The Impact of Subclinical Hypothyroidism on Patients with Polycystic Ovary Syndrome: A Meta-Analysis

2021 ◽  
Vol 53 (06) ◽  
pp. 382-390
Author(s):  
Yuling Xing ◽  
Jinhu Chen ◽  
Jing Liu ◽  
Huijuan Ma
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Subclinical Hypothyroidism ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Chinese Patients ◽  
Cochrane Library ◽  
Academic Journal ◽  
Ovary Syndrome ◽  
Funnel Plot ◽  
The Impact

AbstractThe association between subclinical hypothyroidism (SCH) and polycystic ovary syndrome (PCOS) has been shown in many studies. These findings are still controversial, however. It is unclear whether the co-incidence of subclinical hypothyroidism and polycystic ovary syndrome will affect the severity of metabolism. Therefore, we performed this meta-analysis to investigate the association. A comprehensive search strategy was developed to obtain all relevant studies published in PubMed, EMBASE, Cochrane Library, and Chinese Academic Journal Full-text Database (CNKI) up to 31 December 2020. We adopted the standardized mean difference (SMD) with 95% confidence intervals (CI) for evaluation, and sensitivity analysis was performed. Publication bias was analyzed and represented by a funnel plot, and funnel plot symmetry was assessed with Egger’s test. Twenty-seven studies with 4821 participants (1300 PCOS patients with SCH, 3521 PCOS patients without SCH) were included in the present meta-analysis,among which 71.31% chinese patients out of the total. The results showed that PCOS patients with SCH had higher levels of HOMA-IR, TG, TC, LDL, FBG, FCP, PRL and lower levels of HDL, LH and T. It also recognized the limitation of the lack of a consistent definition of hypothyroidism in the 27 studies included. The results of this study indicated that SCH may aggravate lipid and glucose metabolism in patients with PCOS.

scholarly journals Subclinical Hypothyroidism Impact on the Characteristics of Patients with Polycystic Ovary Syndrome. A Meta-Analysis of Observational Studies

2017 ◽  
Vol 83 (2) ◽  
pp. 105-115 ◽  
Author(s):  
Sebastião Freitas de Medeiros ◽  
Matheus Antônio Souto de Medeiros ◽  
Cinthia Marenza Ormond ◽  
Jacklyne Silva Barbosa ◽  
Márcia Marly Winck Yamamoto
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Subclinical Hypothyroidism ◽  
Observational Studies ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Ovary Syndrome

scholarly journals Association of Estrogen Receptor Genes Polymorphisms With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis Based on Observational Studies

2021 ◽  
Vol 12 ◽  
Author(s):  
Siyu Zhou ◽  
Shu Wen ◽  
Yongcheng Sheng ◽  
Meina Yang ◽  
Xiaoyang Shen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Estrogen Receptor ◽  
Polycystic Ovary Syndrome ◽  
Publication Bias ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Genetic Models ◽  
Cochrane Library ◽  
Ovary Syndrome ◽  
Subgroup Analyses

PurposeControversial results existed in amounts of studies investigating the authentic association of estrogen receptor genes (ESR1 and ESR2) polymorphisms with the occurrence and progression of polycystic ovary syndrome (PCOS). The inconsistency might result from different loci, sample sizes, and ethnicities. To find the potential correlations between ESR1/ESR2 polymorphisms and PCOS risk, we conducted the first systematic review and meta-analysis to comprehensively summarize current studies in a large combined population.MethodsEligible studies were retrieved from PubMed, MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, WANFANG, and VIP up to February 28, 2021. The quality of studies was assessed using the Newcastle–Ottawa Scale (NOS) scoring system. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated to synthesize data in five genetic models. Subgroup analyses were conducted by ethnicity. Heterogeneity and publication bias were also assessed. The protocol was registered in PROSPERO under the number CRD42021239200.ResultsA total of 8 studies involving 1,522 PCOS patients and 4,198 controls were included. No evidence demonstrated the association of ESR1 rs2234693 (OR=1.07 95%CI 0.98–1.18), ESR1 rs9340799 (OR=0.99 95%CI 0.69–1.43), or ESR2 rs4986938 (OR=1.06 95%CI 0.81–1.38) polymorphisms and PCOS risk in five genetic models. According to stratified subgroup analyses, ethnicity was considered the major source of heterogeneity. No publication bias was found in eligible studies.ConclusionThe present meta-analysis found no significant associations between the variants of ESR1 rs2234693, ESR1 rs9340799, ESR2 rs4936938, and individual PCOS susceptibility, even if ethnicity was taken into account.Systematic Review RegistrationThe protocol was registered in PROSPERO (available from https://www.crd.york.ac.uk/PROSPERO) with the ID number CRD42021239200.

