Objectives: Evaluation of the effect of 3 months therapy
of metformin/omega-3 (M/O) combination on body mass
index (BMI), insulin resistance (IR), and oxidative and
inflammatory milieu in PCOS women at probable cardiac
risk (CR) as predicted by the atherogenic index of plasma
(AIP).
Patients and methods: 90 PCOS women were randomly
allocated into the M group received metformin (500 mg
bi-daily) and M/O group received metformin (500 mg
bi-daily) and Omega3 (950 mg active omega-3 once daily).
Pre- and Post-treatment BMI, Homeostasis model assessment for IR (HOMA-IR), AIP and serum tumor necrosis
factor-α (TNF-α), interleukin (IL)-β, superoxide dismutase
(SOD), and malondialdehyde (MDA) levels were evaluated. The primary outcome is the effect of provided 3-m
therapy AIP.
Results: Pre-treatment AIP defined 15.6% and 58.9% of
studied women had high or intermediate cardiac risk (CR),
59 women were obese, 16 women were morbidly obese, and
52 women were insulin resistant with elevated serum levels
of TNF-α, IL-1β, MDA, and lower serum SOD levels. Combined therapy allowed a significant decrease in HOMA-IR
score, serum TNF-α, IL-1β, and MDA levels with significant
elevation of serum SOD. Combination therapy significantly
reduced the AIP in comparison to pre-treatment AIP and to
that of women of the M group. Moreover, no woman still
had high CR after M/O therapy and the frequency of women
who had low CR was increased by about 107%.
Conclusion: Insulin sensitizers could improve PCOS-associated disturbances. However, omega-3 adjuvant therapy
significantly augmented the effects of insulin sensitizers,
minimized the cardiac risk factors, and decreased the risk
of probable cardiac events.