다낭성 난소 증후군 환자에서 메트포민 치료의효과와 인슐린 저항성
Effect of Metformin Treatment and Insulin Resistance in Patients with Polycystic Ovary Syndrome
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목적 : 한국의 다낭성 난소 증후군 여성에 있어서 배란 및 월경 회복에 미치는 메트포민의 효과와 인슐린 저항성의 관련 여부를 파악하고자 한다. 연구 방법 : 2001년 9월부터 2003년 9월까지 서울대학교병원 산부인과에 내원한 여성 중 다낭성 난소 증후군으로 진단된 23명을 대상으로 메트포민을 하루 1500 mg 투약하였다. 3개월간 복용 후 규칙적인 월경 또는 배란의 유무를 조사하여 메트포민의 반응을 평가하였고 반응군과 무반응군의 인슐린 저항성을 비교하였다. 연구 결과 : 23명의 다낭성 난소 증후군 환자 중 11명 (47.8%)에서 메트포민 투약 후 규칙적인 월경 또는 배란이 회복되었으며, 12명 (52.2%)에서는 메트포민을 3개월 복용한 후에도 만성적인 무배란이 지속되었다. 혈중 공복시 포도당/인슐린 지수는 메트포민 반응군에서는 복용 전 7.4±1.9, 3개월간 복용 후 7.8±2.1이었으며, 반응을 보이지 않은 군에서는 복용 전 5.2±0.6, 3개월간 복용 후 5.2±0.8으로 메트포민 반응군과 반응을 보이지 않은 군 사이에 유의한 차이는 없었다. 또한 HOMA 지수는 메트포민 반응군에서는 복용 전 2.7±1.2, 3개월간 복용 후 2.2±0.1이었으며, 반응을 보이지 않은 군에서는 복용 전 4.1±4.4, 3개월간 복용 후 3.6±0.3으로 메트포민 반응군과 반응을 보이지 않은 군 사이에 유의한 차이를 보이지 않았다. 결론 : 비만하지 않은 다낭성 난소 증후군 여성의 경우 HOMA 등의 지수를 바탕으로 한 인슐린 저항성 여부에 상관없이 메트포민이 월경 및 배란 회복에 효과가 있을 것으로 생각된다
Abstract
Objective : This study was performed to investigate the effect of metformin treatment and insulin resistance in the patients with polycystic ovary syndrome. Methods : Twenty three patients with polycystic ovary syndrome were included at Seoul National University Hospital from September 2001 to September 2003. Metformin was administered at daily 1,500 mg for 3 months to these patients. Then restoration of regular menstruation or recovery of ovulation was evaluated and insulin resistance was compared between the responder and the non-responder before and after metformin treatment. Results : Eleven patients (47.8%) showed a significant improvement in menstrual or ovulation cyclicity whereas twelve patients had no change. There was no statistically significant difference in the insulin resistance between the responder and the non-responder before and after metformin treatment. Conclusion : In non-obese patients with polycystic ovary syndrome, metformin treatment seems to be effective to improvement of menstrual or ovulation cyclicity irrespective of insulin resistance expressed as glucose-to- insulin ratio and HOMA.
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