Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Br J Nutr. 2023 Jul 28;130(2):202-210. doi: 10.1017/S0007114522003270. Epub 2023 Jan 4.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases characterised by unusual levels of sex hormones and dysfunction of the ovaries. The infertility rate is high among patients with PCOS. Unusual hormonal status can lead to the inability of ovaries to release functional and mature follicles. Clinical trials on the effects of N-acetylcysteine (NAC) supplementation on ovulation and sex hormones profile in women with PCOS have been controversial. We performed a systematic review and meta-analysis to evaluate the potential effects of NAC supplementation on ovulation and sex hormones profile. PubMed, Scopus, Embase, Web of Science and Cochrane Central library international databases were searched till September 2021. Meta-analysis was performed using a random-effects approach in case of significant between-study heterogeneity. Eighteen studies, including 2185 participants, were included in the present meta-analysis. NAC significantly reduced total testosterone (TT) levels (standardised mean difference (SMD): −0·25 ng/ml; 95 % CI (−0·39, −0·10); ‘ < 0·001’, = 53·9 %, = 0·034) and increased follicle-stimulating hormone (FSH) levels (SMD: 0·39 mg/ml; 95 % CI (0·07, 0·71); = 0·01, = 70·9 %, = 0·002). Oestrogen levels also increased after correcting publication bias. However, no significant effect was observed on the number of follicles, endometrial thickness, progesterone, serum luteinising hormone levels and sex hormone-binding globulin. The results indicated that NAC supplementation decreased TT levels and increased FSH levels. Overall, NAC supplementation might be effective in the improvement of reproductive system function in patients with PCOS.
多囊卵巢综合征（PCOS）是最常见的内分泌疾病之一，其特征是性激素水平异常和卵巢功能障碍。PCOS 患者的不孕率较高。异常的激素状态可导致卵巢无法释放功能正常和成熟的卵泡。关于 N-乙酰半胱氨酸（NAC）补充剂对 PCOS 患者排卵和性激素谱的影响的临床试验一直存在争议。我们进行了系统评价和荟萃分析，以评估 NAC 补充剂对排卵和性激素谱的潜在影响。检索了 PubMed、Scopus、Embase、Web of Science 和 Cochrane 中央图书馆国际数据库，直到 2021 年 9 月。如果存在研究间异质性，采用随机效应方法进行荟萃分析。本荟萃分析共纳入 18 项研究，包括 2185 名参与者。NAC 可显著降低总睾酮（TT）水平（标准化均数差（SMD）：−0·25 ng/ml；95 % CI（−0·39，−0·10）；< 0·001， = 53·9 %， = 0·034）和增加卵泡刺激素（FSH）水平（SMD：0·39 mg/ml；95 % CI（0·07，0·71）； = 0·01， = 70·9 %， = 0·002）。在纠正发表偏倚后，雌激素水平也有所增加。然而，NAC 补充剂对卵泡数量、子宫内膜厚度、孕激素、血清促黄体生成素水平和性激素结合球蛋白无显著影响。结果表明，NAC 补充剂可降低 TT 水平，增加 FSH 水平。总体而言，NAC 补充剂可能对改善 PCOS 患者的生殖系统功能有效。
