Metformin for Ectopic Fat Deposition and Metabolic Markers in Polycystic Ovary Syndrome (PCOS)
Status:
Suspended
Trial end date:
2021-11-30
Target enrollment:
Participant gender:
Summary
This project, "A double-blind placebo-controlled randomized clinical trial assessing the
efficacy of metformin for hepatic fat in adolescents and young adults with polycystic ovary
syndrome", proposes exploring the use of novel and noninvasive methodologies in an at-risk
adolescent and young adult population with polycystic ovary syndrome (PCOS) who may gain
long-term health benefits from early detection and treatment of non-alcoholic fatty liver
disease (NAFLD). PCOS is a common condition that frequently presents in adolescence and young
adulthood and is defined by elevated androgens (male hormones) in the blood leading to 1.
hirsutism and acne and 2. menstrual abnormalities or amenorrhea. Affected individuals are at
increased risk of developing insulin resistance (a precursor of diabetes), NAFLD and lipid
(cholesterol) abnormalities.These features are all associated with the metabolic syndrome, a
rising major public health concern. Recently, an association between PCOS and NAFLD has been
noted but has only been superficially studied in the adolescent and young adult population.
The susceptibility of certain PCOS patients to developing NAFLD is theorized to be due to
having underlying insulin resistance, elevated androgen levels, and a genetic predisposition.
Metformin is an insulin sensitizing medication widely used to treat type 2 diabetes mellitus
that may have beneficial effects on insulin resistance-related conditions including PCOS and
NAFLD. Although widely used in PCOS, its effect on NAFLD in this group has not been
previously studied.
The primary aims of this proposal are: 1) To determine whether PCOS with liver fat >/=4.8%
treated with metformin for six months will have a decline in percentage liver fat compared to
a placebo group. 2) To measure the association of the PNPLA3 I148M allele with NAFLD in PCOS
at baseline (n=40). 2b) To measure the association of percentage liver fat with biomarkers of
NAFLD, dyslipidemia, insulin resistance and body composition at baseline (n=40) and after a
placebo-controlled intervention with metformin in PCOS with liver fat >4.8% (n=20).
The goal of this research proposal is to explore the use of novel and noninvasive
technologies in a young and at risk population. Dr. Sopher hopes to use the results of this
research to lay the groundwork for the prevention and treatment of NAFLD and other metabolic
disorders in adolescents and young adults with PCOS and to prevent lifelong morbidity
associated with PCOS.