PCOS with metabolic disorders: Treatment wird insulin sensitizer and lifestyle change

wei huang (CN), jing tan (CN), qiuyi wang (CN), guojun zhou (CN), tingting liu (CN)

[huang] West China Second University Hospital ，SCU, Chengdu, [tan] West China Second University Hospital of Sichuan University, [wang] West China Second University Hospital of Sichuan University, [zhou] West China Second University Hospital of Sichuan University, [liu] West China Second University Hospital of Sichuan University

Objective：To compare the effects of Metformin (Met), Rosiglitazone(Ros), or combination of Metformin and Rosiglitazone (M+R) in improvement clinical and metabolic parameters in obese Chinese PCOS women. Design: Randomized control trail. Setting: West China Second University Hospital, SCU, China. Patients: 204 Obese Chinese women fulfilled the Rotterdam criteria of PCOS and diagnosed with insulin resistance (HOMA-IR>2.77) Interventions: Patients was treated with Metformin 1500mg/din (Met), or Rosiglitazone 4mg/d (Ros), or combination of Metformin 1000mg/d plus Rosiglitazone 4mg/d (M+R) for continuous use of 6 months. Meantime, lifestyle as dietary and excise were asked andmonitored to all participants. Main outcome Measures: Clinical features [(menstrual cycle, hyperandrogenism as hirsutism or acnes, body weight, waist circumstance and waist-to-hip ratio (WHR)] and biochemical parameters (serum free testerone, LH-FSH ratio, fasting glucose, fasting insulin, HOMA-IR). Results: About half of participants revealed their menstrual cycle recovery to normal or shorter than baseline. The clinical symptoms as acne or hirsutism were improved and androgen levels decreased after 6 months treatment. BMI decreased in three groups when compared to baseline (24.06±2.21vs.27.64±2.47 in Met group, 22.24±2.75 vs. 27.71±2.84 in Ros group, 25.01±2.21vs.27.41±2.34 in M+R group. Notably, HOMA-IR were improved in three groups (3.12±1.93 vs. 5.62±2.54 in Metformin, 3.40±1.50 vs. 5.64±2.18 in Rosiglitazone, 2.85±1.13 vs. 5.53±1.91 in Met plus Ros), although no significant difference among them was observed. The main side effect of Metformin was gastrointestinal reactions, no side effect was found in Rosiglitazone users. Conclusions: IR is so popular in obese Chinese PCOS women. Except lifestyle, insulin sensitizers Metformin and Rosiglitazone are safe and effective in improvement of insulin sensitivity and clinical characteristics. Key words: Polycystic ovary syndrome (PCOS); Obesity; Insulin resistance; Metformin; Rosiglitazone