Abstract
Author(s): Iman Abdul-Kadhim Abdul-Jabbar*, Asma Abdul JaleelSwadi
Background: Polycystic Ovarian Syndrome (PCOS) is an important condition to consider when considering treatment of hyperandrogenism in women. Most women with PCOS have uneven menstrual cycles, infertility and hirsutism. Approximately 60-76 percent of women with PCOS have hirsutism, and 75-90 percent have hyperandrogenism, which is a major clinical characteristic of PCOS. Adiponectin is a protein produced by fat cells that are distributed in the body in areas of the body that are dependent on androgens. The gold standard for the clinical evaluation of hirsutism is the increased Ferriman-Galloway (mFG) score of eight. Adiponectin levels are inversely correlated with the fat content of the bloodstream. Small amounts of adiponectin are associated with insulin resistance, type 2 diabetes, metabolic syndrome and cardiovascular problems associated with obesity. Adiponectin is a peptide hormone that plays a key role in regulating energy balance, food intake and weight regulation. The current investigation was aiming at exploring the effect of metformin combined with finasteride vs. metformin alone on ghrelin, adiponectin and hirsutism outcomes in females with PCOS. Objective: To investigate and compare the effects of metformin, finasteride and combinations of these medicines on adiponectin, ghrelin levels and hair growth in Iraqi women with Polycystic Ovarian Syndrome (PCOS). Patients and methods: The current study included 150 patients aged 18 to 39 years. Patients were divided into three groups: the metformin group, who had a standard starting dose of 500 mg, which was increased by 500 mg every 1-2 weeks with food for three months. Thefinasteride group received a 5 mg daily dose for three months, while the combination group received both medicines at similar doses for the same period of time. Each group had 50 patients. This study included data on BMI, age, adiponectin, ghrelin and Ferriman gollwey score. Results: After treatment, all three modalities of treatment, metformin, finasteride and combination were able to reduce mean BMI significantly (p<0.001) and the magnitudes of reduction were almost comparable in addition, after treatment, all three modalities of treatment were able to reduce mean free testosterone, and FGS, and to increase mean Ghrelin and Adiponectin significantly (p<0.001) and the magnitude of change caused by combination was the best. Conclusion: In women with PCOS, the combination of finasteride and metformin increases the levels of ghrelin and adiponectin in the serum, effectively reducing androgen levels and hirsutism. However, it does not offer any additional weight loss benefits, which makes metformin a safer alternative.