Objective: To investigate effects of metformin and rosiglitazone in non-obese polycystic ovary syndrome (PCOS) women with insulin resistance. Methods: Totally 200 non-obese PCOS women with insulin resistance in West China Second Hospital of Sichuan University were enrolled into this study from Sep. 2013 to Jun. 2016, and were randomly divided into two treatment groups: metformin group (1 500 mg/d) and rosiglitazone group (4 mg/d). The treatment lasted for 6 months. Their clinical and biochemical parameters were collected and compared. Results: In both groups, menstrual cycles [metformin group (37±4) days, rosiglitazone group (35±4) days] were shorter after treatment for 6 months (both P<0.01). After treatment for 6 months, body mass index [metformin group (21.6±1.6) kg/m2, rosiglitazone group (21.7±1.7) kg/m2] decreased in both groups (both P<0.01); decreased LH/FSH ratio (metformin group 1.67±0.80, rosiglitazone group 1.70±0.83) was also observed (both P<0.05). After treatment for 6 months, fasting insulin level [metformin group (13.5±5.1) mU/L, rosiglitazone group (12.7±5.6) mU/L] and homeostasis model assessment-insulin resistance index (metformin group 3.0±1.2, rosiglitazone group 2.8±1.2) were decreased in both groups (all P<0.01). Conclusions: For non-obese PCOS insulin resistance patients, screening of anthropometric and metabolic parameters is necessary. For PCOS with insulin resistance, lifestyle plus insulin sensitizers such as metformin could improve their clinical symptoms, correct the biochemical and metabolic dysfunction.
目的： 探讨二甲双胍与罗格列酮两种胰岛素增敏剂对于有胰岛素抵抗的非肥胖多囊卵巢综合征（PCOS）患者的治疗效果。 方法： 纳入2013年9月至2016年6月在四川大学华西第二医院诊断的PCOS患者，将合并胰岛素抵抗的非肥胖（BMI<25 kg/m2）PCOS患者200例以随机数字法分为二甲双胍组（100例）和罗格列酮组（100例），分别接受二甲双胍（1 500 mg/d）和罗格列酮（4 mg/d）治疗6个月，观察治疗前、后的月经情况、体质指数（BMI）、高雄激素症状（多毛及痤疮评分）、腰围和腰臀比，以及内分泌代谢指标，包括雄激素水平、空腹血糖水平、LH/FSH比值、空腹胰岛素水平、稳态模型评估法计算的胰岛素抵抗指数（HOMA-IR）等。 结果： 治疗前两组患者的临床及生化指标具有可比性。治疗6个月部分患者恢复自然月经周期、月经稀发的发生率降低；二甲双胍组治疗后月经周期缩短为（37±4） d，罗格列酮组治疗后月经周期缩短为（35±4） d，两组的月经周期较各自治疗前均明显缩短，分别比较，差异均有统计学意义（P均<0.01）。二甲双胍组治疗后BMI下降至（21.6±1.6）kg/m2，罗格列酮组下降至（21.7±1.7）kg/m2；治疗后两组的LH/FSH比值分别为1.67±0.80、1.70±0.83；均较治疗前下降且差异均有统计学意义（P均<0.05）。治疗后，两组空腹胰岛素水平［二甲双胍组（13.5±5.1） mU/L、罗格列酮组［（12.7±5.6） mU/L］及HOMA-IR（二甲双胍组3.0±1.2、罗格列酮组2.8±1.2）均较治疗前下降（P均<0.01）。 结论： 对于非肥胖尤其是正常体重的PCOS患者，应进行相关代谢指标的检测，及早发现胰岛素抵抗，并通过生活方式调整和胰岛素增敏剂治疗改善其胰岛素抵抗，纠正其代谢和内分泌紊乱。.