Evidence map›Paper›PMID 41489804›Full record

ArticleJournal of endocrinological investigation2026

Effect on insulin clearance of different pharmacological treatments in women with polycystic ovary syndrome: a hypothesis-generative study.

Flavia Tosi, Maria Elisabetta Zanolin, Sabrina Garofalo, Veronica Gremes, Giacomo Zoppini, Paolo Moghetti

Abstract read
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In one paragraph

Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Flavia TosiEndocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, P.le Stefani, 1, I-37126, Verona, Italy.
Maria Elisabetta ZanolinDepartment of Public Health and Community Medicine, University of Verona, Verona, Italy.
Sabrina GarofaloEndocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, P.le Stefani, 1, I-37126, Verona, Italy.
Veronica GremesEndocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, P.le Stefani, 1, I-37126, Verona, Italy.
Giacomo ZoppiniEndocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, P.le Stefani, 1, I-37126, Verona, Italy.
Paolo MoghettiEndocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, P.le Stefani, 1, I-37126, Verona, Italy. paolo.moghetti@univr.it.ORCID http://orcid.org/0000-0003-3951-0297

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeImpaired insulin clearance has been found in women with PCOS and contribute to generate hyperinsulinemia in these subjects. However, the mechanisms underlying this phenomenon remain unknown. The aim of this retrospective study was to explore if the heterogeneous treatments used in these patients to counteract their hormonal and metabolic alterations can also affect insulin clearance.

methodsForty-seven women with PCOS were included in the study. They belonged to different experimental groups, submitted to treatments with the following drugs: GnRH-agonist (buserelin, n = 10), antiandrogens (spironolactone, n = 9), metformin (n = 18), or placebo (n = 10). Metabolic clearance rate of insulin (MCRI) and insulin sensitivity were measured by the hyperinsulinemic euglycemic clamp, performed before and after treatment. Insulin secretion was estimated by the HOMA β-index.

resultsTreatments were associated, as expected, with different clinical effects. In ANOVA analysis, changes in MCRI significantly differed between treatment groups. In particular, metformin increased MCRI as compared with other treatments or placebo. Mediation analysis showed that about 25% of this effect of metformin was mediated by the concurrent BMI change, whereas it was not influenced by changes in peripheral insulin sensitivity or insulin secretion.

conclusionThe impairment of MCRI, which contributes to the hyperinsulinemia typical of PCOS, significantly improved after treatment with metformin. This effect was only partially explained by the reduction of BMI, whereas changes in insulin sensitivity did not show a mediation effect in this phenomenon, suggesting that other metformin-induced mechanisms are involved.

Indexed as

HyperinsulinismHypoglycemic AgentsInsulinInsulin ResistanceMetforminPolycystic Ovary SyndromeAdultFemaleGlucose Clamp TechniqueHumansRetrospective StudiesYoung AdultHypoglycemic AgentsInsulinMetforminHyperandrogenismInsulin clearanceInsulin sensitivityMetforminPCOSTreatment

Identifiers

PMID41489804

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.