Comparative Study of metformin and pioglitazone in polycystic ovary syndrome

Corresponding Author: Dr Nasrin Jalilian. Professor of Obstetrics and Gynecology, Gynecologist,Kermanshah University of Medical Sciences, Kermanshah, IranEmail:[e-mail] Tell:09181311664Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders inwomen. PCOS comprises a broad spectrum of anomalies, including hyperandrogenism, chronicanovulation, obesity, and infertility. Insulin resistance and its compensatory hyperinsulinemia playa key role in the pathogenicity of PCOS. This study compares the effects of 2 types of insulinsensitizer drugs, metformin and pioglitazone, on clinical, metabolic, and endocrine characteristicsof women with PCOS.Methods: In this randomized clinical trial, 56 women with PCOS (ages 20–49 years) were treatedorally with either metformin (500 mg 3 times daily) or pioglitazone (30 mg daily) for 3 months.Clinical (body weight, blood pressure [BP], and body mass index) and laboratory indices (fastingblood sugar [FBS], serum triglyceride [TG], cholesterol, low‑density lipoprotein, high‑densitylipoprotein, insulin, testosterone, and dehydroepiandrosterone [DHEA]) were measured beforeand after therapy. Data were analyzed by Chi‑square and McNemar’s tests.Results: Significant decreases were seen after treatment with metformin in extent of hair loss (P =0.008),wrist circle (P = 0.011), weight (P = 0.047), diastolic BP (P = 0.023), and DHEA (P = 0.035). Asignificant decrease in TG was seen with pioglitazone treatment (P = 0.047). In both groups,significant decreases in acne, menstrual disturbance, FBS, and serum insulinwere seen.Conclusion: There is a significant amelioration of endocrine and metabolic indices with pioglitazonein PCOS patients. Although we were not able to recommend one treatment regime over the other,pioglitazone offers a useful, alternate treatment in women with PCOS who are not able to toleratemetformin.

Keywords:

Insulin resistance , metformin , pioglitazone , polycystic ovary syndrome