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Ibáñez, L. et al.

Lourdes Ibáñez, Abel Lopez-Bermejo, Marta Diaz, Maria Victoria Marcos, Francis de Zegher,

Early metformin therapy to delay menarche and augment height in girls with precocious pubarche.

OBJECTIVE: To study the effects of early metformin treatment on menarche, height, and polycystic ovary syndrome (PCOS) markers. Low-birthweight (LBW) girls with precocious pubarche (PP) are at risk for an early menarche (<12 years), an adult stature below target level, and PCOS. Hyperinsulinemic insulin resistance is thought to be a key factor. DESIGN: Open-label, randomized study. SETTING: University hospital. PATIENT(S): Thirty-eight LBW-PP girls. INTERVENTION(S): At age 8 years, girls were randomly assigned to remain untreated or to receive metformin for 4 years; subsequently, both subgroups were followed without treatment until each girl was postmenarcheal. MAIN OUTCOME MEASURE(S): Age at menarche, height, weight, endocrine-metabolic state (fasting blood), body composition (by absorptiometry), abdominal fat (subcutaneous vs. visceral), and hepatic adiposity (by magnetic resonance imaging). RESULT(S): At last assessment, girls in each subgroup were on average 2 years beyond menarche; the mean growth velocity was below 2 cm/years. Age at menarche was 11.4 ± 0.1 years in untreated girls and 12.5 ± 0.2 years in metformin-treated girls; the latter girls were taller and much leaner (with less visceral and hepatic fat) and had more favorable levels of circulating insulin, androgens, and lipids. CONCLUSION(S): Early metformin therapy (age ∼ 8-12 years) suffices to delay menarche; to augment postmenarcheal height; to reduce total, visceral, and hepatic adiposity; and to curb the endocrine-metabolic course of LBW-PP girls away from adolescent PCOS.[1]

References

Early metformin therapy to delay menarche and augment height in girls with precocious pubarche. Ibáñez, L., Lopez-Bermejo, A., Diaz, M., Marcos, M.V., de Zegher, F. Fertil. Steril. (2011) [Pubmed]

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