But metformin was more effective than pioglitazonein to improve hyperandrogenemia, serum insulin levels, and insulin-resistance; and pioglitazone was more efficient in regulating the menstrual cycle and clinical sign of hyperandrogenism (acne) and the adjunct of pioglitazone to metformin may not have further benefit compared to treatment with using drugs alone. Here, INS is linked to Insulin resistance.