Zeng Weiwei, Luo Yuning, Ou Juanfeng, Gan Dali, Huang Min, Tomlinson Brian, Jiang Yiming
Department of Pharmacy, Shenzhen Longgang Second People's Hospital, Shenzhen, Guangdong, China.
Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.
Front Pharmacol. 2025 Aug 18;16:1654372. doi: 10.3389/fphar.2025.1654372. eCollection 2025.
Polycystic ovary syndrome (PCOS) represents a prevalent endocrine disorder affecting reproductive-aged women worldwide, characterized by a variety of reproductive, metabolic, and psychological manifestations. This condition disrupts menstrual cycles and fertility, and significantly compromises quality of life, while increasing the risk of severe health consequences, including cardiovascular diseases and endometrial carcinoma. Although the precise etiology of PCOS remains elusive, genetic and environmental factors are thought to contribute to its pathogenesis. In recent years, the escalating global prevalence of PCOS has been observed, and pharmacological intervention has become the primary treatment approach. Metformin, an insulin sensitizer, has emerged as a valuable treatment option in PCOS management. Multiple studies have suggested that metformin have a positive impact on puberty problems, pregnancy complications, and long-term health outcomes in women with PCOS. However, persistent controversies surround its therapeutic efficacy and underlying molecular mechanisms. This review systematically examines the mechanisms of metformin in ameliorating PCOS-associated infertility, with particular emphasis on its pleiotropic effects across critical life stages-from pubertal development through pregnancy to long-term health outcomes, thereby providing valuable insights into the clinical application of metformin in the treatment of PCOS.
多囊卵巢综合征（PCOS）是一种普遍存在的内分泌紊乱疾病，影响着全球育龄妇女，其特征为多种生殖、代谢和心理表现。这种病症会扰乱月经周期和生育能力，并严重损害生活质量，同时增加包括心血管疾病和子宫内膜癌在内的严重健康后果的风险。尽管PCOS的确切病因仍不明确，但遗传和环境因素被认为与其发病机制有关。近年来，全球PCOS患病率不断上升，药物干预已成为主要治疗方法。二甲双胍作为一种胰岛素增敏剂，已成为PCOS管理中有价值的治疗选择。多项研究表明，二甲双胍对PCOS女性的青春期问题、妊娠并发症和长期健康结局有积极影响。然而，其治疗效果和潜在分子机制仍存在持续争议。本综述系统地研究了二甲双胍改善PCOS相关不孕症的机制，特别强调其在从青春期发育到妊娠再到长期健康结局的关键生命阶段的多效性作用，从而为二甲双胍在PCOS治疗中的临床应用提供有价值的见解。
