Allam Diabetes Centre, Academic Diabetes, Endocrinology and Metabolism, The University of Hull, Hull York Medical School (HYMS), Hull, UK.
Dasman Diabetes Institute, Department of Translational Research, State of Kuwait, Kuwait City, Kuwait.
Adv Ther. 2024 Jun;41(6):2168-2195. doi: 10.1007/s12325-024-02848-3. Epub 2024 Apr 29.
Polycystic ovary syndrome (PCOS) is a complex endocrine condition affecting women of reproductive age. It is characterised by insulin resistance and is a risk for type 2 diabetes mellitus (T2DM). The aim of this study was to review the literature on the effect of pioglitazone and rosiglitazone in women with PCOS.
We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library and the Web of Science in April 2020 and updated in March 2023. Studies were deemed eligible if they were randomised controlled trials (RCTs) reporting the effect of pioglitazone and rosiglitazone in PCOS. The study follows the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently extracted data and assessed the risk of bias using the Cochrane risk of bias tool.
Out of 814 initially retrieved citations, 24 randomised clinical trials (RCTs) involving 976 participants were deemed eligible. Among women with PCOS, treatment with rosiglitazone compared to metformin resulted in a significant increase in the mean body weight (mean difference (MD) 1.95 kg; 95% CI 0.03-3.87, p = 0.05). Metformin treatment was associated with a reduction in mean body mass index (BMI) compared to pioglitazone (MD 0.85 kg/m; 95% CI 0.13-1.57, p = 0.02). Both pioglitazone compared to placebo (MD 2.56 kg/m; 95% CI 1.77-3.34, p < 0.00001) and rosiglitazone compared to metformin (MD 0.74 kg/m; 95% CI 0.07-1.41, p = 0.03) were associated with a significant increase in BMI. Treatment with pioglitazone compared to placebo showed a significant reduction in triglycerides (MD - 0.20 mmol/L; 95% CI - 0.38 to - 0.03, p = 0.02) and fasting insulin levels (MD - 11.47 mmol/L; 95% CI - 20.20, - 2.27, p = 0.01). Rosiglitazone compared to metformin was marginally significantly associated with a reduction in the luteinising hormone (LH) (MD - 0.62; 95% CI - 1.25-0.00, p = 0.05).
Both pioglitazone and rosiglitazone were associated with significant increases in body weight and BMI when compared with metformin or placebo. Pioglitazone significantly reduced triglycerides and fasting insulin when compared with placebo while rosiglitazone showed a modest reduction of LH when compared with metformin.
CRD42020178783.
多囊卵巢综合征（PCOS）是一种影响育龄妇女的复杂内分泌疾病。它的特征是胰岛素抵抗，也是 2 型糖尿病（T2DM）的风险因素。本研究旨在综述吡格列酮和罗格列酮治疗多囊卵巢综合征妇女的文献。
我们于 2020 年 4 月在 PubMed、MEDLINE、Scopus、Embase、Cochrane 图书馆和 Web of Science 进行了检索，并于 2023 年 3 月进行了更新。如果研究是随机对照试验（RCT），报告了吡格列酮和罗格列酮在 PCOS 中的作用，则认为其符合纳入标准。该研究遵循 2020 年系统评价和荟萃分析的首选报告项目（PRISMA）。两位评审员独立提取数据，并使用 Cochrane 偏倚风险工具评估偏倚风险。
最初检索到 814 条引文，其中 24 项随机临床试验（RCT）涉及 976 名参与者被认为符合条件。与二甲双胍相比，罗格列酮治疗多囊卵巢综合征妇女的体重平均增加（MD 1.95kg；95%CI 0.03-3.87，p=0.05）。与吡格列酮相比，二甲双胍治疗与体重指数（BMI）的降低相关（MD 0.85kg/m；95%CI 0.13-1.57，p=0.02）。与安慰剂相比，吡格列酮（MD 2.56kg/m；95%CI 1.77-3.34，p<0.00001）和罗格列酮（MD 0.74kg/m；95%CI 0.07-1.41，p=0.03）的治疗均与 BMI 的显著增加相关。与安慰剂相比，吡格列酮治疗与甘油三酯（MD -0.20mmol/L；95%CI -0.38 至 -0.03，p=0.02）和空腹胰岛素水平（MD -11.47mmol/L；95%CI -20.20 至 -2.27，p=0.01）的显著降低相关。与二甲双胍相比，罗格列酮治疗与黄体生成素（LH）的降低相关（MD -0.62；95%CI -1.25 至 0.00，p=0.05）。
与二甲双胍或安慰剂相比，吡格列酮和罗格列酮均与体重和 BMI 的显著增加相关。与安慰剂相比，吡格列酮可显著降低甘油三酯和空腹胰岛素，而罗格列酮与二甲双胍相比可适度降低 LH。
PROSPERO 注册号：CRD42020178783。
