Departamento de Genética, Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.
Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México City, México.
Gynecol Endocrinol. 2021 Nov;37(11):968-976. doi: 10.1080/09513590.2021.1913114. Epub 2021 Apr 26.
To improve insulin action, most clinicians prescribe Metformin in patients with insulin resistance (IR). Women with polycystic ovary syndrome (PCOS), in which IR is an important physiopathological mechanism, treatment with Metformin and specialized diets have been suggested to reduce the patient's IR. However, numerous studies have demonstrated conflicting results with respect to supplementing a diet with Metformin. Therefore, we conducted a meta-analysis to determine if Metformin provides a benefit in conjunction with hypocaloric diets to improve insulin sensitivity in PCOS women.
PubMed, SCOPUS, LILACS, and EBSCO databases and retrieved studies' bibliographies were searched for prospective studies that investigated the effect between Metformin and hypocaloric diets in PCOS women until April 2020. Pre- and post-intervention values for fasting plasma glucose (FPG), fasting plasma insulin (FPI), and IR indices (HOMA1-IR, ISI, and QUICKI) were extracted. Using Comprehensive Meta-Analysis software, the pooled standard difference in the means (SDM) and 95%CIs were calculated.
11 publications (12 studies) were selected. There was not a benefit of adding Metformin to a hypocaloric diet with respect to FPG (SDM= -0.17; 95%CI: -0.48-0.14, = .28) and FPI (SDM = 0.16; 95%CI: -0.24-0.55, = .45). None of the IR indices also demonstrated any benefit of using Metformin when a diet intervention was implemented (HOMA1-IR: SDM = 0.28; 95%CI: -0.27-0.84, = .315; ISI: SDM = 0.344; 95%CI: -0.17-0.85, = .186; QUICKI: SDM= -0.01; 95%CI: -0.42-0.41, = .968).
Here, we determined that adding Metformin to hypocaloric diets did not improve serum glucose or insulin concentrations as well as IR in PCOS women.
为了改善胰岛素作用，大多数临床医生会给胰岛素抵抗（IR）患者开二甲双胍。多囊卵巢综合征（PCOS）患者的 IR 是一种重要的病理生理机制，有研究建议用二甲双胍和专门的饮食来治疗，以降低患者的 IR。然而，许多研究对补充二甲双胍饮食的结果存在争议。因此，我们进行了一项荟萃分析，以确定二甲双胍与低热量饮食联合应用是否能改善 PCOS 女性的胰岛素敏感性。
检索了 PubMed、SCOPUS、LILACS 和 EBSCO 数据库以及检索到的研究参考文献，以寻找直至 2020 年 4 月调查二甲双胍与 PCOS 女性低热量饮食之间影响的前瞻性研究。提取空腹血糖（FPG）、空腹血浆胰岛素（FPI）和 IR 指数（HOMA1-IR、ISI 和 QUICKI）的干预前后值。使用 Comprehensive Meta-Analysis 软件计算合并标准差（SDM）和 95%CI。
共纳入 11 项研究（12 项研究）。与低热量饮食相比，添加二甲双胍并没有降低 FPG（SDM = -0.17；95%CI：-0.48-0.14， = .28）和 FPI（SDM = 0.16；95%CI：-0.24-0.55， = .45）的作用。当实施饮食干预时，IR 指数也没有任何使用二甲双胍的获益（HOMA1-IR：SDM = 0.28；95%CI：-0.27-0.84， = .315；ISI：SDM = 0.344；95%CI：-0.17-0.85， = .186；QUICKI：SDM = -0.01；95%CI：-0.42-0.41， = .968）。
本研究发现，在低热量饮食中添加二甲双胍并不能改善 PCOS 女性的血清葡萄糖或胰岛素浓度以及 IR。
