Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis.

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Insulin 1 endocrinologydiseasesdrugs
Troglitazone 1 endocrinologydiseasesdrugs
hyperandrogenism 2 endocrinologydiseases
pioglitazone 76 endocrinologydiseasesdrugs
polycystic ovary syndrome 15 endocrinologydiseases
metformin 66 endocrinologydiseasesdrugs
obesity 3 endocrinologydiseases
rosiglitazone 3 endocrinologydiseasesdrugs
testosterone 6 endocrinologydiseasesdrugs

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Insulin 3569 of its different hypotypes. For example, PPAR-γ1 can specifically regulate ovarian function [[11]]. Insulin resistance is an important aspect of PCOS and has been observed not only in obese but also in lean women
Troglitazone 26861 and have the effects of anti-inflammatory. TZDs include rosiglitazone, pioglitazone and troglitazone. Troglitazone has been eliminated due to its serious liver toxicity. In 2010, the FDA carried on the strict restrictions
metformin 94 Title: Archives of Gynecology and ObstetricsComparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysisYifeng XuYanxiang WuQin HuangPublication date (epub):
metformin 608 literatures to objectively evaluate the clinical effectiveness and safety by comparing pioglitazone with metformin administrated by PCOS patients. Searches were performed in Cochrane Library, EMBASE and PubMed (last
metformin 1059 that improvement of the menstrual cycle and ovulation in pioglitazone treatment group was better than metformin group [OR = 2.31, 95% CI (1.37, 3.91), P < 0.001, I2 = 41.8%]. Improvement of the F-G scores in
metformin 1171 group [OR = 2.31, 95% CI (1.37, 3.91), P < 0.001, I2 = 41.8%]. Improvement of the F-G scores in metformin treatment group was better than pioglitazone group [SMD = 0.29, 95% CI (0.0, 0.59), P = 0.048, I2 = 0.0%].
metformin 1346 95% CI (0.0, 0.59), P = 0.048, I2 = 0.0%]. BMI was more elevated in pioglitazone group than in metformin group [SMD = 0.83, 95% CI (0.24, 1.41), P = 0.006, I2 = 82.8%]. There were no significant differences
metformin 1617 groups.ConclusionsThis meta-analysis indicated that pioglitazone ameliorated menstrual cycle and ovulation better than metformin and metformin ameliorated BMI and F-G scores better than pioglitazone in treating patients with PCOS.
metformin 1631 meta-analysis indicated that pioglitazone ameliorated menstrual cycle and ovulation better than metformin and metformin ameliorated BMI and F-G scores better than pioglitazone in treating patients with PCOS. Pioglitazone
metformin 1826 PCOS. Pioglitazone might be a good choice for the patients with PCOS who were intolerant or invalid to metformin for the treatment.IntroductionPCOS (polycystic ovary syndrome) is one of the most common endocrine disorders
metformin 4543 literatures to objectively evaluate the clinical effectiveness and safety by comparing pioglitazone with metformin administrated by PCOS patients.Materials and methodsLiterature searchWe searched the literatures on
metformin 4850 was on January 10, 2017. The search terms in full text included the following: “pioglitazone”, “ metformin ”, “polycystic ovary syndrome” or “PCOS”, and “randomized controlled trial” or “randomized”.
metformin 5121 limited.Outcome measuresThe main outcome was to compare the therapeutic effect between pioglitazone and metformin prescribed for the patients with PCOS. Therapeutic parameters included menstrual cycle, body mass index
metformin 6195 (RCT) was conducted in the literature. [[3]] Groups included at least pioglitazone therapy group and metformin therapy group, and there was comparison between the two groups. [[4]] Outcome measures included at least
metformin 6466 Studies were excluded if [[1]] the therapeutic group combined using other agents with pioglitazone or metformin . [[2]] Test design was not reasonable or lacked of effective control. [[3]] Review, case report, or
metformin 8868 were 643 patients, of whom 319 patients were treated with pioglitazone and 324 patients treated with metformin . Table 1 shows the characteristics of the included randomized controlled trials. Detailed data are
metformin 10452 daily/850 mg 3 times dailyITT intention-to-treat (analysis), NR not reported, P/M pioglitazone group/ metformin groupTable 2The difference value between pre and after treatmentAuthorsGroupFBS (mg/dL)INS (μ/L)HOMA-IRBMIWHROvulationF-G
metformin 11649 (2004)P−3.92.31−201.28−4.610.2961.81.110.050.017−4.50.87M−4.72.59−20.11.45−4.780.45−1.21.6500.01−4.90.8P/M pioglitazone group/ metformin groupTable 3The difference value between pre and after treatmentAuthorsGroupTestosteroneDHEAFAISHBGTG
