The Effect Of Insulin Sensitization In Treatment Of The PCOS With Both Insulin Resistance And High Androgen

Objective:The aim of this study was to evaluate and compare the effect of insulin sensitizers alone and combined Diane-35 in the therapy of PCOS with both insulin resistance and high androgen,to provide new ideas for PCOS treatment.Methods:This is a randomized controlled study that was conducted over four years from June2012 to December 2016 in patients visiting Obstetrics and gynecology clinic of The First Hospital of Shanxi Medical University.160 patients aged 20-39 diagnosed PCOS with both hyperandrogenism and insulin resistance were included(all of the patients are oligomenorrhea).The patients diagnosed with high testosterone with only clinical signs and the incomplete data were excluded,at last,104 patients completed the follow-up research.According to the patient's willingness to use short-acting oral contraceptives,The patients were assigned to two groups treated with either traditional therapy with Diane-35 and insulinsensitizers(37 cases)or insulin sensitizers only(67 cases)for 3 month.Indicators for observation include Demographic data,body mass index,blood lipids,sex hormones,glucose tolerance and insulin release and pelvic ultrasound.all patients enrolled were treated with lifestyle intervention and asked to be contraception strictly during treatment.3-month later,performed the examination as pre-treatment,recorded the indicators.Establish database and deal with the data.Results:There were no significant difference among 2 groups in demographic characteristics and other items(P>0.05).Comparing with the base,AUCINS,BMI,HDL-C,T of both the two groups were lower(P < 0.05),the TC,TG,LDL is no increasing trend.(P > 0.05),No significant difference was observed between the two treatment groups with respect to decreasing the body mass index,WHR,wasit,and Improving insulin sensitivity combined with Diane-35 has a lower T and higher HDL-C compared with insulin sensitizers alone.insulin sensitizers group effectively and powerfully,invalid are 47.8%,41.8%,47.8% verus the combinition therpy(64.9%,29.7% and 64.9%),there was no statistically significant difference between the two group.Conclusion:1.Insulin sensitizers can effectively reduce androgen levels and improve insulin resistance,body fat distribution.2.Three months therapy combined Diane-35 with insulin sensitizers has lower androgen level than the insulin sensitizers alone,but not increase the effectiveness of the androgen to the normal range.3.insulin sensitization agents used alone or combined with Diane-35 for three months can increase HDL-C,and the combination effect is more better,but there is no obvious improvement for the TC,TG,LDL-C.