title: Comparison clinical and metabolic effects of metformin and pioglitazone in polycystic ovary syndrome.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. PCOS comprises a broad spectrum of anomalies, including hyperandrogenism, chronic anovulation, obesity, and infertility. Insulin resistance and its compensatory hyperinsulinemia play a key role in the pathogenicity of PCOS. This study compares the effects of 2 types of insulin sensitizer drugs, metformin and pioglitazone, on clinical, metabolic, and endocrine characteristics of women with PCOS.
  
  
  METHODS
  In this randomized clinical trial, 56 women with PCOS (ages 20-49 years) were treated orally with either metformin (500 mg 3 times daily) or pioglitazone (30 mg daily) for 3 months. Clinical (body weight, blood pressure [BP], and body mass index) and laboratory indices (fasting blood sugar [FBS], serum triglyceride [TG], cholesterol, low-density lipoprotein, high-density lipoprotein, insulin, testosterone, and dehydroepiandrosterone [DHEA]) were measured before and after therapy. Data were analyzed by Chi-square and McNemar's tests.
  
  
  RESULTS
  Significant decreases were seen after treatment with metformin in extent of hair loss (P= 0.008), wrist circle (P= 0.011), weight (P= 0.047), diastolic BP (P= 0.023), and DHEA (P= 0.035). A significant decrease in TG was seen with pioglitazone treatment (P= 0.047). In both groups, significant decreases in acne, menstrual disturbance, FBS, and serum insulin were seen.
  
  
  CONCLUSIONS
  There is a significant amelioration of endocrine and metabolic indices with pioglitazone in PCOS patients. Although we were not able to recommend one treatment regime over the other, pioglitazone offers a useful, alternate treatment in women with PCOS who are not able to tolerate metformin.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Karoon
authors.initials: K
authors.lastname: Shahebrahimi
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Jalilian
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Bazgir
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Rezaei
keywords: Insulin resistance; metformin; pioglitazone; polycystic ovary syndrome