Metformin Treatment in Adolescent Patients With PCOS: A Long-term, Winning Metabolic Choice. Results From a Single Center 5-years Retrospective Clinical Study

Data were retrospectively retrieved from a database of clinical data collected in the Outpatient Pediatric and Adolescent Gynecology Clinic of the University Hospital "Duilio Casula," Monserrato, Cagliari (Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, Italy), between 2015 and 2019. PCOS diagnosis was adapted for age following the 2019 update from Witchel SF and Carmina's recommendation.

The population consisted of 168 PCOS patients aged 12 to 17. Clinical examination, medical history, blood sampling, and pelvic ultrasound (US) were performed. The number of post-menarche years and the body mass index (BMI) were collected.

The patients were subjected to physical examination to evaluate hirsutism, according to the criteria of the Ferriman and Gallwey score, as well as acne, using the Cremoncini classification.

Each participant received detailed advice on improving their lifestyle, such as physical activity and nutrition. Investigators gave indications of the various food and their weighted intake and a balanced composition of macronutrients (carbohydrates 55%, lipids 25%, protein 20%; fiber ≥25 g/day), as recommended by the Reference intake levels of nutrients and energy for the Italian population (LARN) guidelines. Vegetables, fruit, cereals, fish, and pulses, typical of the Mediterranean style, were included in the diet.

Investigators recommended ≥150 minutes per week of moderate or ≥75 minutes of vigorous-intensity exercise for weight gain prevention, minimizing sedentary time, and including strength training exercises for two days per week, as reported from the 2018 PCOS guideline.