Evaluating the effect of insulin sensitizers metforminand pioglitazone alone and in combination on womenwith polycystic ovary syndrome: An RCT

Background: Insulin resistance and hyperinsulinemia may play a role inpathogenesis of PCOS. One of the common therapeutic methods is using insulinsensitizing drugs such as metformin and thiazolidinediones.Objective: The purpose was to determine the effect of metformin and pioglitazoneon clinical, hormonal and metabolic parameters in women with PCOS.Materials and Methods: Eighty four women randomly received one of thefollowing for 3 months: metformin (n=28) (500 mg three times a day), pioglitazone(30 mg daily) (n=28) and combination of both metformin and pioglitazone (n=28)(30 mg/day pioglitazone plus 500 mg metformin three times a day). Hormonalprofile, fasting serum insulin, body weight, body mass index, menstrual status andwaist to hip ratio were evaluated before and after treatment.Results: Metformin and pioglitazone and combination therapy induced favorablechanges in fasting serum insulin, HOMA-IR index, QUICKI, fasting glucose toinsulin ratio in women with PCOS. Body weight, BMI, and waist to hip ratioincreased significantly after treatment with pioglitazone but the data were similarafter administration of metformin or combination therapy. Total testosterone leveldecreased significantly only after treatment with metformin. After 3 months inpatients who received pioglitazone or combination therapy, menstrual cycles becameregular in 71.4% and 73.9% respectively. While menstrual improvement happenedonly in 36.4% of the patients treated with metformin.Conclusion: These findings suggest that insulin-sensitizing drugs induce beneficialeffect in insulin resistance and menstrual cyclicity but only metformin amelioratedhyperandrogenemia in women with PCOS. Treatment with combination ofmetformin and pioglitazone did not show more benefit than monotherapy with eachdrug alone

کلیدواژه ها:

Polycystic ovary syndrome ، Metformin ، Pioglitazone ، Insulin resistance