Evaluating the effect of insulin sensitizers metformin and pioglitazone alone and in combination on women with polycystic ovary syndrome: An RCT

Sohrevardi, Seyed Mojtaba; Nosouhi, Fahime; khalilzade, Saeed hossein; Kafaie, Parichehr; Karimi-Zarchi, Mojgan; Halvaei, Iman; Mohsenzadeh, Mehdi

doi:10.29252/ijrm.14.12.743

Cited by 28 publications

(67 citation statements)

References 70 publications

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“…Total 486 related articles were extracted from the three databases and 436 articles were left after removing duplication. Finally, 11 articles meeting the criteria [ 16 – 26 ] were left after the abstract and the full text had been read. Figure 1 shows the search strategy for selection of trials.…”

Section: Resultsmentioning

confidence: 99%

Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis

Huang

2017

Arch Gynecol Obstet

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BackgroundPioglitazone was used to treat patients of PCOS in many researches, but the treatment has not been recognized by public or recommended by all the guidelines.MethodWe conducted a meta-analysis of the related literatures to objectively evaluate the clinical effectiveness and safety by comparing pioglitazone with metformin administrated by PCOS patients. Searches were performed in Cochrane Library, EMBASE and PubMed (last updated December 2016).ResultsEleven studies among 486 related articles were identified through searches. Fixed effects and random effects models were used to calculate the overall risk estimates. The results of the meta-analysis suggest that improvement of the menstrual cycle and ovulation in pioglitazone treatment group was better than metformin group [OR = 2.31, 95% CI (1.37, 3.91), P < 0.001, I 2 = 41.8%]. Improvement of the F-G scores in metformin treatment group was better than pioglitazone group [SMD = 0.29, 95% CI (0.0, 0.59), P = 0.048, I 2 = 0.0%]. BMI was more elevated in pioglitazone group than in metformin group [SMD = 0.83, 95% CI (0.24, 1.41), P = 0.006, I 2 = 82.8%]. There were no significant differences of the other data between the two groups.ConclusionsThis meta-analysis indicated that pioglitazone ameliorated menstrual cycle and ovulation better than metformin and metformin ameliorated BMI and F-G scores better than pioglitazone in treating patients with PCOS. Pioglitazone might be a good choice for the patients with PCOS who were intolerant or invalid to metformin for the treatment.

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Section: Resultsmentioning

confidence: 99%

Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis

Huang

2017

Arch Gynecol Obstet

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“…Metformin is one of the most efficient drugs for the treatment of type 2 diabetes and also acts as insulin sensitizer [37,50]. Our results demonstrated that metformin has no difference in average body weight with HFD-treated group, but it was observed treatment with metformin decrease the average body weight when compared with before metformin treatment.…”

Section: Discussionmentioning

confidence: 49%

Potential role of cinnamaldehyde and costunolide to counteract metabolic syndrome induced by excessive fructose consumption

Rashwan

El-Beltagy

Saleh

et al. 2019

Beni-Suef Univ J Basic Appl Sci

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Background: One of the serious public health problems in the world is metabolic syndrome. It includes visceral obesity, dyslipidemia, insulin resistance, hyperglycemia, and hypertension. As a contributor to almost all the classic signs of metabolic syndrome, fructose was the ideal choice. There are certain shortcomings with existing drugs for insulin-resistant treatment. Plants still represent the main source of most available medicines. Cinnamaldehyde (CNA) is an active principle of Cinnamomum zeylanicum. Costunolide (CE) is natural sesquiterpene lactones, which is the main bioactive constituent of Saussurea lappa. The main aim of the present study is to investigate the effect of the synthetic antidiabetic agent (metformin) in comparison with natural constituents (cinnamaldehyde, costunolide) after developing a reliable model for insulin resistance by using high fructose diet (HFD). Results: It was found that HFD increased plasma glucose, insulin, glycosylated hemoglobin, HbA1c, serum total cholesterol, LDL-cholesterol, triglyceride, ALT, AST, creatinine, and uric acid. Moreover, HFD decreased hepatic reduced glutathione and superoxide dismutase levels. While oral administration of cinnamaldehyde and costunolide significantly decreased plasma glucose, HbA1c, total cholesterol, LDL-cholesterol, triglyceride, and increased level of hepatic reduced glutathione and superoxide dismutase activity. Also, cinnamaldehyde and costunolide restored the altered plasma levels of ALT, AST, creatinine, and uric acid to normal. Conclusions: The results of this experimental study showed that cinnamaldehyde and costunolide could be used as safe drugs for treating different abnormalities of metabolic syndrome.

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“…They concluded that insulinsensitizing drugs induce beneficial effects in insulin resistance and menstrual cycle, but only metformin aided in reducing hyperandrogenemia in women with PCOS. 23 These findings further evidence the fact that metformin has real potential in eliminating clinical signs and symptoms of PCOS.…”

Section: Findings Metformin Use In Pcosmentioning

confidence: 63%

“…16,17 Weight reduction and lifestyle modification should be considered first-line treatment for BMI and cardiovascular risk reduction Propst et al, 2,3 but metformin can be a suitable alternative for obese or overweight women with insulin resistance. 5,11 Metformin is the only insulinsensitizing drug that has succeeded in decreasing hyperandrogenemia in women with PCOS Mojtaba Sohrevardi et al, 23 and has also been shown to decrease body weight Du et al 31 as well as to regulate the menstrual cycle. 18 Metformin and clomiphene-citrate combined have also been shown to be more effective than the placebo in inducing ovulation in women with clomid-resistant PCOS.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that there is low-quality evidence pointing to a benefit of metformin supplementation on clinical pregnancy and live birth rates. 22 Lastly, Sohrevardi et al 23 attempted to determine the effect of metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. They concluded that insulinsensitizing drugs induce beneficial effects in insulin resistance and menstrual cycle, but only metformin aided in reducing hyperandrogenemia in women with PCOS.…”

Section: Findings Metformin Use In Pcosmentioning

confidence: 99%

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Efficacy of metformin use to induce ovulation in women with polycystic ovarian syndrome

Mellott¹,

Metcalfe²,

Hensley³

2018

OGIJ

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Polycystic Ovarian Syndrome (PCOS), a common disorder of the endocrine system, is diagnosed based on inclusion criteria of an ovulation or oligo-ovulation, clinical signs of hyperandrogenism, and/or presence of polycystic ovaries on ultrasound. Many women with PCOS also have hyperinsulinemia, leading to over production of ovarian androgens. Due to this differential, the use of the insulin-sensitizing agent metformin has been explored to induce ovulation in women with PCOS. The use of metformin combined with the fertility drug clomiphene citrate (clomid) has shown to be more effective than the placebo in stimulating ovulation. While metformin has not yet gained the title of a first-line pharmacological agent for ovulation induction, research shows it has many benefits in PCOS treatment.

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Evaluating the effect of insulin sensitizers metformin and pioglitazone alone and in combination on women with polycystic ovary syndrome: An RCT

Cited by 28 publications

References 70 publications

Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis

Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis

Potential role of cinnamaldehyde and costunolide to counteract metabolic syndrome induced by excessive fructose consumption

Efficacy of metformin use to induce ovulation in women with polycystic ovarian syndrome

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