Abdalla Mohammed A, Shah Najeeb, Deshmukh Harshal, Sahebkar Amirhossein, Östlundh Linda, Al-Rifai Rami H, Atkin Stephen L, Sathyapalan Thozhukat
Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School (HYMS), The University of Hull, Hull, UK.
Biotechnology Research Centre, Mashhad University of Medical Sciences, Pharmaceutical Technology Institute, Mashhad, Iran.
Clin Endocrinol (Oxf). 2022 Apr;96(4):443-459. doi: 10.1111/cen.14636. Epub 2021 Nov 14.
Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age. It is associated with dyslipidaemia and elevated plasma C-reactive protein (CRP), which increase the risks of cardiovascular disease (CVD).
To review the existing evidence on the effects of different pharmacological interventions on lipid profiles and CRP of women with PCOS.
We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library, and Web of Science in April 2020 and updated the results in March 2021.
The study included randomized controlled trials (RCTs) and follows the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA).
Two independent researchers extracted data and assessed for risk of bias using the Cochrane risk of bias tool. Covidence systematic review software were used for blinded screening and study selection.
In 29 RCTs, there were significant reductions in triglycerides with atorvastatin versus placebo [mean difference (MD): -0.21 mmol/L; 95% confidence interval (CI): -0.39, -0.03, I = 0%, moderate grade evidence]. Significant reductions were seen for low-density lipoprotein cholesterol (LDL-C) with metformin versus placebo [standardized mean difference (SMD): -0.41; 95% CI: -0.85, 0.02, I = 59%, low grade evidence]. Significant reductions were also seen for total cholesterol with saxagliptin versus metformin (MD: -0.15 mmol/L; 95% CI: -0.23, -0.08, I = 0%, very low grade evidence). Significant reductions in C-reactive protein (CRP) were seen for atorvastatin versus placebo (MD: -1.51 mmol/L; 95% CI: -3.26 to 0.24, I = 75%, very low-grade evidence).
There were significant reductions in the lipid parameters when metformin, atorvastatin, saxagliptin, rosiglitazone and pioglitazone were compared with placebo or other agents. There was also a significant reduction of CRP with atorvastatin.
多囊卵巢综合征（PCOS）是一种影响育龄女性的异质性疾病。它与血脂异常和血浆C反应蛋白（CRP）升高有关，这会增加心血管疾病（CVD）的风险。
综述不同药物干预对PCOS女性血脂谱和CRP影响的现有证据。
我们于2020年4月检索了PubMed、MEDLINE、Scopus、Embase、Cochrane图书馆和Web of Science，并于2021年3月更新了结果。
该研究纳入了随机对照试验（RCT），并遵循2020年系统评价和Meta分析的首选报告项目（PRISMA）。
两名独立研究人员提取数据，并使用Cochrane偏倚风险工具评估偏倚风险。使用Covidence系统评价软件进行盲法筛选和研究选择。
在29项RCT中，与安慰剂相比，阿托伐他汀使甘油三酯显著降低[平均差（MD）：-0.21 mmol/L；95%置信区间（CI）：-0.39，-0.03，I² = 0%，中等质量证据]。与安慰剂相比，二甲双胍使低密度脂蛋白胆固醇（LDL-C）显著降低[标准化平均差（SMD）：-0.41；95%CI：-0.85，0.02，I² = 59%，低质量证据]。与二甲双胍相比，沙格列汀使总胆固醇显著降低（MD：-0.15 mmol/L；95%CI：-0.23，-0.08，I² = 0%，极低质量证据）。与安慰剂相比，阿托伐他汀使C反应蛋白（CRP）显著降低（MD：-1.51 mmol/L；95%CI：-3.26至0.24，I² = 75%，极低质量证据）。
与安慰剂或其他药物相比，二甲双胍、阿托伐他汀、沙格列汀、罗格列酮和吡格列酮可使血脂参数显著降低。阿托伐他汀还可使CRP显著降低。
