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多囊卵巢综合征(PCOS)导致生殖和代谢功能紊乱的同时也增加罹患2型糖尿病及代谢综合征的危险。认识到胰岛素抵抗在PCOS发病中起到的作用后,以二甲双胍为代表的胰岛素增敏剂在临床广泛应用。最近一个以胎儿活产率(live-birth rate)为终点的随机对照试验(RCT)表明,单用二甲双胍治疗由PCOS引起的不孕症,其效果不及氯米芬。无证据证明应用二甲双胍能防止PCOS的妊娠妇女发生自然流产和妊娠期糖尿病。有研究噻唑烷二酮(TZD)类药物可能会增加心血管事件发生率。长期用药安全性的问题重新引起关注。
Polycystic ovary syndrome (PCOS) causes reproductive and metabolic dysfunction while also increasing the risk of developing type 2 diabetes and metabolic syndrome. Recognizing the role of insulin resistance in the pathogenesis of PCOS, insulin sensitizers represented by metformin are widely used clinically. A recent randomized controlled trial (RCT) based on a live-birth rate showed that metformin alone was less effective than clomiphene in treating infertility caused by PCOS. There is no evidence that metformin is used to prevent spontaneous abortion and gestational diabetes in pregnant women with PCOS. Studies of thiazolidinedione (TZD) drugs may increase the incidence of cardiovascular events. Long-term drug safety problems re-attract attention.