metformin 12578 (2004)P−0.950.37−27.433.7−14.914.6−15.17.65M−0.860.31−6.218.5−26.810.14−1.86.85P/M pioglitazone group/ metformin groupThe therapeutic effects of pioglitazone in comparison with metforminImprovement of the menstrual
metformin 12652 (2004)P−0.950.37−27.433.7−14.914.6−15.17.65M−0.860.31−6.218.5−26.810.14−1.86.85P/M pioglitazone group/metformin groupThe therapeutic effects of pioglitazone in comparison with metformin Improvement of the menstrual cycle and ovulationThere were five articles [[16], [20], [24]–[26]] in
metformin 13318 treatment group the curative effect of improving menstrual cycle and ovulation was superior to that in metformin treatment group (Fig. 2).Fig. 2The effect of pioglitazone or metformin on menstrual cycle and ovulation
metformin 13391 ovulation was superior to that in metformin treatment group (Fig. 2).Fig. 2The effect of pioglitazone or metformin on menstrual cycle and ovulation in patients with polycystic ovary syndrome. Overall pioglitazone superior
metformin 13511 menstrual cycle and ovulation in patients with polycystic ovary syndrome. Overall pioglitazone superior to metformin . OR Odds ratio, CI confidence intervalEffect of sex hormones and the clinical manifestationsOnly one
metformin 14356 P > 0.05]. It showed that there was no difference of free testosterone induced by pioglitazone or metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free testosterone in patients with polycystic
metformin 14413 free testosterone induced by pioglitazone or metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free testosterone in patients with polycystic ovary syndrome. Overall no differences between two
metformin 15131 (−0.61, 0.36), P > 0.05]. It showed that there was no difference of DHEA induced by pioglitazone or metformin (Fig. 4).Fig. 4The effect of pioglitazone or metformin on DHEA in patients with polycystic ovary syndrome.
metformin 15188 difference of DHEA induced by pioglitazone or metformin (Fig. 4).Fig. 4The effect of pioglitazone or metformin on DHEA in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 15883 (−1.16, 0.7), P > 0.05]. It showed that there was no difference of FAI induced by pioglitazone or metformin (Fig. 5).Fig. 5The effect of pioglitazone or metformin on FAI in patients with polycystic ovary syndrome.
metformin 15940 difference of FAI induced by pioglitazone or metformin (Fig. 5).Fig. 5The effect of pioglitazone or metformin on FAI in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 16634 (−0.5, 5.06), P > 0.05]. It showed that there was no difference of SHBG induced by pioglitazone or metformin (Fig. 6).Fig. 6The effect of pioglitazone or metformin on SHBG in patients with polycystic ovary syndrome.
metformin 16691 difference of SHBG induced by pioglitazone or metformin (Fig. 6).Fig. 6The effect of pioglitazone or metformin on SHBG in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 17332 significant between the two groups [SMD = 0.29, 95% CI (0.0, 0.59), P = 0.048]. It showed that in metformin treatment group the improvement of F-G score was superior to that in pioglitazone treatment group (Fig. 7).Fig. 7The
metformin 17487 was superior to that in pioglitazone treatment group (Fig. 7).Fig. 7The effect of pioglitazone or metformin on F-G scores in patients with polycystic ovary syndrome. Overall metformin superior to pioglitazone.
metformin 17563 effect of pioglitazone or metformin on F-G scores in patients with polycystic ovary syndrome. Overall metformin superior to pioglitazone. SMD standardized mean difference, CI confidence intervalEffects on glucose
metformin 18229 (−0.09, 0.38), P > 0.05]. It showed that there was no difference of FBS induced by pioglitazone or metformin (Fig. 8).Fig. 8The effect of pioglitazone or metformin on FBS in patients with polycystic ovary syndrome.
metformin 18286 difference of FBS induced by pioglitazone or metformin (Fig. 8).Fig. 8The effect of pioglitazone or metformin on FBS in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 19001 (−1.39, 0.01), P = 0.054]. It showed that there was no difference of INS induced by pioglitazone or metformin (Fig. 9).Fig. 9The effect of pioglitazone or metformin on INS in patients with polycystic ovary syndrome.
metformin 19058 difference of INS induced by pioglitazone or metformin (Fig. 9).Fig. 9The effect of pioglitazone or metformin on INS in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 19783 (−1.28, 0.14), P > 0.05]. It showed that there was no difference of HOMA-IR induced by pioglitazone or metformin (Fig. 10).Fig. 10The effect of pioglitazone or metformin on HOMA-IR in patients with polycystic ovary
metformin 19842 difference of HOMA-IR induced by pioglitazone or metformin (Fig. 10).Fig. 10The effect of pioglitazone or metformin on HOMA-IR in patients with polycystic ovary syndrome. Overall no differences between two therapies.
