Dataset of Insulin sensitizers for improving endocrine metabolism in overweight women with PCOS: a network meta-analysis

Objective: To evaluate the efficacy of insulin sensitizers on menstrual frequency, sex hormone and metabolic parameters in overweight women with PCOS.

Methods: We searched multiple databases from inception to September 2019 for RCTs. Network meta-analysis was conducted using multivariate random effects method.

Results: 14 trials reporting on 619 women were included. Compared with metformin, metformin + TZDs was more superior in menstrual recovery (WMD 3.68, 95% CrI 1.65 to 8.20), metformin + GLP-1 receptor agonists was more effective in decreasing AND (WMD -2.53, 95% CrI -3.96 to -1.09), both metformin + GLP-1 receptor agonists (WMD 9.22, 95% CrI 5.46 to 12.98) and metformin + TZDs (WMD 4.30, 95% CrI 0.78 to 7.82) were more effective in increasing SHBG, while TZDs was less effective in decreasing BMI (WMD 1.69, 95% CrI 0.72 to 2.66). Compared with GLP-1 receptor agonists, metformin + GLP-1 receptor agonists was associated with higher SHBG (WMD 7.80, 95% CrI 4.75 to 10.85), lower FT (WMD -1.77, 95% CrI -3.25 to -0.29), lower AND (WMD -2.70, 95% CrI -3.91 to -1.50) and lower FG (WMD -0.41, 95% CrI -0.73 to -0.08).

Conclusion: For overweight women with PCOS, both metformin combined with GLP-1 receptor agonists and metformin combined with TZDs appear superior to monotherapy in improving hyperandrogenemia. Metformin combined with TZDs could be particularly effective in promoting the recovery of menstruation. Metformin combined with GLP-1 receptor agonists has additional advantage in improving fasting glucose when compared with GLP-1 receptor agonists alone. TZDs is inferior to metformin in decreasing BMI.