title: Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study.
abstract: BACKGROUND
  Due to the central role of metabolic abnormalities in the pathophysiology of polycystic ovary syndrome (PCOS), insulin sensitizing agents have been proposed as a feasible treatment option.
  
  
  OBJECTIVE
  To investigate which is the more effective between metformin and myoinositol (MYO) on hormonal, clinical and metabolic parameters in obese patients with PCOS.
  
  
  METHODS
  Crossover randomized controlled study.
  
  
  METHODS
  Thirty-four PCOS obese women (age: 25·62 ± 4·7 years; BMI: 32·55 ± 5·67 kg/m2) were randomized to receive metformin (850 mg twice a day) or MYO (1000 mg twice a day) for 6 months. After a 3 month washout, the same subjects received the other compound for the following 6 months.
  
  
  METHODS
  Ultrasonographic pelvic examinations, hirsutism score, anthropometric and menstrual pattern evaluation, hormonal profile assays, oral glucose tolerance test (OGTT) and lipid profile at baseline and after 6 months of treatment were performed.
  
  
  RESULTS
  Both metformin and MYO significantly reduced the insulin response to OGTT and improved insulin sensitivity. Metformin significantly decreased body weight and improved menstrual pattern and Ferriman-Gallwey score. Metformin treatment was also associated with a significant decrease in LH and oestradiol levels, androgens and anti-müllerian hormone levels. None of these clinical and hormonal changes were observed during MYO administration.
  
  
  CONCLUSIONS
  Both treatments improved the glyco-insulinaemic features of obese PCOS patients, but only metformin seems to exert a beneficial effect on the endocrine and clinical features of the syndrome.
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Tagliaferri
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Romualdi
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Valentina
authors.identifier: http://orcid.org/0000-0001-8241-3949
authors.initials: V
authors.lastname: Immediata
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: De Cicco
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Di Florio
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.|Department of Obstetrics and Gynaecology, Ospedale Generale Regionale Ente Ecclesiastico F.Miulli, Acquaviva delle Fonti, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lanzone
authors.affiliation: Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.|Department of Obstetrics and Gynaecology, Ospedale Generale Regionale Ente Ecclesiastico F.Miulli, Acquaviva delle Fonti, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guido
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D007294:Inositol / Q000008:administration & dosage / Q000494:pharmacology*; D008687:Metformin / Q000008:administration & dosage / Q000494:pharmacology*; D009765:Obesity / Q000188:drug therapy* / Q000209:etiology; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007294:Inositol; D008687:Metformin