metformin 20727 (0.24, 1.41), P = 0.006]. It showed that in pioglitazone treatment group BMI added more than that in metformin treatment group (Fig. 11).Fig. 11The effect of pioglitazone or metformin on BMI in patients with polycystic
metformin 20802 added more than that in metformin treatment group (Fig. 11).Fig. 11The effect of pioglitazone or metformin on BMI in patients with polycystic ovary syndrome. Overall pioglitazone added more than metformin. SMD
metformin 20900 or metformin on BMI in patients with polycystic ovary syndrome. Overall pioglitazone added more than metformin . SMD standardized mean difference, CI confidence intervalMeasure of WHR: WHR of the two groups was measured
metformin 21507 (−0.53, 1.7), P > 0.05]. It showed that there was no difference of WHR induced by pioglitazone or metformin (Fig. 12).Fig. 12The effect of pioglitazone or metformin on WHR in patients with polycystic ovary
metformin 21566 difference of WHR induced by pioglitazone or metformin (Fig. 12).Fig. 12The effect of pioglitazone or metformin on WHR in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 22276 (−1.29, 0.31), P > 0.05]. It showed that there was no difference of TC induced by pioglitazone or metformin (Fig. 13).Fig. 13The effect of pioglitazone or metformin on TC in patients with polycystic ovary syndrome.
metformin 22335 difference of TC induced by pioglitazone or metformin (Fig. 13).Fig. 13The effect of pioglitazone or metformin on TC in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 23029 (−0.26, 0.24), P > 0.05]. It showed that there was no difference of TG induced by pioglitazone or metformin (Fig. 14).Fig. 14The effect of pioglitazone or metformin on TG in patients with polycystic ovary syndrome.
metformin 23088 difference of TG induced by pioglitazone or metformin (Fig. 14).Fig. 14The effect of pioglitazone or metformin on TG in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD
metformin 28436 analysis results show that pioglitazone could improve the menstrual cycle and ovulation better than metformin , but significantly increase BMI compared with metformin. Improvement of hirsutism by metformin was superior
metformin 28492 the menstrual cycle and ovulation better than metformin, but significantly increase BMI compared with metformin . Improvement of hirsutism by metformin was superior to that by pioglitazone. Pioglitazone had the similar
metformin 28531 than metformin, but significantly increase BMI compared with metformin. Improvement of hirsutism by metformin was superior to that by pioglitazone. Pioglitazone had the similar effects on FBS, INS, HOMA-IR, TG,
metformin 28676 pioglitazone. Pioglitazone had the similar effects on FBS, INS, HOMA-IR, TG, TC, T, DHEA, FAI, SHBG and WHR as metformin .The menstrual cycle and ovulation was ameliorated by pioglitazone or metformin in four literatures,
metformin 28755 FAI, SHBG and WHR as metformin.The menstrual cycle and ovulation was ameliorated by pioglitazone or metformin in four literatures, and pioglitazone was better than metformin. In nine literatures, pioglitazone obviously
metformin 28819 was ameliorated by pioglitazone or metformin in four literatures, and pioglitazone was better than metformin . In nine literatures, pioglitazone obviously elevated BMI but metformin decreased BMI, and this was
metformin 28891 pioglitazone was better than metformin. In nine literatures, pioglitazone obviously elevated BMI but metformin decreased BMI, and this was in accordance with the guideline or consensus. In five literatures, pioglitazone
metformin 29013 BMI, and this was in accordance with the guideline or consensus. In five literatures, pioglitazone or metformin had no effects on WHR; there was no difference between the two agents and this indirectly showed that
metformin 29592 fluid retention [[44]]. In four literatures, F-G scores of hirsutism were decreased by pioglitazone or metformin , and metformin was a little better than pioglitazone. In seven literatures, FBS, insulin and HOMA-IR
metformin 29607 [[44]]. In four literatures, F-G scores of hirsutism were decreased by pioglitazone or metformin, and metformin was a little better than pioglitazone. In seven literatures, FBS, insulin and HOMA-IR were deceased
metformin 29736 than pioglitazone. In seven literatures, FBS, insulin and HOMA-IR were deceased by pioglitazone or metformin , and there were no differences between the two agents. The effects on androgen and lipid were different
metformin 29955 the literatures. Many literatures showed that pioglitazone ameliorated androgen and lipid better than metformin , but there was no difference between the two agents from meta-analysis. Based on different dosages and
metformin 30791 compared in detail only in one literature of Kashani. Gastrointestinal reaction was more significant in metformin group than in pioglitazone group. Pioglitazone increased appetite more than metformin. The two agents
metformin 30877 significant in metformin group than in pioglitazone group. Pioglitazone increased appetite more than metformin . The two agents both had no effects on liver function such as AST and ALT.There are some deficiencies
metformin 32214 All of the above might increase the error of the results. (4) The dosages of both pioglitazone and metformin used in the individual studies are very heterogeneous. Dosages of pioglitazone were 30 and 45 mg per
metformin 32346 studies are very heterogeneous. Dosages of pioglitazone were 30 and 45 mg per day, and dosages of metformin were 1000, 1500, 1700, and 2550 mg per day. This fact might strongly affect the outcomes of the studies.
