Zhao Han, Zhang Jiaqi, Xing Chuan, Cheng Xiangyi, He Bing
Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Wuxi, Jiangsu, 214000, PR China.
Department of Endocrinology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, 110000, PR China.
J Ovarian Res. 2024 Feb 19;17(1):42. doi: 10.1186/s13048-024-01367-7.
To investigate the effects of metformin (MET) monotherapy and pioglitazone plus MET (PIOMET) therapy on gonadal and metabolic profiles in normal-weight women with polycystic ovary syndrome (PCOS).
Sixty normal-weight women with PCOS were recruited between January and September 2022 at the Shengjing Hospital of China Medical University. They were randomly assigned to the MET or PIOMET groups for 12 weeks of MET monotherapy or PIOMET therapy. Anthropometric measurements, menstrual cycle changes, gonadal profiles, and the oral glucose insulin-releasing test (OGIRT) were performed at baseline and after the 12-week treatment.
Thirty-six participants completed the trial. MET and PIOMET therapies improved menstrual cycles after the 4- and 12-week treatments; however, there was no statistical difference between the two groups. PIOMET therapy improved luteinizing hormone (LH), luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio, and free androgen index (FAI) levels after the 4-week treatment, whereas MET monotherapy only improved total testosterone (TT) levels compared to baseline (P < 0.05). Both MET and PIOMET therapies improved TT and anti-Mullerian hormone (AMH) levels after the 12-week treatment (P < 0.05). In addition, only PIOMET therapy significantly improved sex hormone-binding globulin (SHBG), FAI, and androstenedione (AND) levels than the baseline (P < 0.05). PIOMET therapy improved SHBG and AMH levels more effectively than MET monotherapy (P < 0.05). Furthermore, PIOMET treatment was more effective in improving blood glucose levels at 120 and 180 min of OGIRT compared to MET monotherapy (P < 0.05).
In normal-weight women with PCOS, PIOMET treatment may have more benefits in improving SHBG, AMH, and postprandial glucose levels than MET monotherapy, and did not affect weight. However, the study findings need to be confirmed in PCOS study populations with larger sample sizes.
探讨二甲双胍（MET）单药治疗及吡格列酮联合MET（PIOMET）治疗对体重正常的多囊卵巢综合征（PCOS）女性性腺及代谢指标的影响。
2022年1月至9月在中国医科大学附属盛京医院招募了60名体重正常的PCOS女性。她们被随机分为MET组或PIOMET组，分别接受12周的MET单药治疗或PIOMET治疗。在基线及12周治疗后进行人体测量、月经周期变化、性腺指标及口服葡萄糖胰岛素释放试验（OGIRT）。
36名参与者完成了试验。MET和PIOMET治疗在4周和12周治疗后均改善了月经周期；然而，两组之间无统计学差异。PIOMET治疗在4周治疗后改善了黄体生成素（LH）、黄体生成素/卵泡刺激素（LH/FSH）比值及游离雄激素指数（FAI）水平，而MET单药治疗仅使总睾酮（TT）水平较基线有所改善（P < 0.05）。MET和PIOMET治疗在12周治疗后均改善了TT及抗苗勒管激素（AMH）水平（P < 0.05）。此外，仅PIOMET治疗使性激素结合球蛋白（SHBG）、FAI及雄烯二酮（AND）水平较基线有显著改善（P < 0.05）。PIOMET治疗比MET单药治疗更有效地改善了SHBG及AMH水平（P < 0.05）。此外，与MET单药治疗相比，PIOMET治疗在OGIRT的120分钟和180分钟时改善血糖水平更有效（P < 0.05）。
在体重正常的PCOS女性中，PIOMET治疗在改善SHBG、AMH及餐后血糖水平方面可能比MET单药治疗更有益，且不影响体重。然而，研究结果需要在更大样本量的PCOS研究人群中得到证实。
