Comparison of Calcitriol and Metformin Effects on Clinical and Metabolic Consequences of Polycystic Ovary Syndrome

Prevalence of polycystic ovarian syndrome (PCOS) in reproductive age women is about 10 %. There is a lot of morbidity due to this syndrome. Vitamin D deficiency is a common problem in the world and especially in Iran. Because of probable role of activated vitamin D on induction of insulin secretion and reduction in insulin resistance and the effect of hyperinsulinemia on elevation of free androgens; we designed to evaluate the effect of active form of vitamin D on control of PCOS clinical and metabolic complications. This clinical trial study was carried out in Ghaem hospital. 51 untreated PCOS patients randomly were divided into three groups. Treatment with calcitriol (0. 5mg)، metformin (1000 mg) and placebo were started for each group for three month. After three month assessment for improvement in clinical (improvement of ovulation) and metabolic status (fasting blood glucose، glucose tolerance test، insulin resistance and androgen levels) were performed. Only 22. 9% of patients had sufficient vitamin D levels (>30 ng/ml). Treatment with metformin significantly decreased weight (p=0. 027)، insulin level (p=0. 043)، insulin resistance (p=0. 048) and BMI (p=0. 019). Systolic blood pressure and PTH significantly decreased after calcitriol therapy (p=0. 029، 0. 009 respectively). An improvement in ovulation was detected after calcitriol treatment and 7 patients without ovulation demonstrated ovulation features after treatment with calcitriol. Resumption of ovulation was observed in treatment with metformin and placebo but this changes were significantly more evident in calcitriol group (p=0. 02). It seems that treatment with calcitriol may be effective in management of PCOS and it may be better in ovulation induction than metformin therapy.