metformin 33134 groups.ConclusionsOur study shows that pioglitazone improved menstrual cycle and ovulation of PCOS patients better than metformin . In contrast with pioglitazone, metformin could reduce weight and ameliorate symptoms of hirsutism better.
metformin 33176 menstrual cycle and ovulation of PCOS patients better than metformin. In contrast with pioglitazone, metformin could reduce weight and ameliorate symptoms of hirsutism better. Two agents had similar effects on other
metformin 33437 alternative treatment in insulin-resistant or obese PCOS women who do not tolerate or do not respond to metformin therapy and 30 mg daily of pioglitazone therapy for 3–6 months may be a better choice. In the future,
pioglitazone 77 Title: Archives of Gynecology and ObstetricsComparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysisYifeng XuYanxiang WuQin HuangPublication
pioglitazone 590 the related literatures to objectively evaluate the clinical effectiveness and safety by comparing pioglitazone with metformin administrated by PCOS patients. Searches were performed in Cochrane Library, EMBASE and
pioglitazone 1014 estimates. The results of the meta-analysis suggest that improvement of the menstrual cycle and ovulation in pioglitazone treatment group was better than metformin group [OR = 2.31, 95% CI (1.37, 3.91), P < 0.001, I2 = 41.8%].
pioglitazone 1213 P < 0.001, I2 = 41.8%]. Improvement of the F-G scores in metformin treatment group was better than pioglitazone group [SMD = 0.29, 95% CI (0.0, 0.59), P = 0.048, I2 = 0.0%]. BMI was more elevated in pioglitazone
pioglitazone 1319 pioglitazone group [SMD = 0.29, 95% CI (0.0, 0.59), P = 0.048, I2 = 0.0%]. BMI was more elevated in pioglitazone group than in metformin group [SMD = 0.83, 95% CI (0.24, 1.41), P = 0.006, I2 = 82.8%]. There
pioglitazone 1550 significant differences of the other data between the two groups.ConclusionsThis meta-analysis indicated that pioglitazone ameliorated menstrual cycle and ovulation better than metformin and metformin ameliorated BMI and F-G
pioglitazone 1684 cycle and ovulation better than metformin and metformin ameliorated BMI and F-G scores better than pioglitazone in treating patients with PCOS. Pioglitazone might be a good choice for the patients with PCOS who were
pioglitazone 3286 treatment of diabetes. TZDs, the classical insulin sensitizers include troglitazone, rosiglitazone and pioglitazone . The pathogenesis of PCOS may be related to the alteration of PPAR-γ gene, and PPAR-γ seems to play
pioglitazone 4525 the related literatures to objectively evaluate the clinical effectiveness and safety by comparing pioglitazone with metformin administrated by PCOS patients.Materials and methodsLiterature searchWe searched the
pioglitazone 4830 last searching time was on January 10, 2017. The search terms in full text included the following: “ pioglitazone ”, “metformin”, “polycystic ovary syndrome” or “PCOS”, and “randomized controlled trial”
pioglitazone 5104 languages were not limited.Outcome measuresThe main outcome was to compare the therapeutic effect between pioglitazone and metformin prescribed for the patients with PCOS. Therapeutic parameters included menstrual cycle,
pioglitazone 6164 The randomized controlled study (RCT) was conducted in the literature. [[3]] Groups included at least pioglitazone therapy group and metformin therapy group, and there was comparison between the two groups. [[4]] Outcome
pioglitazone 6450 in the study. Studies were excluded if [[1]] the therapeutic group combined using other agents with pioglitazone or metformin. [[2]] Test design was not reasonable or lacked of effective control. [[3]] Review, case
pioglitazone 8825 [[48]]Study characteristicsIn total, there were 643 patients, of whom 319 patients were treated with pioglitazone and 324 patients treated with metformin. Table 1 shows the characteristics of the included randomized
pioglitazone 10433 dailyOrtega2004MéxicoYesNRNRNRYes25/275/628.8 ± 0.9/29 ± 0.8NR630 mg daily/850 mg 3 times dailyITT intention-to-treat (analysis), NR not reported, P/M pioglitazone group/metformin groupTable 2The difference value between pre and after treatmentAuthorsGroupFBS (mg/dL)INS
pioglitazone 11630 (2004)P−3.92.31−201.28−4.610.2961.81.110.050.017−4.50.87M−4.72.59−20.11.45−4.780.45−1.21.6500.01−4.90.8P/M pioglitazone group/metformin groupTable 3The difference value between pre and after treatmentAuthorsGroupTestosteroneDHEAFAISHBGTG
pioglitazone 12559 (2004)P−0.950.37−27.433.7−14.914.6−15.17.65M−0.860.31−6.218.5−26.810.14−1.86.85P/M pioglitazone group/metformin groupThe therapeutic effects of pioglitazone in comparison with metforminImprovement
