Guan Yuanyuan, Wang Dongjun, Bu Huaien, Zhao Tieniu, Wang Hongwu
Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
School of Health Sciences and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
Int J Endocrinol. 2020 Sep 16;2020:5150684. doi: 10.1155/2020/5150684. eCollection 2020.
Metformin is an important component of PCOS treatment. At present, the effect of metformin in overweight women with PCOS has not been evaluated. Therefore, we conducted a systematic review to assess the effects of metformin in overweight women with PCOS and to analyze the effects of metformin in overweight women with PCOS.
We searched the PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases for studies published before March 2020. Randomized controlled trials were identified to study the effects of metformin in overweight women with PCOS. Data from studies including body mass index (BMI), waist circumference (WC), follicle-stimulating hormone (FSH), homeostasis model assessment of insulin resistance (HOMA-IR), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol (TC), triglycerides (TG), fasting blood glucose (FBG), fasting insulin, testosterone, and androstenedione were pooled. Qualified trials were selected, and methodological quality was strictly assessed. Two reviewers chose the studies independently of each other.
Twelve trials were included. The intervention group and the control group had significant differences in the changes in body mass index (BMI) (WMD = -1.25, 95% CI (-1.60, -0.91), < 0.00001) and waist circumference (WC) (WMD = -1.41, 95% CI (-2.46, -0.37), =0.008) after metformin. The comprehensive results show that, in all studies, overweight women with polycystic ovary syndrome treated with metformin had significantly improved endocrine and metabolic indicators, including testosterone, follicle-stimulating hormone, luteinizing hormone, and low-density lipoprotein cholesterol. However, metformin did not regulate the secretion indexes of fasting insulin, homeostasis model assessment of insulin resistance, sex hormone-binding globulin, high-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting blood glucose, and androstenedione.
Compared with control interventions, metformin appears to be an effective intervention for overweight women with PCOS.
二甲双胍是多囊卵巢综合征（PCOS）治疗的重要组成部分。目前，二甲双胍在超重PCOS女性中的疗效尚未得到评估。因此，我们进行了一项系统评价，以评估二甲双胍对超重PCOS女性的影响，并分析二甲双胍在超重PCOS女性中的作用。
我们检索了截至2020年3月发表的PubMed、Cochrane图书馆、Embase、中国知网（CNKI）、维普资讯（VIP）和万方数据库。纳入随机对照试验，以研究二甲双胍对超重PCOS女性的影响。汇总了包括体重指数（BMI）、腰围（WC）、促卵泡生成素（FSH）、胰岛素抵抗稳态模型评估（HOMA-IR）、促黄体生成素（LH）、性激素结合球蛋白（SHBG）、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、总胆固醇（TC）、甘油三酯（TG）、空腹血糖（FBG）、空腹胰岛素、睾酮和雄烯二酮等研究数据。选择合格的试验，并严格评估方法学质量。两名评审员相互独立地选择研究。
纳入12项试验。二甲双胍治疗后，干预组和对照组在体重指数（BMI）变化（加权均数差（WMD）=-1.25，95%置信区间（CI）（-1.60，-0.91），P<0.00001）和腰围（WC）变化（WMD=-1.41，95%CI（-2.46,-0.37），P=0.008）方面存在显著差异。综合结果显示，在所有研究中，接受二甲双胍治疗的超重多囊卵巢综合征女性的内分泌和代谢指标有显著改善，包括睾酮、促卵泡生成素、促黄体生成素和低密度脂蛋白胆固醇。然而，二甲双胍并未调节空腹胰岛素分泌指标、胰岛素抵抗稳态模型评估、性激素结合球蛋白、高密度脂蛋白胆固醇、总胆固醇、甘油三酯、空腹血糖和雄烯二酮。
与对照干预相比，二甲双胍似乎是超重PCOS女性的有效干预措施。
