Metformin versus myoinositol: which is better in obese PCOS patients? A randomized controlled crossover study

Summary

Context

due to the central role of metabolic abnormalities in the pathophysiology of PCOS, insulin sensitising agents have been proposed as a feasible treatment option.

Objective

to investigate which is the more effective between metformin and myoinositol on hormonal, clinical and metabolic parameters in obese patients with polycystic ovary syndrome (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 myoinositol (1000 mg twice a day) for six months. After a three month washout, the same subjects received the other compound for the following six 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 myoinositol 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 estradiol levels, androgens and AMH levels. None of these clinical and hormonal changes were observed during myoinositol 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.

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