pioglitazone 12620 (2004)P−0.950.37−27.433.7−14.914.6−15.17.65M−0.860.31−6.218.5−26.810.14−1.86.85P/M pioglitazone group/metformin groupThe therapeutic effects of pioglitazone in comparison with metforminImprovement of the menstrual cycle and ovulationThere were five articles
pioglitazone 13202 significant between the two groups [OR = 2.31, 95% CI (1.37, 3.91), P < 0.001]. It showed that in pioglitazone treatment group the curative effect of improving menstrual cycle and ovulation was superior to that
pioglitazone 13375 cycle and ovulation was superior to that in metformin treatment group (Fig. 2).Fig. 2The effect of pioglitazone or metformin on menstrual cycle and ovulation in patients with polycystic ovary syndrome. Overall pioglitazone
pioglitazone 13486 pioglitazone or metformin on menstrual cycle and ovulation in patients with polycystic ovary syndrome. Overall pioglitazone superior to metformin. OR Odds ratio, CI confidence intervalEffect of sex hormones and the clinical
pioglitazone 14340 (−0.22, 0.31), P > 0.05]. It showed that there was no difference of free testosterone induced by pioglitazone or metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free testosterone in patients
pioglitazone 14397 difference of free testosterone induced by pioglitazone or metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free testosterone in patients with polycystic ovary syndrome. Overall no differences
pioglitazone 15115 [SMD = −0.12, 95% CI (−0.61, 0.36), P > 0.05]. It showed that there was no difference of DHEA induced by pioglitazone or metformin (Fig. 4).Fig. 4The effect of pioglitazone or metformin on DHEA in patients with polycystic
pioglitazone 15172 there was no difference of DHEA induced by pioglitazone or metformin (Fig. 4).Fig. 4The effect of pioglitazone or metformin on DHEA in patients with polycystic ovary syndrome. Overall no differences between two
pioglitazone 15867 [SMD = −0.23, 95% CI (−1.16, 0.7), P > 0.05]. It showed that there was no difference of FAI induced by pioglitazone or metformin (Fig. 5).Fig. 5The effect of pioglitazone or metformin on FAI in patients with polycystic
pioglitazone 15924 there was no difference of FAI induced by pioglitazone or metformin (Fig. 5).Fig. 5The effect of pioglitazone or metformin on FAI in patients with polycystic ovary syndrome. Overall no differences between two therapies.
pioglitazone 16618 [SMD = 2.28, 95% CI (−0.5, 5.06), P > 0.05]. It showed that there was no difference of SHBG induced by pioglitazone or metformin (Fig. 6).Fig. 6The effect of pioglitazone or metformin on SHBG in patients with polycystic
pioglitazone 16675 there was no difference of SHBG induced by pioglitazone or metformin (Fig. 6).Fig. 6The effect of pioglitazone or metformin on SHBG in patients with polycystic ovary syndrome. Overall no differences between two
pioglitazone 17411 P = 0.048]. It showed that in metformin treatment group the improvement of F-G score was superior to that in pioglitazone treatment group (Fig. 7).Fig. 7The effect of pioglitazone or metformin on F-G scores in patients with
pioglitazone 17471 improvement of F-G score was superior to that in pioglitazone treatment group (Fig. 7).Fig. 7The effect of pioglitazone or metformin on F-G scores in patients with polycystic ovary syndrome. Overall metformin superior to
pioglitazone 17585 or metformin on F-G scores in patients with polycystic ovary syndrome. Overall metformin superior to pioglitazone . SMD standardized mean difference, CI confidence intervalEffects on glucose metabolismMeasure of FBS:
pioglitazone 18213 [SMD = 0.14, 95% CI (−0.09, 0.38), P > 0.05]. It showed that there was no difference of FBS induced by pioglitazone or metformin (Fig. 8).Fig. 8The effect of pioglitazone or metformin on FBS in patients with polycystic
pioglitazone 18270 there was no difference of FBS induced by pioglitazone or metformin (Fig. 8).Fig. 8The effect of pioglitazone or metformin on FBS in patients with polycystic ovary syndrome. Overall no differences between two therapies.
pioglitazone 18985 [SMD = −0.69, 95% CI (−1.39, 0.01), P = 0.054]. It showed that there was no difference of INS induced by pioglitazone or metformin (Fig. 9).Fig. 9The effect of pioglitazone or metformin on INS in patients with polycystic
pioglitazone 19042 there was no difference of INS induced by pioglitazone or metformin (Fig. 9).Fig. 9The effect of pioglitazone or metformin on INS in patients with polycystic ovary syndrome. Overall no differences between two therapies.
