Abstract
Objective: To determine the effect of metformin on BMI, body circumferences (waist and hip) and metabolic parameters in polycystic ovarian syndrome (PCOS).
Methodology: This clinical trial was carried out from September 2018 to March 2019 in the Pharmacology Department of Bahria University Medical and Dental College in collaboration with a private hospital in Karachi. Forty infertile women aged 20-40 were enrolled under the Rotterdam 2003 criteria using a non-probability sampling technique. Tablet metformin hydrochloride 500 mg was administered three times daily orally for three months. Body mass index (BMI), body circumferences (waist and hip) and metabolic measurements, including fasting serum glucose and insulin, total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), High-density lipoprotein cholesterol (HDL-C) and serum hs-CRP were measured before and after treatment. We compared results at baseline and three months later using a paired t-test in SPSS version 23.
Results: Thirty participants completed the study. We found significant reduction in weight with p-values of 0.016, BMI 0.017, serum fasting glucose <0.001, insulin <0.001, HDL-C <0.001, LDL-C 0.035, VLDL-C <0.001, total cholesterol 0.021, triglyceride <0.001 and serum hs-CRP level <0.001. Non-significant reduction found in waist-hip ratio (p=0.062).
Conclusion: Metformin produced significant effects on BMI, body circumferences (waist and hip) and metabolic parameters such as carbohydrates, fats and protein in polycystic ovarian syndrome. It could be a good option for PCOS with metabolic syndrome.

Key words: Insulin resistance, metformin, polycystic ovarian syndrome.