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To compare the effects and safety of low-dose spironolactone combined with metformin or either drug alone on insulin resistance (IR) and functional improvement in patients with PCOS, this was a single-center, randomized, open-label, pilot study of patients with PCOS at the Third Affiliated Hospital of Guangzhou Medical University between 01\/2014 and 01\/2016. The participants were randomized 1\u2009:\u20091\u2009:\u20091 to metformin, spironolactone, or metformin\u2009+\u2009spironolactone. The primary endpoint was the change in the homeostatic model assessment (HOMA)-IR after 12 weeks of treatment. A total of 189 participants were randomized (63 per group); 31 dropped out, and 54, 51, and 53 completed the 12-week treatment in the metformin, spironolactone, and combined groups, respectively. There were no differences in any parameters between the metformin and spironolactone groups (all P\u2009&gt;\u20090.05). In the combined group, after 12 weeks of treatment, HOMA-IR (1.71\u2009\u00b1\u20090.91) was lower than in the metformin (1.92\u2009\u00b1\u20091.07, P\u2009&lt;\u20090.05) and spironolactone (2.38\u2009\u00b1\u20091.14, P\u2009&lt;\u20090.05) groups. In addition, total testosterone (TT), free androgen index (FAI), and area under the curve-insulin (AUCins) were lower in the combined group compared with the metformin group (all P\u2009&lt;\u20090.05), while TT, FAI, HOMA-\u03b2, fasting plasma glucose, and AUCins were lower in the spironolactone group (all P\u2009&lt;\u20090.05). Both metformin and spironolactone decreased HOMA-IR in patients with PCOS but without differences between the two monotherapies. The combined therapy decreased HOMA-IR to a greater extent than monotherapy.<\/jats:p>","DOI":"10.1155\/2022\/9927240","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T19:35:05Z","timestamp":1647718505000},"page":"1-8","source":"Crossref","is-referenced-by-count":13,"title":["Effects of Low-Dose Spironolactone Combined with Metformin or Either Drug Alone on Insulin Resistance in Patients with Polycystic Ovary Syndrome: A Pilot Study"],"prefix":"10.1155","volume":"2022","author":[{"given":"Tao","family":"Long","sequence":"first","affiliation":[{"name":"Endocrinology Department, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0245-8694","authenticated-orcid":true,"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Endocrinology Department, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunping","family":"Zeng","sequence":"additional","affiliation":[{"name":"Endocrinology Department, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Endocrinology Department, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Endocrinology Department, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Endocrinology Department, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2350"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000002656"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1056\/nejmcp1514916"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.4158\/ep15748.dsc"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.05.003"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.19.2081"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.4158\/ep15748.dscpt2"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.09.024"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1530\/eje-14-0253"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.57"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.08.031"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd005552.pub2"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.03.036"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1210\/er.2008-0030"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000194.pub2"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1040"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031780"},{"issue":"1","key":"18","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/humrep\/deh098","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)","volume":"19","author":"E. 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