scholarly journals Treatment of Polycystic Ovary Syndrome-Related Infertility Using a Combination of Compound Xuanju Capsules and Hormone Therapy: A Meta-Analysis

2021 ◽  
Author(s):  
Qianwen Ma ◽  
Yong Tan
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Hormone Therapy ◽  
Polycystic Ovary ◽  
Therapy Group ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Ovary Syndrome

Abstract Objective To compare the therapeutic effects of compound Xuanju capsules combined with hormone therapy versus hormone therapy alone on polycystic ovary syndrome (PCOS)-related infertility using a meta-analysis. Methods Electronic databases including PubMed, The Cochrane Library, Web of science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were manually searched. The quality of included studies was evaluated based on the Cochrane systematic review standards, and the valid data were extracted for meta-analysis using Revman 5.3 software. Results A total of 14 randomized controlled trials accounting for 1249 patients were included. Meta-analysis showed that patients in the compound Xuanju capsule + hormone therapy group had higher estradiol levels and overall rates of effective treatment than those in the hormone therapy alone group. Moreover, they also exhibited lower levels of luteinizing hormone and follicle-stimulating hormone as well as lower Kupperman scores than the hormone therapy alone group. Conclusions The combination of compound Xuanju capsules and hormone therapy is more effective than hormone therapy alone in the treatment of PCOS-related infertility. However, the quality of current studies is low, and high-quality clinical trials are warranted.

A Meta-Analysis of Oocyte Quality and Clinical Outcome of Intracytoplasmic Sperm Injection Cycles in Patients with Polycystic Ovary Syndrome

2018 ◽  
Vol 8 (9) ◽  
pp. 1886-1894
Author(s):  
Na Duan ◽  
Hui Wang ◽  
Ziru Niu ◽  
Yifan Guo ◽  
Shuling Wang ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Intracytoplasmic Sperm Injection ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Oocyte Quality ◽  
Cochrane Library ◽  
Miscarriage Rate ◽  
Ovary Syndrome ◽  
Pcos Group

Whether treatment outcomes in intracytoplasmic sperm injection (ICSI) cycles differ between polycystic ovary syndrome (PCOS) and non-PCOS patients remains inconclusive. The aim of this meta-analysis is to compare oocyte quality and clinical outcomes in PCOS patients and non-PCOS patients undergoing ICSI procedure. Methods: Databases including Medline, Embase and the Cochrane Library were searched for studies published up to 18 January 2018. All articles searched were independently reviewed and selected by two evaluators according to predetermined inclusion and exclusion criteria. Results: Eight studies were selected for inclusion, and a total of 474 PCOS patients (627 cycles) were compared to age-matched controls (962 patients, 992 cycles). The total gonadotropin usage was significant less in PCOS group, and the MD was –481.72 IU [95% CI:– 603.76–359.68, P < 0.00001]. A significantly higher mean number of oocytes, metaphase II (MII) oocytes and 2-pronucleated (2PN) oocytes per cycle were observed in the PCOS group than in the non-PCOS group (P < 0.005), the total MDs were 4.20 [95% CI: 2.50–5.90], 1.52 [95% CI: 0.84–2.20] and 1.71 [95% CI: 0.73–2.69], respectively. The fertilization rate was comparable. The clinical pregnancy rate per transfer cycle was higher in the PCOS group, the odd ratio (OR) was 1.59 [95% CI: 1.23–2.05, P < 0.005] and the live birth rate was comparable. A higher miscarriage rate was observed in the PCOS group, but this did not reach statistical significance. The risk of ovarian hyperstimulation syndrome (OHSS) was significantly higher in the PCOS group [OR: 3.01, 95% CI: 1.16–7.82, P < 0.05]. Conclusions: This meta-analysis demonstrated that PCOS patients may have more favourable ICSI outcomes than non-PCOS patients. Our findings should be evaluated in further prospective cohort studies.

THADA_rs13429458 Minor Allele Increases the Risk of Polycystic Ovary Syndrome in Asian, but Not in Caucasian Women: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 51 (10) ◽  
pp. 661-670 ◽  
Author(s):  
Sunmin Park ◽  
Meiling Liu ◽  
Ting Zhang
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Publication Bias ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Group Analysis ◽  
Minor Allele ◽  
Genetic Models ◽  
Cochrane Library ◽  
Ovary Syndrome ◽  
Increased Risk

