INTRODUCTION Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 5-10% of women of reproductive age. It is characterized by chronic anovulation leading to menstrual disorders, and increased infertility. The syndrome can also manifest as hirsutism and acne. AIM OF THE STUDY The aim of the study was to compare, over a duration of 6 months, the effects of drospirenone (DRSP) versus chlormadinone acetate (CMA) containing oral contraceptives (OCs) on clinical, hormonal, and metabolic parameters in 120 PCOS women. MATERIALS AND METHODS 120 women with the diagnosis of PCOS according to the Rotterdam 2003 criteria were recruited to the study. All patients were divided to two treatment groups of OCs, containing: 3 mg DRSP/30 mcg EE (ethinylestradiol) (60 patients) and 2 mg CMA/30 mcg EE (60 patients). Clinical parameters such as hirsutismus and acne were evaluated. Metabolic parameters such as serum insulin, glucose concentration, homeostatic model assessment of insulin resistance, body mass index, systolic and diastolic blood pressures were also measured. Among hormonal parameters, serum estradiol, luteinizing hormone, follicle-stimulating hormone, prolactin, testosterone, dehydroepiandrosterone sulfate, thyroid-stimulating hormone, and free thyroxine were measured. RESULTS The use of both DRSP- or CMA-containing OCs provided similar positive therapeutic effects with regard to clinical, metabolic, and hormonal parameters. Among clinical parameters, like hirsutismus, after 6 months of continuous OC treatment, a statistically significant improvement was observed in both groups: DRSP (p <  0.0001) and CMA OC treatment (p < 0.0001). In addition, significant improvement was showed according to acne lesions both after DRSP (p < 0.0001) and CMA treatments (p < 0.0001). Among glucose, insulin levels and HOMA-IR, there were statistically significant higher levels in both groups after DRSP (p < 0.0001, p < 0.0001, p < 0.05) and CMA OC treatment (p < 0.02, p < 0.0001, p < 0.0001). Hormonal parameters such as LH, FSH, prolactin, testosterone and DHEA-S were statistically significant lower in both groups after DRSP (p < 0.0001, p < 0.0001, p < 0.01, p < 0,002, and p < 0.0001) and CMA OC treatment (p < 0.0001, p < 0.0001, p < 0.04, p < 0.002, and p < 0.0001). CONCLUSIONS Further research, however, is needed not only to define optimal duration, and to clarify the effects of treatment on long-term metabolic outcomes, but also to explore different treatment options and possible combined therapies.

中文翻译：

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使用不同复方口服避孕药（含醋酸氯地酮与屈螺酮）的 PCOS 女性的临床、激素和代谢参数。

引言 多囊卵巢综合征 (PCOS) 是一种常见的内分泌疾病，影响 5-10% 的育龄妇女。它的特点是慢性无排卵导致月经失调和不孕症增加。该综合征还可以表现为多毛症和痤疮。研究目的 本研究的目的是在 6 个月内比较屈螺酮 (DRSP) 与含有口服避孕药 (OCs) 的醋酸氯地酮 (CMA) 对 120 例 PCOS 临床、激素和代谢参数的影响女性。材料和方法 120 名根据鹿特丹 2003 年标准诊断为 PCOS 的女性被招募到研究中。所有患者被分为 OC 的两个治疗组，包含：3 mg DRSP/30 mcg EE（炔雌醇）（60 名患者）和 2 mg CMA/30 mcg EE（60 名患者）。评估临床参数，例如多毛症和痤疮。还测量了代谢参数，例如血清胰岛素、葡萄糖浓度、胰岛素抵抗的稳态模型评估、体重指数、收缩压和舒张压。在激素参数中，测量了血清雌二醇、促黄体激素、促卵泡激素、催乳素、睾酮、硫酸脱氢表雄酮、促甲状腺激素和游离甲状腺素。结果 使用含有 DRSP 或 CMA 的 OC 在临床、代谢和激素参数方面提供了相似的积极治疗效果。在临床参数中，如多毛症，在连续 OC 治疗 6 个月后，两组均观察到统计学上显着的改善：DRSP (p < 0.0001) 和 CMA OC 治疗 (p < 0.0001)。此外，根据 DRSP (p < 0.0001) 和 CMA 治疗 (p < 0.0001) 后的痤疮病变，均显示出显着改善。在 DRSP (p < 0.0001, p < 0.0001, p < 0.05) 和 CMA OC 治疗 (p < 0.02, p < 0.0001, p < 0.0001 ）。在 DRSP (p < 0.0001, p < 0.0001, p < 0.01, p < 0,002, and p < 0.0001) 和 CMA OC 治疗后，LH、FSH、催乳素、睾酮和 DHEA-S 等激素参数在两组中均显着降低（p < 0.0001、p < 0.0001、p < 0.04、p < 0.002 和 p < 0.0001）。结论 然而，进一步的研究不仅需要确定最佳持续时间，还需要阐明治疗对长期代谢结果的影响，