Effects of Thiazolidinediones on Polycystic Ovary Syndrome: a Meta-analysis of Randomized Placebo-Controlled Trials

Du, Qiang; Yang, Shuai; Wang, Yanjun; Wu, Bo; Zhao, Yating; Fan, Bin

doi:10.1007/s12325-012-0044-6

Cited by 36 publications

(34 citation statements)

References 37 publications

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“…At present there is not sufficient evidence to support the suggestion that TZDs are superior to metformin in metabolic and reproductive aspects of PCOS (222). Most importantly, TZDs may increase body weight due to fluid retention, which is a major concern in women with PCOS having a high prevalence of obesity (224). Hence, TZDs are not considered as a first-line choice for women with PCOS, but they may be an alternative treatment in insulin-resistant or obese PCOS women who do not tolerate or do not respond to metformin therapy.…”

Section: Subclinical CV Disease In Pcosmentioning

confidence: 93%

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

558

489

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Polycystic ovary syndrome (PCOS) is the most common ovarian disorder associated with androgen excess in women, which justifies the growing interest of endocrinologists. Great efforts have been made in the last 2 decades to define the syndrome. The presence of three different definitions for the diagnosis of PCOS reflects the phenotypic heterogeneity of the syndrome. Major criteria are required for the diagnosis, which in turn identifies different phenotypes according to the combination of different criteria. In addition, the relevant impact of metabolic issues, specifically insulin resistance and obesity, on the pathogenesis of PCOS, and the susceptibility to develop earlier than expected glucose intolerance states, including type 2 diabetes, has supported the notion that these aspects should be considered when defining the PCOS phenotype and planning potential therapeutic strategies in an affected subject. This paper offers a critical endocrine and European perspective on the debate on the definition of PCOS and summarises all major aspects related to aetiological factors, including early life events, potentially involved in the development of the disorder. Diagnostic tools of PCOS are also discussed, with emphasis on the laboratory evaluation of androgens and other potential biomarkers of ovarian and metabolic dysfunctions. We have also paid specific attention to the role of obesity, sleep disorders and neuropsychological aspects of PCOS and on the relevant pathogenetic aspects of cardiovascular risk factors. In addition, we have discussed how to target treatment choices based according to the phenotype and individual patient's needs. Finally, we have suggested potential areas of translational and clinical research for the future with specific emphasis on hormonal and metabolic aspects of PCOS.

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Section: Subclinical CV Disease In Pcosmentioning

confidence: 93%

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

558

489

View full text Add to dashboard Cite

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“…Pioglitazone decreases peripheral insulin resistance via the peroxisome proliferator-activated receptor-γ (PPAR-γ) pathway [18]. Several studies have demonstrated that pioglitazone improves clinical, hormonal, and metabolic status in patients with PCOS [15,19-21]. Moreover, pioglitazone directly inhibits estradiol and testosterone production in human ovarian cells in vitro [22].…”

Section: Introductionmentioning

confidence: 99%

Pioglitazone counteracts the tumor necrosis factor-α inhibition of follicle-stimulating hormone-induced follicular development and estradiol production in an in vitro mouse preantral follicle culture system

et al. 2013

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BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age and is characterized by chronic anovulation. Insulin resistance may be a key component of the pathogenesis of this disorder. Pioglitazone is a thiazolidinedione derivative that acts by improving insulin resistance via the peroxisome proliferator-activated receptor-γ (PPAR-γ) pathway. Reportedly, pioglitazone improves the anovulation status in patients with PCOS. In the present study, we examined whether pioglitazone directly affects ovarian follicular development and steroidogenesis using in vitro mouse preantral follicle culture system.MethodsAn isolated individual in vitro mouse preantral follicle culture was used to test the effects of pioglitazone on the follicle development and steroidogenesis. Tumor necrosis factor-α (TNF-α), which plays a role in insulin resistance, has been reported to inhibit the follicle stimulating hormone (FSH)-induced follicular development and steroidogenesis in an in vitro mouse preantral follicle culture system. Therefore, we examined whether pioglitazone counteracts these effects by TNF-α. We assessed the follicle diameter and follicle survival and antral-like cavity formation rates, the 17β-estradiol (E2) levels in the culture medium, and the ovulation rate using the in vitro preantral follicle culture.ResultsPioglitazone treatment counteracted the inhibition of TNF-α in FSH-induced follicle development in a dose-dependent manner. Pioglitazone, at a concentration of 5 μM, which was the minimum effective concentration, significantly counteracted the inhibition of TNF-α in FSH-induced follicle survival (29 versus 56%, P < 0.05), antral-like cavity formation (29 versus 48%, P < 0.05), E2 concentration in the culture medium (mean ± SEM = 21 ± 1 versus mean ± SEM = 27 ± 1 pg/mL, P < 0.05), and human chorionic gonadotropin-induced ovulation rate (9 versus 28%, P < 0.05).ConclusionsPioglitazone counteracted the inhibition by TNF-α on FSH-induced follicle development and steroidogenesis in the in vitro mouse preantral follicle culture. The results suggest that pioglitazone may directly affect the follicular development and steroidogenesis.

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“…A total of 74 trials and 5282 participants with PCOS were involved. All 5 reviews assessed the anthropometric, endocrine and metabolic outcomes of thiazolidinediones (n = 3 compared with metformin, n = 2 compared with placebo) . BMI was significantly increased with thiazolidinediones in all 5 reviews while endocrine benefits (reduced free testosterone) were reported in one review when compared to metformin .…”

Section: Resultsmentioning

confidence: 99%

Pharmacological and surgical treatment of nonreproductive outcomes in polycystic ovary syndrome: An overview of systematic reviews

Tay

Joham

Hiam

et al. 2018

Clinical Endocrinology

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Effects of Thiazolidinediones on Polycystic Ovary Syndrome: a Meta-analysis of Randomized Placebo-Controlled Trials

Cited by 36 publications

References 37 publications

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

The polycystic ovary syndrome: a position statement from the European Society of Endocrinology

Pioglitazone counteracts the tumor necrosis factor-α inhibition of follicle-stimulating hormone-induced follicular development and estradiol production in an in vitro mouse preantral follicle culture system

Pharmacological and surgical treatment of nonreproductive outcomes in polycystic ovary syndrome: An overview of systematic reviews

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