AbstractPolycystic ovary syndrome (PCOS) is a highly prevalent disease in young women that also features increased insulin resistance. Genetic factors have a strong relationship with the etiology of PCOS. We assessed whether carrying THADA rs13429458 is associated with the development of PCOS by meta-analysis and whether the association is influenced by ethnicity. Articles were searched using PubMed, EMBASE, Cochrane Library, Korean scientific database, and Chinese and Indian medical databases to identify all eligible studies for evaluating the association of THADA rs13429458 and PCOS risk. The association was assessed in five genetic random effects models including the allelic (AG), recessive (RG), dominant (DG), homozygous (HMG), and heterozygous (HTG) genetic models. Subgroup analyses stratified by ethnicity (Asians and non-Asians) were assessed. Nine articles were selected and 1 association analysis of Korea PCOS study met Hardy–Weinberg equilibrium criteria. A set of 38 224 PCOS women and 120 173 healthy women were included. The AG and RG showed heterogeneity in the overall and Asian subjects, but the other genetic model did not exhibit heterogeneity in all subjects. AG, RG, DG, and HMG, but not HTG, exhibited publication bias in total subjects but there was no publication bias in all genetic models among Asians and non-Asians. The overall effect of THADA_rs13429458 on PCOS risk showed significant positive associations in pooling 10 studies. In sub-group analysis only Asians, but not non-Asians, had a positive association (AG: OR=1.24, p=0.001; RG: OR=1.32, p=0.002; DG: OR, 1.70, p<0.00001; HMG: OR, 1.71, p=0.002; HTG: OR=1.34, p=0,006). In conclusions, young Asian women with the minor allele (C) for THADA rs13429458 were at increased risk of PCOS.

Negative impact of polycystic ovary syndrome on bone health: a systematic review and meta-analysis

2019 ◽  
Vol 25 (5) ◽  
pp. 634-646 ◽  
Author(s):  
Júlia Mottecy Piovezan ◽  
Melissa Orlandin Premaor ◽  
Fábio Vasconcellos Comim
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Bone Health ◽  
Bone Markers ◽  
Bone Fractures ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Mineral Density ◽  
Ovary Syndrome ◽  
The Impact

Abstract BACKGROUND Polycystic ovary syndrome (PCOS) has reproductive and metabolic aspects that may affect bone health. Controversial results from different studies regarding the risk of fractures, bone mineral density (BMD) or bone markers led to uncertainty whether PCOS might improve or deteriorate bone health. OBJECTIVE AND RATIONALE This study aimed to investigate the impact of PCOS on bone markers, BMD and fracture risk. SEARCH METHODS A systematic review and a meta-analysis were carried out. PubMed, EMBASE and Cochrane databases were searched for eligible studies from 1st of January of 1990 to 9th of October of 2018. Eligible studies enrolled women older than 18 years with PCOS, which should be diagnosed according to the Rotterdam Consensus, the Androgen Excess Society, the National Institutes of Health Consensus or the International Classification of Diseases. The studies were grouped according to patient mean BMI: <27 kg/m2 or ≥27 kg/m2. The results were polled as mean difference (MD), standardized MD (SMD) and hazard ratio (HR). OUTCOMES Overall, 921 studies were retrieved, and 31 duplicated studies were removed. After screening the titles and abstracts, 80 studies were eligible for full text reading. Of those, 23 studies remained for qualitative synthesis. With the exception of one study, all studies were considered high quality based on the Newcastle–Ottawa scale (NOS; score ≥6). Meta-analysis was performed in 21 studies, with a total of 31 383 women with PCOS and 102 797 controls. Women with PCOS with BMI <27 kg/m2 had lower BMD of the total femur (MD, −0.04; 95% CI, −0.07 to 0.00; I2 = 31%; P = 0.22) and spine (MD, −0.07; 95% CI, −0.13 to −0.01; I2 = 70%; P < 0.01) when compared with the control group, whereas for women with BMI ≥27 kg/m2 no difference was observed (femur: MD, 0.02; 95% CI, −0.02 to 0.05; I2 = 20%, P = 0.29; spine: MD, 0.02; 95% CI, −0.06 to 0.05; I2 = 0%; P = 0.84). Osteocalcin was remarkably reduced in women with PCOS with BMI <27 kg/m2 (SMD, −2.68; 95% CI, −4.70 to −0.67; I2 = 98%; P < 0.01), but in women with BMI ≥27 kg/m2, there were no differences between PCOS and controls. Few studies (n = 3) addressed the incidence of bone fractures in women with PCOS. The HR for total bone fractures did not identify differences between women with PCOS and controls. WIDER IMPLICATIONS On the basis of the available evidence, it is possible to assume that PCOS in women with BMI <27 kg/m2 is associated with reduced BMD in the spine and femur, and decreased bone formation, as manifested by lower levels of circulating osteocalcin. These findings suggest that bone parameters in PCOS may be linked, to some extent, to adiposity. These studies included premenopausal women, who have already achieved peak bone mass. Hence, further prospective studies are necessary to clarify the existence of increased risk of fractures in women with PCOS.

