Hum. Reprod. Advance Access originally published online on March 27, 2008
Human Reproduction 2008 23(7):1594-1601; doi:10.1093/humrep/den095
Serum uric acid concentration as non-classic cardiovascular risk factor in women with polycystic ovary syndrome: effect of treatment with ethinyl-estradiol plus cyproterone acetate versus metformin
1 Department of Endocrinology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Carretera de Colmenar Viejo Km 9,1., 28034 Madrid, Spain 2 Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas CIBERDEM, Instituto de Salud Carlos III, Spanish Ministry of Health and Consumer Affairs, Madrid, Spain
5 Correspondence address. Tel/Fax: +34-91-336-9029; E-mail: hescobarm.hrc{at}salud.madrid.org
BACKGROUND: Serum uric acid levels have emerged as a cardiovascular risk factor, and interventions aimed to decrease its level have been related with an improvement in clinical and non-clinical cardiovascular outcomes.
METHODS: Serum uric acid levels were measured in 40 polycystic ovary syndrome (PCOS) patients and 40 non-hyperandrogenic women matched for BMI and grade of obesity, and were followed-up in 34 PCOS patients who were randomized to an oral contraceptive containing 35 mg ethinyl-estradiol plus 2 mg cyproterone acetate (Diane35 Diario) or metformin (850 mg twice daily) for 24 weeks.
RESULTS: There were no statistically significant differences in uric acid levels between PCOS and non-hyperandrogenic control women. Considering all PCOS and non-hyperandrogenic control women as a whole, obese women showed higher uric acid concentrations than lean and overweight women, and the main determinant of serum uric acid level was the BMI. In PCOS women, Diane35 Diario treatment was related with a decrease in uric acid levels (P = 0.018), whereas no changes were observed with metformin.
CONCLUSIONS: Obesity is the main determinant of serum uric acid concentrations in PCOS patients, yet amelioration of androgen excess with an antiandrogenic contraceptive pill results in a significant decrease in these levels, an effect that is not observed with metformin. ClinicalTrials.gov NLM Identifier: NCT00428311 [ClinicalTrials.gov] .
Key words: obesity/metformin/insulin resistance/hyperandrogenemia/clinical trial
3 Present address: Department of Endocrinology Hospital Universitario de La Princesa, Madrid, Spain.
4 Present address: Department of Nephrology, Hospital Universitario Son Dureta, Palma de Mallorca, Spain.
Submitted on October 18, 2007; resubmitted on January 8, 2008; accepted on March 4, 2008.
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