Metformin and/or clomiphene do not adversely affect liver or renal function in women with polycystic ovary syndrome

Mira Aubuchon, Allen R. Kunselman, William D. Schlaff, Michael P. Diamond, Christos Coutifaris, Sandra A. Carson, Michael P. Steinkampf, Bruce R. Carr, Peter G. McGovern, Nicholas A. Cataldo, Gabriella G. Gosman, John E. Nestler, Evan R. Myers, Richard S. Legro

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Context: Nonalcoholic fatty liver disease is common to insulin-resistant states such as polycystic ovary syndrome (PCOS). Metformin (MET) is often used to treat PCOS but information is limited as to its effects on liver function. Objective:Wesought to determine the effects of MET on serum hepatic parameters in PCOS patients. Design: This was a secondary analysis of a randomized, doubled-blind trial from 2002-2004. Setting: This multi-center clinical trial was conducted in academic centers. Patients: Six hundred twenty-six infertile women with PCOS with serum liver function parameters less than twice the upper limit of normal were included. Interventions: Clomiphene citrate (n = 209), MET (n = 208), or combined (n = 209) were given for up to 6 months. Main Outcome Measure: The percent change from baseline in renal and liver function betweenand within-treatment arms was assessed. Results: Renal function improved in all treatment arms with significant decreases in serum blood urea nitrogen levels (range, -14.7 to -21.3%) as well as creatinine (-4.2 to -6.9%). There were similar decreases in liver transaminase levels in the clomiphene citrate and combined arms (-10% in bilirubin, -9 to -11% in transaminases) without significant changes in the MET arm. When categorizing baseline bilirubin, aspartate aminotransferase, and alanine aminotransferase into tertiles, there were significant within-treatment arm differences between the tertiles with the highest tertile having the largest decrease from baseline regardless of treatment arm. Conclusion: Women with PCOS can safely use metformin and clomiphene even in the setting of mildly abnormal liver function parameters, and both result in improved renal function.

Original languageEnglish (US)
Pages (from-to)E1645-E1649
JournalJournal of Clinical Endocrinology and Metabolism
Volume96
Issue number10
DOIs
StatePublished - Oct 1 2011

Fingerprint

Clomiphene
Polycystic Ovary Syndrome
Metformin
Liver
Kidney
Transaminases
Bilirubin
Serum
Blood Urea Nitrogen
Therapeutics
Aspartate Aminotransferases
Alanine Transaminase
Urea
Creatinine
Blood
Nitrogen
Outcome Assessment (Health Care)
Clinical Trials
Insulin

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Metformin and/or clomiphene do not adversely affect liver or renal function in women with polycystic ovary syndrome. / Aubuchon, Mira; Kunselman, Allen R.; Schlaff, William D.; Diamond, Michael P.; Coutifaris, Christos; Carson, Sandra A.; Steinkampf, Michael P.; Carr, Bruce R.; McGovern, Peter G.; Cataldo, Nicholas A.; Gosman, Gabriella G.; Nestler, John E.; Myers, Evan R.; Legro, Richard S.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 96, No. 10, 01.10.2011, p. E1645-E1649.

Research output: Contribution to journalArticle

Aubuchon, M, Kunselman, AR, Schlaff, WD, Diamond, MP, Coutifaris, C, Carson, SA, Steinkampf, MP, Carr, BR, McGovern, PG, Cataldo, NA, Gosman, GG, Nestler, JE, Myers, ER & Legro, RS 2011, 'Metformin and/or clomiphene do not adversely affect liver or renal function in women with polycystic ovary syndrome', Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 10, pp. E1645-E1649. https://doi.org/10.1210/jc.2011-1093
Aubuchon, Mira ; Kunselman, Allen R. ; Schlaff, William D. ; Diamond, Michael P. ; Coutifaris, Christos ; Carson, Sandra A. ; Steinkampf, Michael P. ; Carr, Bruce R. ; McGovern, Peter G. ; Cataldo, Nicholas A. ; Gosman, Gabriella G. ; Nestler, John E. ; Myers, Evan R. ; Legro, Richard S. / Metformin and/or clomiphene do not adversely affect liver or renal function in women with polycystic ovary syndrome. In: Journal of Clinical Endocrinology and Metabolism. 2011 ; Vol. 96, No. 10. pp. E1645-E1649.
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AU - Aubuchon, Mira

AU - Kunselman, Allen R.

AU - Schlaff, William D.

AU - Diamond, Michael P.

AU - Coutifaris, Christos

AU - Carson, Sandra A.

AU - Steinkampf, Michael P.

AU - Carr, Bruce R.

AU - McGovern, Peter G.

AU - Cataldo, Nicholas A.

AU - Gosman, Gabriella G.

AU - Nestler, John E.

AU - Myers, Evan R.

AU - Legro, Richard S.

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N2 - Context: Nonalcoholic fatty liver disease is common to insulin-resistant states such as polycystic ovary syndrome (PCOS). Metformin (MET) is often used to treat PCOS but information is limited as to its effects on liver function. Objective:Wesought to determine the effects of MET on serum hepatic parameters in PCOS patients. Design: This was a secondary analysis of a randomized, doubled-blind trial from 2002-2004. Setting: This multi-center clinical trial was conducted in academic centers. Patients: Six hundred twenty-six infertile women with PCOS with serum liver function parameters less than twice the upper limit of normal were included. Interventions: Clomiphene citrate (n = 209), MET (n = 208), or combined (n = 209) were given for up to 6 months. Main Outcome Measure: The percent change from baseline in renal and liver function betweenand within-treatment arms was assessed. Results: Renal function improved in all treatment arms with significant decreases in serum blood urea nitrogen levels (range, -14.7 to -21.3%) as well as creatinine (-4.2 to -6.9%). There were similar decreases in liver transaminase levels in the clomiphene citrate and combined arms (-10% in bilirubin, -9 to -11% in transaminases) without significant changes in the MET arm. When categorizing baseline bilirubin, aspartate aminotransferase, and alanine aminotransferase into tertiles, there were significant within-treatment arm differences between the tertiles with the highest tertile having the largest decrease from baseline regardless of treatment arm. Conclusion: Women with PCOS can safely use metformin and clomiphene even in the setting of mildly abnormal liver function parameters, and both result in improved renal function.

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