EFFECTS OF PIOGLITAZONE AND METFORMIN IN IMPROVING INSULIN RESISTANCE AND CLINICAL ANDROGENIC SYMPTOMS IN PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME

Mais Munif Hayek*, Maysoon Aziz Dayoob and Ahmed Abed Alrahman

ABSTRACT

Background: polycystic ovary syndrome PCO is a common hormonal disorder that affects women of reproductive age. It is characterized by menstrual disorders, hyperandrogenism, insulin resistance, obesity and infertility, in addition to long-term consequences as cardiovascular diseases such as atherosclerosis and hyperlipidemia, which justifies the importance of diagnosing and treating this syndrome to improve the quality of life and decrease the symptoms of hyperandrogenism. Objective: identify the optimal therapy to improve insulin resistance and symptoms of hyperandrogenism in patients with Polycystic Ovary Syndrome. Methods: This study included patients with polycystic ovarian syndrome in a randomized clinical trial (RCT) who had visited obstetrics and gynecology department in Tishreen University Hospital, Lattakia according to inclusion criteria. The patients were divided into two groups, the first treated with Pioglitazone and the second treated with Metformin. A Clinical, laboratory and abdominal ultrasound examination were carried out for all the participating patients at the first visit and also after 6 months. Results: weight and body mass index BMI decreased in both groups, in Group B, weight decreased by up to 10 % compared to 5% for Pioglitazone with important statistical differences P = 0.00 and body mass index decreased in Group B by 8% compared to 6 % with important statistical differences P = 0.02. Fasting blood Glucose Concentration decreased in both groups without significant statistical differences. The concentration of fasting insulin decreased in both groups, but with clear advantage for Group A with significant statistical differences P= 0.00. The concentration of insulin resistance decreased in both groups with a preference for Group A with significant statistical differences P= 0.19. Conclusion: Using Pioglitazone has an advantage over Metformin in improving insulin resistance in patients with Polycystic Ovary Syndrome, in contrast, Metformin has better results in reducing weight and BMl.

Keywords: Polycystic Ovarian Syndrome, insulin resistance, hyperandrogenism, Metformin, Pioglitazone.