Effect of oral contraceptives and/or metformin on GLP-1 secretion and reactive hypoglycaemia in polycystic ovary syndrome

摘要

Context Insulin resistance in polycystic ovary syndrome (PCOS) may increase the risk of reactive hypoglycaemia (RH) and decrease glucagon-like peptide-1 (GLP-1) secretion. The possible effects of treatment with oral contraceptives (OCP) and/or metformin on GLP-1 secretion and risk of RH in PCOS is undetermined. Setting Outpatient clinic. Patients and interventions Randomized, controlled clinical trial. Ninety women with PCOS were randomized to 12-month treatment with OCP (150?mg desogestrel?+?30?mg ethinylestradiol), metformin (2?g/day) or metformin?+?OCP. Five-hour oral glucose tolerance tests (5-h OGTT) measuring fasting and area under the curve (AUC) for GLP-1, glucose, insulin and C-peptide were performed before and after the intervention period. Sixty-five women completed the study and 34 weight-matched healthy women were included as controls. Main outcome measures Changes in GLP-1, glucose, insulin and C-peptide during 5-h OGTT. Results Fasting GLP-1 levels increased during metformin?+?OCP vs OCP treatment, whereas AUC GLP-1 levels were unchanged during medical treatment. The prevalence of reactive hypoglycemia increased from 9/65 to 14/65 after intervention (P?