Effects of Metformin and Exercise in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 738-745
Author(s):  
Yu Song ◽  
Huimin Wang ◽  
Zhengyan Zhu ◽  
Hongli Huang
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Exercise Intervention ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Reproductive Age ◽  
China National Knowledge Infrastructure ◽  
Ovary Syndrome ◽  
Menstrual Cycles ◽  
Beneficial Effects ◽  
Knowledge Infrastructure

AbstractPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Metformin is introduced for treatment of women with PCOS, and the beneficial effects of exercise in women with PCOS are found for a range of outcomes. Our aim is to compare the effects of metformin plus exercise with exercise intervention in PCOS on clinical, anthropometric, metabolic, and psychological parameters. MEDLINE, EMBASE, Web of Science and China National Knowledge Infrastructure were searched for studies. Nine studies were considered eligible for inclusion. The meta-analysis reveals that metformin offers additive benefits to exercise, leading to modest improvements in menstrual cycles, hyperandrogenism, and abdominal fat.

scholarly journals Update on polycystic ovary syndrome

2021 ◽  
Author(s):  
Jin Ju Kim
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Daily Practice ◽  
Antral Follicle ◽  
Reproductive Age ◽  
Lifestyle Modifications ◽  
First Line ◽  
Ovary Syndrome ◽  
Wide Range

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4–6 based on a lower percentile of 85%–90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

scholarly journals Effect of Acupuncture on Polycystic Ovary Syndrome in Animal Models: Study Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Jinjin Gao ◽  
Wei Li ◽  
Yangyang Li ◽  
Yan Li
Keyword(s):  
Systematic Review ◽  
Animal Models ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Reproductive Age ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Complementary And Alternative Therapy

Abstract Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. As a widely used complementary and alternative therapy, acupuncture is increasingly used to treat PCOS. However, the effect of acupuncture in treating PCOS is uncertain and the mechanisms are unclear. This systematic review aims to determine the efficacy of acupuncture on PCOS in animal preclinical models.Methods: We will search the following databases: PubMed, Web of Science, China National Knowledge Infrastructure and Chinese Science and Technology Periodical Database. We will only include animal experiments of acupuncture in treating PCOS. The primary outcome will be homeostatic model assessment- insulin resistance. The risk of bias will be assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. Confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. All meta-analyses will be conducted using Review Manager 5.4. Discussion: To the best of our knowledge, the use of acupuncture in treating PCOS has not yet been systematically reviewed in animal models. The evidence generated from this systematic review and meta-analysis could benefit future researches. Systematic review registration: OSF (Registration DOI: 10.17605/OSF.IO/FNM37)

scholarly journals Investigation on the Use of Traditional Chinese Medicine for Polycystic Ovary Syndrome in a Nationwide Prescription Database in Taiwan

2018 ◽  
Vol 7 (7) ◽  
pp. 179 ◽  
Author(s):  
Wan-Ting Liao ◽  
Jen-Huai Chiang ◽  
Chia-Jung Li ◽  
Ming-Tsung Lee ◽  
Cheng-Chiung Su ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Polycystic Ovary Syndrome ◽  
Large Scale ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Chinese Society ◽  
Prescription Database ◽  
Ovary Syndrome ◽  
Beneficial Effects

Polycystic ovary syndrome (PCOS) is a common condition, affecting 5–10% of women of reproductive age worldwide. It has serious reproductive implications and causes mood disorders and metabolic disorders, such as type-2 diabetes. Because PCOS reflects multiple abnormalities, there is no single drug that can treat all its symptoms. Existing pharmaceutical agents, such as oral contraceptives (OCs), are suggested as a first-line therapy for menstrual irregularities; however, OCs are not appropriate for women pursuing pregnancy. Additionally, insulin-sensitizing agents, which appear to decrease insulin levels and hyperandrogenemia in women with PCOS, have been associated with a high incidence of gastrointestinal adverse effects. It is a common practice in Chinese society to receive traditional Chinese medicine (TCM) for treatment of gynecological problems and infertility. Current research demonstrates that several herbs and herbal formulas show beneficial effects in PCOS treatment. In this study, we conducted the first large-scale survey through the Taiwan National Health Insurance Program database to analyze TCM utilization patterns among women with PCOS in Taiwan during 1997–2010. The survey results revealed that 89.22% women with newly diagnosed PCOS had received TCM therapy. Jia-Wei-Xiao-Yao-San and Xiang-Fu (Rhizoma Cyperi) were the most commonly used formula and single herb, respectively, in the database. In addition, we found that the top five commonly prescribed single herbs and herbal formulas have shown promise in treating symptoms associated with PCOS.

