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...