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辛伐他汀联合二甲双胍治疗多囊卵巢综合征的疗效:一项随机对照试验的荟萃分析。

Efficacy of simvastatin plus metformin for polycystic ovary syndrome: A meta-analysis of randomized controlled trials.

作者信息

Meng Jie, Zhu Yingjun

机构信息

Department of Obstetrics, Sino-Singapore Ego-City Hospital of Tianjin Medical University, China.

Department of Obstetrics, Tianjin Central Obstetrics and Gynecology Hospital, China.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 Feb;257:19-24. doi: 10.1016/j.ejogrb.2020.11.070. Epub 2020 Dec 1.

DOI:10.1016/j.ejogrb.2020.11.070
PMID:33338947
Abstract

INTRODUCTION

The efficacy of simvastatin plus metformin to treat polycystic ovary syndrome (PCOS) remained controversial. Therefore, we conducted this meta-analysis to explore the influence of simvastatin plus metformin versus metformin monotherapy on the treatment of PCOS.

METHODS

We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2020 and included randomized controlled trials (RCTs) assessing simvastatin plus metformin versus metformin for PCOS. This meta-analysis was performed using the random-effect model.

RESULTS

Five RCTs were included in the meta-analysis. Overall, compared with metformin monotherapy for PCOS, combined treatment with simvastatin plus metformin was associated with significantly reduced total testosterone (mean difference [MD] = -0.31; 95 % confidence interval [CI] = -0.50 to -0.13; P = 0.0009), leuteinizing hormone: follicle stimulating hormone (LH:FSH) ratio (MD = -0.92; 95 % CI = -1.62 to -0.23; P = 0.009) and low-density lipoprotein (LDL) cholesterol (MD = -34.90; 95 % CI = -39.33 to -30.47; P < 0.00001), but spontaneous menses per 6 months, volume of both ovaries, body mass index (BMI) and fasting glucose were found to be similar between two groups.

CONCLUSIONS

Combined treatment with simvastatin plus metformin was better to treat PCOS than metformin alone as evidenced by significantly reduced total testosterone, LH:FSH ratio and LDL cholesterol.

摘要

引言

辛伐他汀联合二甲双胍治疗多囊卵巢综合征(PCOS)的疗效仍存在争议。因此,我们进行了这项荟萃分析,以探讨辛伐他汀联合二甲双胍与二甲双胍单药治疗对PCOS治疗的影响。

方法

我们检索了截至2020年6月的PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库,并纳入了评估辛伐他汀联合二甲双胍与二甲双胍治疗PCOS的随机对照试验(RCT)。本荟萃分析采用随机效应模型进行。

结果

荟萃分析纳入了5项RCT。总体而言,与二甲双胍单药治疗PCOS相比,辛伐他汀联合二甲双胍治疗可显著降低总睾酮水平(平均差值[MD]=-0.31;95%置信区间[CI]=-0.50至-0.13;P=0.0009)、促黄体生成素:促卵泡生成素(LH:FSH)比值(MD=-0.92;95%CI=-1.62至-0.23;P=0.009)和低密度脂蛋白(LDL)胆固醇水平(MD=-34.90;95%CI=-39.33至-30.47;P<0.00001),但两组每6个月的自然月经情况、双侧卵巢体积、体重指数(BMI)和空腹血糖水平相似。

结论

辛伐他汀联合二甲双胍治疗PCOS的效果优于二甲双胍单药治疗,总睾酮水平、LH:FSH比值和LDL胆固醇水平显著降低即为证据。

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