pioglitazone 19767 [SMD = −0.57, 95% CI (−1.28, 0.14), P > 0.05]. It showed that there was no difference of HOMA-IR induced by pioglitazone or metformin (Fig. 10).Fig. 10The effect of pioglitazone or metformin on HOMA-IR in patients with
pioglitazone 19826 was no difference of HOMA-IR induced by pioglitazone or metformin (Fig. 10).Fig. 10The effect of pioglitazone or metformin on HOMA-IR in patients with polycystic ovary syndrome. Overall no differences between two
pioglitazone 20670 significant between the two groups [SMD = 0.83, 95% CI (0.24, 1.41), P = 0.006]. It showed that in pioglitazone treatment group BMI added more than that in metformin treatment group (Fig. 11).Fig. 11The effect
pioglitazone 20786 treatment group BMI added more than that in metformin treatment group (Fig. 11).Fig. 11The effect of pioglitazone or metformin on BMI in patients with polycystic ovary syndrome. Overall pioglitazone added more than
pioglitazone 20871 (Fig. 11).Fig. 11The effect of pioglitazone or metformin on BMI in patients with polycystic ovary syndrome. Overall pioglitazone added more than metformin. SMD standardized mean difference, CI confidence intervalMeasure of WHR: WHR
pioglitazone 21491 [SMD = 0.58, 95% CI (−0.53, 1.7), P > 0.05]. It showed that there was no difference of WHR induced by pioglitazone or metformin (Fig. 12).Fig. 12The effect of pioglitazone or metformin on WHR in patients with polycystic
pioglitazone 21550 there was no difference of WHR induced by pioglitazone or metformin (Fig. 12).Fig. 12The effect of pioglitazone or metformin on WHR in patients with polycystic ovary syndrome. Overall no differences between two therapies.
pioglitazone 22260 [SMD = −0.49, 95% CI (−1.29, 0.31), P > 0.05]. It showed that there was no difference of TC induced by pioglitazone or metformin (Fig. 13).Fig. 13The effect of pioglitazone or metformin on TC in patients with polycystic
pioglitazone 22319 there was no difference of TC induced by pioglitazone or metformin (Fig. 13).Fig. 13The effect of pioglitazone or metformin on TC in patients with polycystic ovary syndrome. Overall no differences between two therapies.
pioglitazone 23013 [SMD = −0.01, 95% CI (−0.26, 0.24), P > 0.05]. It showed that there was no difference of TG induced by pioglitazone or metformin (Fig. 14).Fig. 14The effect of pioglitazone or metformin on TG in patients with polycystic
pioglitazone 23072 there was no difference of TG induced by pioglitazone or metformin (Fig. 14).Fig. 14The effect of pioglitazone or metformin on TG in patients with polycystic ovary syndrome. Overall no differences between two therapies.
pioglitazone 24110 of the literaturesAnalysis of meta-regressionPublication year, number of cases, therapeutic doses of pioglitazone and duration of therapy were taken as covariant for meta-regression analysis. It showed that the above
pioglitazone 26830 leading to an increased appetite) and have the effects of anti-inflammatory. TZDs include rosiglitazone, pioglitazone and troglitazone. Troglitazone has been eliminated due to its serious liver toxicity. In 2010, the FDA
pioglitazone 27220 researches had not confirmed the increased risk. Animal experiments and epidemiological survey found that pioglitazone might lead to increased risk of bladder cancer. In recent years, many clinical studies have shown that
pioglitazone 27336 might lead to increased risk of bladder cancer. In recent years, many clinical studies have shown that pioglitazone treatment is not associated with increased bladder cancer risk [[32]–[39]]. In 2017, FDA determined
pioglitazone 27589 informed about the uncertainty in the literature, while retaining the current warning against the use of pioglitazone in patients with active bladder cancer and for careful considerations of risks and benefits in patients
pioglitazone 28363 in the statement of European Society of Endocrinology in 2014 [[44]]. Our analysis results show that pioglitazone could improve the menstrual cycle and ovulation better than metformin, but significantly increase BMI
pioglitazone 28565 increase BMI compared with metformin. Improvement of hirsutism by metformin was superior to that by pioglitazone . Pioglitazone had the similar effects on FBS, INS, HOMA-IR, TG, TC, T, DHEA, FAI, SHBG and WHR as metformin.The
pioglitazone 28739 TG, TC, T, DHEA, FAI, SHBG and WHR as metformin.The menstrual cycle and ovulation was ameliorated by pioglitazone or metformin in four literatures, and pioglitazone was better than metformin. In nine literatures, pioglitazone
pioglitazone 28790 menstrual cycle and ovulation was ameliorated by pioglitazone or metformin in four literatures, and pioglitazone was better than metformin. In nine literatures, pioglitazone obviously elevated BMI but metformin decreased
pioglitazone 28851 or metformin in four literatures, and pioglitazone was better than metformin. In nine literatures, pioglitazone obviously elevated BMI but metformin decreased BMI, and this was in accordance with the guideline or
