Polycystic ovarian syndrome (PCOS) is by far the most prevalent metabolic disease affecting women during their reproductive life. Obesity is a frequently associated manifestation of polycystic ovary syndrome. Central body fat accumulation has been associated with the production of a variety of cytokines associated with low-grade inflammation in polycystic ovary syndrome. This study aimed to evaluate the effect of metformin and cabergoline, each alone and in combination, on several immune markers in women with hyperprolactinemia. The three-arm interventional study included 75 women with PCOS according to the Rotterdam criteria. They were categorized into three groups: those given metformin alone, those given cabergoline alone, and those given combined agents. Baseline and follow-up characteristics included immune markers such as anti-glutamic acid decarboxylase (anti-GAD) antibodies, gonadotropin-releasing hormone (GnRH) antibodies, and interleukin-18 (IL-18). It was observed that the use of either drug alone resulted in no significant change in the level of anti-GAD; however, combined use of the two drugs resulted in a significant reduction in the level, indicating that these two drugs acted synergistically. It was observed that the combined use of either drug resulted in a more significant reduction of GnRH antibody level. It was observed that the combined use of either drug resulted in a more significant reduction of IL-18 level (P <0.001). Metformin and cabergoline are efficient, act synergistically, and are safe when used in combination, reducing IL-8 levels and autoantibodies to GAD and GnRH in women with PCOS.
