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Clin Endocrinol (Oxf). 2017 May;86(5):725-730. doi: 10.1111/cen.13304. Epub 2017 Feb 10.

Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study.

Author information

1
Department of Obstetrics and Gynaecology, Università Cattolica del Sacro Cuore, Roma, Italy.
2
Department of Obstetrics and Gynaecology, Ospedale Generale Regionale Ente Ecclesiastico F.Miulli, Acquaviva delle Fonti, Italy.

Abstract

CONTEXT:

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.

STUDY DESIGN:

Crossover randomized controlled study.

PATIENTS:

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.

MEASUREMENTS:

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.

PMID:
28092404
DOI:
10.1111/cen.13304
[Indexed for MEDLINE]

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