Data from: 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.