Metformin, rosiglitazone, or both for obese women with polycystic ovary syndrome?
Abstract
In this issue, Yujing et al. (1) compared the effects of the two most commonly used insulin sensitizers for obese, insulin resistant women with polycystic ovary syndrome (PCOS; by Rotterdam criteria). Two hundred four participants were randomized into three comparable groups. Group 1 received 1,500 mg metformin, group 2 received 4 mg of rosiglitazone, and group 3 received 1000 mg metformin plus 4 mg rosiglitazone for six months. In addition to drugs, dietary adjustment and moderate-strength physical exercises for 40 minutes three times a week were recommended to all groups. Homeostatic model assessed insulin resistance. Of interest were effects on average menstrual intervals, anthropometric measurements, androgens, and metabolic indices of insulin, carbohydrates, and lipids. Most participants showed an improvement in their menstrual pattern, as well as their metabolic indices. Serum free testosterone (T), acne scores, and anthropometric measures (weight, waist circumference, waist to hip ratio and body mass index) also improved. Metformin was associated with greater weight loss. Rosiglitazone alone or in combination was better in reducing total cholesterol and triglyceride levels. However, better predictors of cardiovascular disease risk (total cholesterol/high-density lipoproteins and low-density lipoproteins/high-density lipoproteins ratios) were improved equally in all three groups. Dietary changes and exercise activities for all participants were monitored, yet…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 204 participants or records.
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