scholarly journals The Effects of Salvia miltiorrhiza on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Wenjuan Shen ◽  
Bao Jin ◽  
Yaguang Han ◽  
Hongwei Wang ◽  
Huan Jiang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Salvia Miltiorrhiza ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cochrane Library ◽  
Ovary Syndrome ◽  
Significant Difference

Objective. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. As a traditional medicine, Salvia miltiorrhiza (S. miltiorrhiza) has been widely used in the treatment of many gynecological diseases, but the efficacy of S. miltiorrhiza in women with PCOS has not been assessed. The purpose of this systematic review and meta-analysis was to evaluate the effectiveness and safety of S. miltiorrhiza in women with PCOS. Methods. We conducted searches in PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, the Wanfang Database, the Chinese Scientific Journal Database, and the Chinese BioMedical database from inception to December 23, 2020, to identify studies that met the inclusion criteria. The quality of the evidence was estimated using the Cochrane Reviewer Handbook 5.0.0, and the meta-analysis was performed using RevMan 5.3.5 software. Results. Six randomized controlled trials (RCTs) involving 390 patients with PCOS were included. The studies suggested that S. miltiorrhiza extract combined with letrozole (LET) was more effective in improving pregnancy rate (RR: 2.60, 95% CI: 1.06 to 6.39, P = 0.04 ) compared to LET alone. S. miltiorrhiza extract was associated with decreased fasting blood glucose (MD: –0.25, 95% CI: –0.37 to –0.13, P < 0.0001 ), fasting insulin (MD: –1.16, 95% CI: –1.74 to –0.58, P < 0.0001 ), total cholesterol (TC) (MD: –0.58, 95% CI: –0.72 to –0.43, P < 0.00001 ), and triglycerides (TG) (MD: –0.31, 95% CI: –0.35 to –0.26, P < 0.00001 ) compared with placebo, but not with improvements in body mass index or waist-to-hip ratio (MD: –1.41, 95% CI: –4.81 to 2.00, P = 0.42 ; MD: –0.02, 95% CI: –0.05 to 0.01, P = 0.16 , respectively). There was a significant difference between S. miltiorrhiza extract combined with cyproterone acetate (CPA) and CPA alone in terms of decreasing TC (MD: –0.77, 95% CI: –0.89 to –0.65, P < 0.00001 ), TG (MD: –0.43, 95% CI: –0.65 to –0.20, P < 0.0001 ), and low-density lipoprotein cholesterol (MD: –0.49, 95% CI: –0.66 to –0.33, P < 0.00001 ) and increasing high-density lipoprotein cholesterol (MD: 0.30, 95% CI: 0.20, 0.40, P < 0.00001 ). In addition, S. miltiorrhiza extract also decreased testosterone, follicle-stimulating hormone, and luteinizing hormone. The studies did not mention any adverse events with S. miltiorrhiza extract. Conclusion. The current studies indicate that S. miltiorrhiza has beneficial effects on reproduction and glucose and lipid metabolism in patients with PCOS, and it is generally safe for clinical application. However, more prospective RCTs with large samples, multiple centers, and longer intervention duration are needed in the future to obtain more reliable conclusions.

scholarly journals Elevated Anti-Müllerian Hormone Levels in Newborns of Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis Based on Observational Studies

2021 ◽  
Author(s):  
Siyu Zhou ◽  
Danhua Lu ◽  
Shu Wen ◽  
Yongcheng Sheng ◽  
Deying Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Maternal Body Mass Index ◽  
Ovary Syndrome ◽  
Random Effects Models ◽  
Hormone Levels

AbstractWe performed this updated systematic review and meta-analysis to evaluate anti-Müllerian hormone levels (AMH) in newborns of mothers with polycystic ovary syndrome (PCOS) compared with healthy controls. A search of the literature was conducted in the PubMed, MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, WANFANG, and VIP for articles to assess AMH levels in offspring of PCOS and non-PCOS mothers irrespective of language. These databases were searched from their inception to December 7, 2020. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) scoring system. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were adopted to calculate the overall estimates with random-effects models. A total of 6 studies with 846 participants were included. The pooled analysis found an increased AMH level in the umbilical cord blood in newborns of PCOS mothers (SMD =0.62, 95% CI [0.28, 0.95]). Subgroup analyses revealed an elevation of AMH concentrations in female neonates, neonates born to American and Asian PCOS mothers. In addition, higher AMH levels were also found in studies diagnosed by the National Institute of Health (NIH) criteria, maternal clinical/biochemical hyperandrogenism, or maternal body mass index (BMI) >30 kg/m2. Meta-regression analysis suggested that diagnostic criterion contributed mostly to the high heterogeneity. We demonstrated that AMH levels in neonates born to PCOS mothers were essentially higher, which indicates that AMH may act as an enigmatic role in the pathogenesis of PCOS which inhibits folliculogenesis in the fetal stage.

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