Introduction: Polycystic ovary syndrome (PCOS) is often associated with obesity, insulin resistance, abnormal glucose tolerance, lipid metabolic disorders, and fatty liver. It remains unknown how current therapies impact these different components of PCOS.

Objective: We aim to evaluate the effects of lifestyle intervention (low calorie diet, LCD), metformin and acarbose treatment on fat mass, insulin sensitivity, hormone profiles, liver fat content and lipids profile in obese PCOS patients with impaired glucose tolerance (IGT).

Methods: In a 12-week, randomized, open tag prospective clinical trial, we recruited thirty obese PCOS patients, and randomly divided them into three groups: LCD, metformin, and acarbose group. Body weight, adipose tissue distribution, and serum sex hormone levels were measured before and after treatment. MRI was used to measure the liver fat content (LFC) and abdominal fat mass (AFM); Insulin sensitivity and beta-cell function were evaluated by OGTT and two-step hyperglycemic clamp; Serum free fatty acids (FFAs) were measured by GC-MS.

Results: In all three groups, AFM and insulin secretion were significantly decreased as measured by MRI, OGTT and glucose clamp, respectively. LCD significantly improved the insulin sensitivity as determined by HOMA-IR, disposition index, and matsuda index. Metformin significantly improved hyperandrogenism. Interestingly, we found only acarbose significantly decreased triglyceride, FFAs, and LFC.

Conclusion: All treatment modalities were effective in the treatment of PCOS women with obesity and IGT, only acarbose significantly decreased the triglyceride and FFAs, and ameliorated the LFC, suggesting that acarbose is an effective agent that could be used in PCOS patients with IGT and fatty liver.


S. Li: None. Y. Wang: None. J. Cai: None. W. Liu: None. H. Yin: None. T. Tao: None.

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