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Cited by 67Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGenetic and Kidney Cyst Diseases

Metformin vs thiazolidinediones for treatment of clinical, hormonal and metabolic characteristics of polycystic ovary syndrome: a meta-analysis: Metformin vs thiazolidinediones for PCOS

Li, X-J., Yu, Y-X., Liu, C-Q., Zhang, W., Zhang, H-J., Yan, B., Wang, L-Y., Yang, S-Y. +1 more·2011·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2010.03917.x
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Abstract

OBJECTIVES: Insulin-sensitizing drugs (ISDs) have been advocated for the long-term treatment of polycystic ovary syndrome (PCOS). It is therefore important to compare the efficacy and safety of ISDs such as metformin and thiazolidinediones (TZDs) for the treatment of this syndrome. METHODS: A meta-analysis to assess the effectiveness and safety of metformin vs TZDs (including pioglitazone and rosiglitazone) in the treatment of PCOS was conducted, using MEDLINE (1966-May 2010) and EMBASE (1988-May 2010) to select randomized controlled trials comparing clinical, hormonal and metabolic results. RESULTS: Ten trials were included. TZDs were superior to metformin in reducing serum levels of free testosterone (P=0.03) and dehydroepiandrosterone sulfate (DHEA) (P=0.002) after 3 months treatment. Decreases in triglyceride levels were more pronounced with metformin after 6 months (P<0.0001). Decreases in body mass index (BMI) were greater with metformin treatment as assessed at 3 and 6 months (P<0.00001). There were no significant between-group differences concerning improvements in ovulation, pregnancy rate, menstrual patterns or insulin sensitivity, or changes in serum levels of androstenedione, luteinizing hormone, follicle-stimulating hormone, total cholesterol, low-density lipoprotein C or insulin. Metformin caused a significantly higher incidence of side effects such as nausea, diarrhoea and abdominal cramping (P<0.00001). Significant between-study heterogeneity was detected for several variables assessed. CONCLUSIONS: The findings from this meta-analysis do not indicate that metformin is superior to TZD's for the treatment of PCOS or vice versa. Between studies, heterogeneity was a major confounder. A large scale, well-designed, randomized, controlled trial is needed to further address this issue.

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  • A meta-analysis reported a statistically significant difference in adverse effects incidence between PCOS patients taking metformin and those in treatment with thiazolidinediones, OR = 8.88 for metformin vs. TZD (95% CI = 3.54, 22.27; p < 0.00001).

    “A meta-analysis reported a statistically significant difference in adverse effects incidence between PCOS patients taking metformin and those in treatment with thiazolidinediones (OR = 8.88 for metformin vs. TZD, 95% CI = 3.54, 22.27; p < 0.00001) [66].”

    From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [66]

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Authors
Li, X.-J., Yu, Y.-X., Liu, C.-Q., Zhang, W., Zhang, H.-J., Yan, B., Wang, L.-Y., Yang, S.-Y., & Zhang, S.-H.
Affiliations
  • Xiamen University (CN)
  • The Affiliated Yongchuan Hospital of Chongqing Medical University (CN)
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2011-02-08
Volume
74
Issue
3
Pages
332-339
ISSN
0300-0664 (ISSN-L)
DOI
10.1111/j.1365-2265.2010.03917.x
OpenAlex
W1577136074
Cited by
67
References
54
Citations by year
2024: 2 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 10 · 2015: 5 · 2014: 10 · 2013: 8 · 2012: 6
FWCI
0.72
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1666 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
Keywords
polycystic ovary syndrome, metformin, thiazolidinediones, pioglitazone, rosiglitazone, insulin-sensitizing drugs, insulin sensitivity, hyperandrogenism, free testosterone, dehydroepiandrosterone sulfate, triglycerides, body mass index, ovulation, menstrual irregularity, adverse drug reactions
MeSH terms
Rosiglitazone, Pioglitazone, Diarrhea, Female, Humans, Hypoglycemic Agents, Metformin, Nausea, Polycystic Ovary Syndrome, Testosterone, Time Factors, Triglycerides, Randomized Controlled Trials as Topic, Treatment Outcome, Dehydroepiandrosterone Sulfate, Thiazolidinediones

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