Objective: Comparison of metformin and N acetylcysteine on clinical, metabolic parameter and hormonal profile in women with polycystic ovarian syndrome.
Design: Prospective comparative study.
Setting: Obstetrics and Gynecology department in Kamala Nehru Memorial Hospital Allahabad.
Patients: On the basis of inclusion and exclusion criteria, 100 patients of PCOS were selected for study and assigned randomly in two groups to receive either metformin (1500 mg/day) (group M) or N acetylcysteine (1800 mg/day) (group N) for 24 weeks.
Interventions: Metabolic parameter and hormonal profile were determined before and after the treatment.
Main outcome measures: Metabolic parameters, fasting glucose, fasting insulin and testosterone changes.
Results: Forty-five patients of both groups were ultimately evaluated. There was a significant improvement of body mass index, waist circumference and waist-hip ratio in group N, but there was no significant difference found in weight reduction among two groups. The biochemical marker of insulin resistance like fasting insulin, fasting glucose/insulin ratio improved significantly in group N. Greater reduction of total testosterone was observed in group N.
Conclusions: Better improvement of metabolic and hormonal profile was observed in N acetylcysteine group. Because of its less side effect comparing to metformin, NAC can be used as a substitute for insulin-sensitizing agent in treatment of PCOS.
Keywords: Metformin; N acetylcysteine (NAC); Polycystic ovarian syndrome (PCOS).