16th July 12:51
Iron in Obesity and Polycystic Ovary Syndrome (metformin estradiol amenorrhea ferritin insulin)
increased body iron stores of obese women with polycystic ovary
The increased body iron stores of obese women with polycystic ovary
syndrome are a consequence of insulin resistance and hyperinsulinism,
and do not result from reduced menstrual losses.
Manuel Luque-Ramírez, M.D., Francisco Álvarez-Blasco, M.D., José I.
Botella-Carretero, M.D., Ph.D., Raul Sanchón, M.D., José L. San
Millán, Ph.D. and Héctor F. Escobar-Morreale, M.D., Ph.D.
Endocrinology and Molecular Genetics, Hospital Universitario Ramón y
Cajal & Universidad de Alcalá, Madrid, Spain
Objective:Increased serum ferritin levels, indicating increased body
iron stores, have been found in overweight and obese PCOS women. This
finding might result from the reduced menstrual losses secondary to
from oligo- or amenorrhea, or from the hyperinsulinism secondary to
insulin resistance because insulin favors the intestinal absorption
and the tissue deposition of iron. To explore which of these
mechanisms is responsible for the increase in body iron stores in PCOS
women, we have monitored the changes in serum ferritin levels during
treatment with an antiandrogenic oral contraceptive or with an insulin
Research Design and Methods:Thirty-four consecutive PCOS patients were
randomized to an oral contraceptive containing 35 µg of ethinyl-
estradiol plus 2 mg of cyproterone acetate (Diane35 Diario) or
metformin (850 mg twice daily), and their serum ferritin levels were
evaluated at baseline and after 12 and 24 weeks of treatment.
Resultsespite the fact that treatment with Diane35 Diario restored
regular menstrual cycles in all the patients, whereas metformin only
did so in 50% of them, serum ferritin levels decreased at 12 and 24
weeks of treatment only with metformin, in association with a marked
increase in insulin sensitivity. On the contrary, no changes in
ferritin and insulin sensitivity were observed with Diane35 Diario.
Conclusions:Our present results suggest that insulin resistance and
hyperinsulinism, and not the reduced menstrual losses secondary to
from oligo- or amenorrhea, are responsible of the increased ferritin
levels and body iron stores found in overweight and obese PCOS women.
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