pioglitazone 28997 metformin decreased BMI, and this was in accordance with the guideline or consensus. In five literatures, pioglitazone or metformin had no effects on WHR; there was no difference between the two agents and this indirectly
pioglitazone 29125 had no effects on WHR; there was no difference between the two agents and this indirectly showed that pioglitazone elevated BMI not for increasing central obesity. Studies in diabetics suggest that pioglitazone can
pioglitazone 29221 that pioglitazone elevated BMI not for increasing central obesity. Studies in diabetics suggest that pioglitazone can increase peripheral fat and may reduce visceral fat stores [[45]]. Pioglitazone can reduce ectopic
pioglitazone 29576 weight due to fluid retention [[44]]. In four literatures, F-G scores of hirsutism were decreased by pioglitazone or metformin, and metformin was a little better than pioglitazone. In seven literatures, FBS, insulin
pioglitazone 29642 scores of hirsutism were decreased by pioglitazone or metformin, and metformin was a little better than pioglitazone . In seven literatures, FBS, insulin and HOMA-IR were deceased by pioglitazone or metformin, and there
pioglitazone 29720 a little better than pioglitazone. In seven literatures, FBS, insulin and HOMA-IR were deceased by pioglitazone or metformin, and there were no differences between the two agents. The effects on androgen and lipid
pioglitazone 29899 agents. The effects on androgen and lipid were different in the literatures. Many literatures showed that pioglitazone ameliorated androgen and lipid better than metformin, but there was no difference between the two agents
pioglitazone 30105 two agents from meta-analysis. Based on different dosages and time of treatment, it shows that the pioglitazone therapy for 3 or 6 months seems better than that for 1.5 months, and either 30 or 45 mg of pioglitazone
pioglitazone 30212 pioglitazone therapy for 3 or 6 months seems better than that for 1.5 months, and either 30 or 45 mg of pioglitazone therapy is effective. But 45 mg of pioglitazone therapy seems more BMI gained. Side effects may be
pioglitazone 30261 than that for 1.5 months, and either 30 or 45 mg of pioglitazone therapy is effective. But 45 mg of pioglitazone therapy seems more BMI gained. Side effects may be mitigated using a moderate dose (e.g., ≤30 mg)
pioglitazone 30378 therapy seems more BMI gained. Side effects may be mitigated using a moderate dose (e.g., ≤30 mg) of pioglitazone [[43]]. So 30 mg daily of pioglitazone therapy for 3–6 months may be a better choice for PCOS. There
pioglitazone 30418 may be mitigated using a moderate dose (e.g., ≤30 mg) of pioglitazone [[43]]. So 30 mg daily of pioglitazone therapy for 3–6 months may be a better choice for PCOS. There was only descriptive information and
pioglitazone 30815 one literature of Kashani. Gastrointestinal reaction was more significant in metformin group than in pioglitazone group. Pioglitazone increased appetite more than metformin. The two agents both had no effects on liver
pioglitazone 32197 efficiency of the agents. All of the above might increase the error of the results. (4) The dosages of both pioglitazone and metformin used in the individual studies are very heterogeneous. Dosages of pioglitazone were 30
pioglitazone 32290 of both pioglitazone and metformin used in the individual studies are very heterogeneous. Dosages of pioglitazone were 30 and 45 mg per day, and dosages of metformin were 1000, 1500, 1700, and 2550 mg per day. This
pioglitazone 33053 data such as liver function before and after treatment in both groups.ConclusionsOur study shows that pioglitazone improved menstrual cycle and ovulation of PCOS patients better than metformin. In contrast with pioglitazone,
pioglitazone 33162 pioglitazone improved menstrual cycle and ovulation of PCOS patients better than metformin. In contrast with pioglitazone , metformin could reduce weight and ameliorate symptoms of hirsutism better. Two agents had similar effects
pioglitazone 33475 or obese PCOS women who do not tolerate or do not respond to metformin therapy and 30 mg daily of pioglitazone therapy for 3–6 months may be a better choice. In the future, high quality and multi-center study
pioglitazone 33683 study of RCT with sufficient cases are required to confirm the curative effects and side effects of pioglitazone
rosiglitazone 3268 gamma) for the treatment of diabetes. TZDs, the classical insulin sensitizers include troglitazone, rosiglitazone and pioglitazone. The pathogenesis of PCOS may be related to the alteration of PPAR-γ gene, and PPAR-γ
rosiglitazone 26815 (perhaps leading to an increased appetite) and have the effects of anti-inflammatory. TZDs include rosiglitazone , pioglitazone and troglitazone. Troglitazone has been eliminated due to its serious liver toxicity.
