Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis.
Comparison of the effect between pioglitazone and metformin in treating patients with PCOS:a meta-analysis.
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DOI：
10.1007/s00404-017-4480-z
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发表时间：
2017-10
影响因子：
2.6
通讯作者：
Huang Q
中科院分区：
文献类型：
--
作者：
Xu Y;Wu Y;Huang Q
吡格列酮在许多研究中被用于治疗PCOS患者，但这种治疗方法并没有得到公众的认可，也没有得到所有指南的推荐。我们对相关文献进行荟萃分析，比较吡格列酮与二甲双胍对PCOS患者的临床疗效和安全性。检索在Cochrane Library， EMBASE和PubMed（最近更新于2016年12月）中进行。通过搜索，在486篇相关文章中发现了11篇研究。采用固定效应和随机效应模型计算总体风险估计值。荟萃分析结果显示，吡格列酮治疗组对月经周期和排卵的改善情况优于二甲双胍组[OR = 2.31, 95% CI (1.37, 3.91), P < 0.001, I 2 = 41.8%]。二甲双胍治疗组F-G评分改善情况优于吡格列酮组[SMD = 0.29, 95% CI (0.0, 0.59), P = 0.048, i2 = 0.0%]。吡格列酮组BMI高于二甲双胍组[SMD = 0.83, 95% CI (0.24, 1.41), P = 0.006, i2 = 82.8%]。两组间其他数据差异无统计学意义。本荟萃分析显示，吡格列酮治疗PCOS患者改善月经周期和排卵的效果优于二甲双胍，改善BMI和F-G评分的效果优于吡格列酮。对于二甲双胍治疗不耐受或无效的PCOS患者，吡格列酮可能是一个不错的选择。
Pioglitazone was used to treat patients of PCOS in many researches, but the treatment has not been recognized by public or recommended by all the guidelines. We conducted a meta-analysis of 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 PubMed (last updated December 2016). Eleven studies among 486 related articles were identified through searches. Fixed effects and random effects models were used to calculate the overall risk 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, I 2 = 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, I 2 = 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, I 2 = 82.8%]. There were no significant differences of the other data between the two groups. This 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 might be a good choice for the patients with PCOS who were intolerant or invalid to metformin for the treatment.
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