The combined pharmacological treatment increased the expression of PKM2 and LDH-A and the lactate and ATP levels, without altering the NAD+/NADH ratio, thus suggesting that the reversal of some pathological changes in the ovarian tissue of PCOS rats as observed after the combined treatment, may be associated with the action of metformin on glucose metabolism [46]. Here, PKM is linked to polycystic ovary syndrome.