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Hum. Reprod. Advance Access published online on March 24, 2005
Human Reproduction, doi:10.1093/humrep/deh825
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received December 8, 2004
Revised January 27, 2005
Accepted February 4, 2005

Article

Administration of B-group vitamins reduces circulating homocysteine in polycystic ovarian syndrome patients treated with metformin: a randomized trial

Esra Bulgan Kilicdag 1*, Tayfun Bagis 1, Ebru Tarim 1, Erdogan Aslan 1, Serkan Erkanli 1, Erhan Simsek 1, Bulent Haydardedeoglu 1, and Esra Kuscu 1

1 Department of Obstetrics and Gynecology, Baskent University Faculty of Medicine, Turkey

* To whom correspondence should be addressed.
Esra Bulgan Kilicdag, E-mail: esrabulgan1972{at}mynet.com


  Abstract

BACKGROUND: The aim of the current study was to assess the effects of B-group vitamins and folic acid administration on serum levels of homocysteine (Hcy) in patients with polycystic ovarian syndrome (PCOS) on short-term metformin treatment. METHODS: Patients were randomly assigned to one of three treatment groups. Group 1 patients (n=20) received metformin (850 mg twice daily); group 2 patients (n=20) received metformin (850 mg twice daily) and B-group vitamins (vitamin B1, 250 mg; vitamin B6, 250 mg; vitamin B12, 1000 µg twice daily); and group 3 patients (n=20) received metformin (850 mg twice daily) and folic acid (174 µg twice daily). In all groups, lipid profiles and plasma total Hcy, vitamin B12, folic acid and glucose levels were recorded at baseline and at 3 months. RESULTS: A 26.5% increase in Hcy levels was seen after 12 weeks of metformin therapy, while 21.17 and 8.33% decreases in Hcy levels were detected when B-group vitamins or folic acid plus metformin were given respectively. There were no statistically significant differences recorded in insulin sensitivity using homeostasis model assessment in the three groups. CONCLUSION: These findings suggest that B-group vitamins and folic acid administration counteract the Hcy-increasing effect seen with metformin therapy.

Keywords: B-group vitamin; folic acid; hyperhomocysteinaemia; metformin; PCOS.
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