Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial

Abstract

Objective: To compare the effects of metformin, rosiglitazone, and their combination in obese polycystic ovary syndrome (PCOS) patients with insulin resistance. Design: Prospective randomized controlled trail. Setting: Tertiary teaching hospital. Patient(s): Obese Chinese women (body mass index [BMI] R25 kg/m 2 ) with insulin resistance who fulfilled the Rotterdam criteria of PCOS. Intervention(s): In group 1, 68 patients administered metformin (1,500 mg/day); in group 2, 67 patients administered rosiglitazone (4 mg/day); in group 3, 69 patients administered metformin (1,000 mg/day) and rosiglitazone (4 mg/day) for 6 months, all with the same diet and regular exercise lifestyle recommendation. Main Outcome Measure(s): Average menstrual interval, anthropometric measurements, androgen-related parameters, and metabolic features of insulin, carbohydrates, and lipids, with intention-to-treat analysis. Result(s): The baseline parameters showed no statistically significant differences. After the 6-month treatment, most participants showed an improved menstrual pattern. There were statistically significant decreases in acne scores, weight, BMI, waist circumference, waist-to-hip ratio, and serum testosterone. The metabolic indexes of insulin, carbohydrates, and lipids were improved obviously compared with the baseline in each group. Among the three groups, the patients administered 1,500 mg/day metformin experienced greater reductions in weight. However, the rosiglitazone users (alone or combined with metformin) showed a more notable decline in total cholesterol and triglyceride levels. Conclusion(s):Considering the benefits of metformin on weight loss, high-dose metformin (1,500 mg/day) along with lifestyle modification should be recommended for obese, insulin-resistant women with PCOS. Rosiglitazone alone or combined with lowdosage metformin plus lifestyle modification should be considered for the women with abnormal lipid profiles.

Metformin, rosiglitazone, or both for obese women with polycystic ovary syndrome?

“…Fixeddose combination of rosiglitazone/metformin is approved and is available in the U.S., indicated when NIDDM is not well controlled with a single drug. Yujing et al (1) reported no side effects related to rosiglitazone in their study. Metformin was well tolerated or gradually adapted within 1 week to 5 weeks although one patient withdrew due to intolerance.…”

Acne Management in Polycystic Ovary Syndrome

“…Diarrhea, nausea, abdominal discomfort, anorexia are the most common side effect (63). While, vitamin B12 deficiency with the long term use of metformin (64).…”

Growth Hormone Activates PI3K/Akt Signaling and Inhibits ROS Accumulation and Apoptosis in Granulosa Cells of Patients With Polycystic Ovary Syndrome

“…The waist-to-hip ratio (WHR) was calculated as the waist circumference divided by the hip circumference. Androgen-related symptoms of hirsutism and acne were evaluated as previously reported [22]. Antral follicle count (AFC) were assessed by performing transvaginal ultrasound examination on days 2-3 of menstruation or progestin-induced withdrawal bleeding.…”

“…Plasma glucose, estradiol (E 2 ), progesterone, total testosterone (TT), luteinizing hormone (LH), folliclestimulation hormone (FSH), sex hormone binding globulin (SHBG), and fasting insulin (FINS) levels were measured as reported previously [22]. The free androgen index (FAI) was calculated as TT (nmol/L)/SHBG (nmol/L) × 100.…”

“…The free androgen index (FAI) was calculated as TT (nmol/L)/SHBG (nmol/L) × 100. The homeostasis model assessment (HOMA-IR) index was calculated as fasting glucose (mmol/L) × fasting insulin (mIU/L)/22.5 [22]. The intra-and inter-assay coe cients of variation for these values were <5% and <10%, respectively.…”