期刊
JOURNAL OF CLINICAL MEDICINE
卷 12, 期 11, 页码 -出版社
MDPI
DOI: 10.3390/jcm12113715
关键词
insulin resistance; gonadotrope secretory function; menopause; vitamin D
Metformin reduces FSH levels and tends to decrease LH levels in postmenopausal women, but only in those with normal vitamin D status or receiving vitamin D supplementation. Vitamin D status determines the impact of metformin on gonadotropin secretion. The drug does not affect the levels of other anterior pituitary hormones or vitamin D.
Metformin was found to decrease elevated levels of anterior pituitary hormones. Its impact on lactotrope secretory function was absent in women with vitamin D insufficiency. This study investigated whether vitamin D status determines metformin action on overactive gonadotropes. We compared the effect of six-month metformin treatment on the plasma levels of gonadotropins, TSH, prolactin, ACTH, estradiol, free thyroid hormones, IGF-1, and 25-hydroxyvitamin D, as well as on glucose homeostasis markers between three matched groups of postmenopausal women at high risk for diabetes: untreated subjects with vitamin D insufficiency (group A), untreated women with normal vitamin D status (group B), and individuals receiving vitamin D supplementation with normal 25-hydroxyvitamin D levels (group C). Only in groups B and C did metformin reduce FSH levels and tend to decrease LH levels, and these effects correlated with baseline gonadotropin levels, baseline 25-hydroxyvitamin D levels, and the improvement in insulin sensitivity. Follow-up gonadotropin levels were higher in group A than in the other two groups. The drug did not affect circulating levels of TSH, prolactin, ACTH, estradiol, free thyroid hormones, IGF-1, or 25-hydroxyvitamin D. The obtained results suggest that the impact of metformin on gonadotropin secretion in women after menopause is determined by vitamin D status.
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