Effectiveness of Probiotics, Metformin and Their Combination Therapy in Ameliorating Dyslipidemia Associated With PCOS

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous metabolic disorder affecting women of the child-bearing age. Alteration in lipid profile is one of the troublesome features faced by PCOS patients that need to be treated. Aim: The purpose of this study was to compare the effects of Probiotics, Metformin and their Combination therapy on lipid profile in women suffering from PCOS. Study Design: Single-Centered Randomized Controlled Trial. Setting: Gynecological clinic of Karachi at Tertiary care Hospital from December 2018 to May 2019. Patients and Methods: Total 78 PCOS patients of age between 18 to 40 years were involved in this trial rendering to Rotterdam criteria. After taking written and informed consent they were randomly allocated to three groups and were received: Metformin 500 mg BD (n = 26), Probiotic Capsule 180 mg BD (n = 26) and Combination of Metformin 500 mg BD / Probiotic Capsule 180 mg OD for 12-weeks. Lipid profile was measured at baseline and after 12-weeks of intervention along with the body weight. In the end, pre versus post therapy and comparison of different group’s results were analyzed.   Results: Metformin and Met/Pro Combination groups resulted in a significant reduction in Total Cholesterol (TC) as compared to Probiotic group. Fall in Low-Density Lipoprotein Cholesterol (LDL-C) levels were noteworthy after Probiotics and Met/Pro treatment. Serum TG concentrations were significantly reduced in all the groups. High-Density Lipoprotein Cholesterol (HDL-C) levels were slightly elevated after Probiotics treatment, which was not statistically significant but Metformin and Met/Pro group increases it to the significant value. No substantial change was found in the Very Low-Density Lipoprotein Cholesterol VLDL-C levels in any of the three groups. Conclusion: Overall, Probiotics treatment in PCOS women for 12 weeks exhibited noteworthy changes in TG, and LDL-C levels. Metformin markedly improve Cholesterol, TG and HDL-C. However, Met/Pro improved all the lipid changes to the significant value except for VLDL-C.