rosiglitazone 26984 eliminated due to its serious liver toxicity. In 2010, the FDA carried on the strict restrictions of rosiglitazone for possible increased risk of cardiovascular events. Its restriction was relieved in December 2015
testosterone 5484 assessment for insulin resistance index (HOMA-IR), total cholesterol (TC), triglyceride (TG), free testosterone (T), dehydroepiandrosterone (DHEA), free androgen index (FAI), luteinizing hormone/follicle-stimulating
testosterone 13795 the therapy between the two groups, so the above-mentioned factors were not analyzed.Measure of free testosterone : Free testosterone of the two groups was measured before and after the therapy in four articles [[17],
testosterone 13814 the two groups, so the above-mentioned factors were not analyzed.Measure of free testosterone: Free testosterone of the two groups was measured before and after the therapy in four articles [[17], [21], [23], [25]].
testosterone 14161 adopted for meta-analysis because of the clinical homogeneity. Results showed that difference of free testosterone was not significant between the two groups [SMD = 0.04, 95% CI (−0.22, 0.31), P > 0.05]. It showed
testosterone 14316 [SMD = 0.04, 95% CI (−0.22, 0.31), P > 0.05]. It showed that there was no difference of free testosterone induced by pioglitazone or metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free
testosterone 14431 induced by pioglitazone or metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free testosterone in patients with polycystic ovary syndrome. Overall no differences between two therapies. SMD standardized
Select Disease Character Offset Disease Term Instance
hyperandrogenism 2108 [[1]] who accounts for 30–60% of anovulatory infertility patients. Its basic characteristics are hyperandrogenism , chronic anovulation and polycystic ovaries. It increases the incidence of endometrial cancer and ovarian
hyperandrogenism 25670 mass and fasting insulin levels in patients with PCOS. It can obviously improve insulin sensitivity, hyperandrogenism , menstrual cycle and ovulation. Metformin is relatively safe for the fetus during pregnancy (FDA Pregnancy
obesity 2318 and ovarian cancer. In addition, patients always have the character of insulin resistance, central obesity , impaired glucose, dyslipidemia, cardiovascular risk and subclinical atherosclerosis [[2]–[4]]. PCOS
obesity 2553 type 2 diabetes in 5–10% [[5]–[7]], and 30–70% of patients with PCOS may be accompanied with obesity [[8], [9]]. The prevalence of IGT in patients with PCOS in America reached 30–35%, and 5% of these
obesity 29178 the two agents and this indirectly showed that pioglitazone elevated BMI not for increasing central obesity . Studies in diabetics suggest that pioglitazone can increase peripheral fat and may reduce visceral
polycystic ovary syndrome 1872 patients with PCOS who were intolerant or invalid to metformin for the treatment.IntroductionPCOS ( polycystic ovary syndrome ) is one of the most common endocrine disorders in women, and it affects about 5–7% women of reproductive
polycystic ovary syndrome 4867 2017. The search terms in full text included the following: “pioglitazone”, “metformin”, “ polycystic ovary syndrome ” or “PCOS”, and “randomized controlled trial” or “randomized”. Publication time, genre
polycystic ovary syndrome 13451 (Fig. 2).Fig. 2The effect of pioglitazone or metformin on menstrual cycle and ovulation in patients with polycystic ovary syndrome . Overall pioglitazone superior to metformin. OR Odds ratio, CI confidence intervalEffect of sex hormones
polycystic ovary syndrome 14461 metformin (Fig. 3).Fig. 3The effect of pioglitazone or metformin on free testosterone in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 15223 pioglitazone or metformin (Fig. 4).Fig. 4The effect of pioglitazone or metformin on DHEA in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 15974 pioglitazone or metformin (Fig. 5).Fig. 5The effect of pioglitazone or metformin on FAI in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 16726 pioglitazone or metformin (Fig. 6).Fig. 6The effect of pioglitazone or metformin on SHBG in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 17528 treatment group (Fig. 7).Fig. 7The effect of pioglitazone or metformin on F-G scores in patients with polycystic ovary syndrome . Overall metformin superior to pioglitazone. SMD standardized mean difference, CI confidence intervalEffects
polycystic ovary syndrome 18320 pioglitazone or metformin (Fig. 8).Fig. 8The effect of pioglitazone or metformin on FBS in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 19092 pioglitazone or metformin (Fig. 9).Fig. 9The effect of pioglitazone or metformin on INS in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 19880 or metformin (Fig. 10).Fig. 10The effect of pioglitazone or metformin on HOMA-IR in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalEffects
polycystic ovary syndrome 20836 treatment group (Fig. 11).Fig. 11The effect of pioglitazone or metformin on BMI in patients with polycystic ovary syndrome . Overall pioglitazone added more than metformin. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 21600 pioglitazone or metformin (Fig. 12).Fig. 12The effect of pioglitazone or metformin on WHR in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 22368 pioglitazone or metformin (Fig. 13).Fig. 13The effect of pioglitazone or metformin on TC in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalMeasure
polycystic ovary syndrome 23121 pioglitazone or metformin (Fig. 14).Fig. 14The effect of pioglitazone or metformin on TG in patients with polycystic ovary syndrome . Overall no differences between two therapies. SMD standardized mean difference, CI confidence intervalAnalysis

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