Obstetric and Gynecologic Department, Hangzhou Women's Hospital, Hangzhou, Zhejiang, China.
The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.
BMC Womens Health. 2024 Jul 26;24(1):426. doi: 10.1186/s12905-024-03275-w.
This study aims to analyze the efficacy of metformin on carotid intima media thickness (CIMT) and flow-mediated dilation (FMD) for patients with polycystic ovary syndrome (PCOS).
A literature search of PubMed, Embase, and the Cochrane Library from inception to December 2023 was conducted. Then, after studies selection and data extraction, the mean difference (MD) with a 95% confidence interval (CI) was used to evaluate metformin efficacy in CIMT and FMD for PCOS patients. Heterogeneity was investigated through subgroup and sensitivity analysis. The protocol of our study has been registered in PROSPERO (CRD42024497239).
A total of 12 studies with 248 patients were included. CIMT was lower in the endpoint group (after metformin) compared with the baseline group (before metformin) (MD = -0.11, 95% CI = -0.21 to -0.01, p = 0.04). FMD was higher in the endpoint group compared with the baseline group (MD = 3.25, 95% CI = 1.85 to 4.66, p < 0.01). No statistically significant difference was observed in nitroglycerin-mediated dilation (NMD) between the two groups (MD = 0.65, p = 0.51). Subgroup analysis showed that a relatively lower MD of CIMT in PCOS patients from Europe in the endpoint group compared with the baseline group (MD = -0.09, 95% CI = -0.14 to -0.04, p < 0.001). However, the MD in CIMT was not significantly different between the endpoint group and baseline group in PCOS patients from Asia (p = 0.270).
Metformin may have a beneficial effect on CIMT and FMD, but not on NMD, suggesting that metformin may help reduce cardiovascular events in PCOS patients. Notably, the clinical efficacy of metformin can be influenced by regional differences and study types.
本研究旨在分析二甲双胍对多囊卵巢综合征（PCOS）患者颈动脉内膜中层厚度（CIMT）和血流介导的扩张（FMD）的疗效。
对 PubMed、Embase 和 Cochrane Library 从建库至 2023 年 12 月的文献进行检索。然后，经过研究选择和数据提取，使用均数差（MD）和 95%置信区间（CI）来评估二甲双胍对 PCOS 患者 CIMT 和 FMD 的疗效。通过亚组和敏感性分析来探讨异质性。我们的研究方案已在 PROSPERO（CRD42024497239）注册。
共纳入 12 项研究，共 248 例患者。与基线组（服用二甲双胍前）相比，终点组（服用二甲双胍后）的 CIMT 更低（MD=-0.11，95%CI=-0.21 至-0.01，p=0.04）。与基线组相比，终点组的 FMD 更高（MD=3.25，95%CI=1.85 至 4.66，p<0.01）。两组之间的硝酸甘油介导的扩张（NMD）无统计学差异（MD=0.65，p=0.51）。亚组分析显示，欧洲 PCOS 患者终点组与基线组相比，CIMT 的 MD 值较低（MD=-0.09，95%CI=-0.14 至-0.04，p<0.001）。然而，亚洲 PCOS 患者终点组与基线组的 CIMT 差异无统计学意义（p=0.270）。
二甲双胍可能对 CIMT 和 FMD 有有益的影响，但对 NMD 没有影响，这表明二甲双胍可能有助于降低 PCOS 患者的心血管事件风险。值得注意的是，二甲双胍的临床疗效可能受到地域差异和研究类型的影响。
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