOS compared to EE/CA treatment. The clinical relevance of this conclusion may be clarified by longer metformin treatment and clinical follow-up.