Glueck et al reported that when pioglitazone was added to metformin therapy, in women with PCOS who failed to respond optimally to metformin, insulin resistance, fasting glucose, insulin level, and DHEAS significantly decreased and HDL cholesterol and sex hormone-binding globulin striking increased and menstrual cyclicity was improved (39). This evidence concerns the gene SHBG and polycystic ovary syndrome.