scholarly journals Metabolic profile of women with PCOS in Brazil: a systematic review and meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Poli Mara Spritzer ◽  
Ramon Bossardi Ramos ◽  
Lucas Bandeira Marchesan ◽  
Monica de Oliveira ◽  
Enrico Carmina
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Metabolic Profile ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Reproductive Age ◽  
Control Group ◽  
Cochrane Central Register ◽  
Ovary Syndrome ◽  
Metabolic Traits

Abstract Background Polycystic ovary syndrome (PCOS) is a common endocrine disease affecting women of reproductive age and associated with reproductive and metabolic dysfunction. Few studies are available regarding metabolic traits in Brazilian women with PCOS. The aim of this systematic review and meta-analysis was to summarize the available evidence regarding metabolic traits and comorbidities in Brazilian women with polycystic ovary syndrome (PCOS). Methods We systematically searched PubMed, Cochrane Central Register of Controlled Trials, and Embase for cross-sectional, case–control, or cohort studies focusing on populations of different regions from Brazil, published until July 31, 2019. Studies were selected if they reported PCOS diagnostic criteria. Studies without a control group were included if they presented relevant metabolic data. Results Of 4856 studies initially identified, 27 were included in the systematic review and 12 were included in the meta-analysis, for a total of 995 women with PCOS defined by Rotterdam criteria and 2275 controls from different regions of Brazil. Obesity, metabolic syndrome and IGT were prevalent, and standard mean differences for BMI (SMD 0.67, 95% CI, 0.29, 1.05), waist circumference (SMD 0.22, 95% CI 0.02, 0.41), systolic (SMD 0.66, 95% CI 0.30, 1.01) and diastolic blood pressure (SMD 0.55, 95% CI 0.24, 0.87), glucose (SMD 0.21, 95% CI 0.04, 0.38) and HOMA (SMD 0.78, 95% CI 0.52, 1.04) were significantly higher in Brazilian women with PCOS compared to controls. Lipid profile was more adverse in PCOS vs. non-PCOS women. Between-study heterogeneities were low/moderate for glucose and HOMA and moderate/high for the other variables. Conclusions The data of this systematic review and meta-analysis indicate that Brazilian women with PCOS have a worse metabolic profile than women without PCOS with no important regional differences. The prevalence of metabolic changes is intermediate in Brazil vs. other countries.

scholarly journals The Association Between Genetically Predicted Systemic Inflammatory Regulators and Polycystic Ovary Syndrome: A Mendelian Randomization Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Hanxiao Chen ◽  
Yaoyao Zhang ◽  
Shangwei Li ◽  
Yuanzhi Tao ◽  
Rui Gao ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Genome Wide Association Study ◽  
Metabolic Diseases ◽  
Mendelian Randomization ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Reproductive Age ◽  
European Ancestry ◽  
Ovary Syndrome ◽  
Increased Risk

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic diseases among women of reproductive age. Inflammation may be involved in the pathogenesis of PCOS, but its exact relationship with PCOS remains unclear. Herein, we investigate the causal association between systemic inflammatory regulators and PCOS risk through a two-sample Mendelian randomization (MR) approach based on the latest and largest genome-wide association study (GWAS) of 41 systemic inflammatory regulators in 8293 Finnish participants and a GWAS meta-analysis consisting of 10,074 PCOS cases and 103,164 controls of European ancestry. Our results suggest that higher levels of IL-17 and SDF1a, as well as lower levels of SCGFb and IL-4, are associated with an increased risk of PCOS (OR = 1.794, 95% CI = 1.150 – 2.801, P = 0.010; OR = 1.563, 95% CI = 1.055 – 2.315, P = 0.026; OR = 0.838, 95% CI = 0.712 – 0.986, P = 0.034; and OR = 0.637, 95% CI = 0.413 – 0.983, P = 0.042, respectively). In addition, genetically predicted PCOS is related to increased levels of IL-2 and VEGF (OR = 1.257, 95% CI = 1.022 – 1.546, P = 0.030 and OR = 1.112, 95% CI = 1.006 – 1.229, P = 0.038, respectively). Our results indicate the essential role of cytokines in the pathogenesis of PCOS. Further studies are warranted to assess the possibility of these biomarkers as targets for PCOS prevention and treatment.

scholarly journals Ovarian angiogenesis in polycystic ovary syndrome

Reproduction ◽  
2018 ◽  
Vol 155 (5) ◽  
pp. R199-R209 ◽  
Author(s):  
Mariana Di Pietro ◽  
Natalia Pascuali ◽  
Fernanda Parborell ◽  
Dalhia Abramovich
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Corpus Luteum ◽  
Polycystic Ovary ◽  
Follicular Development ◽  
Reproductive Age ◽  
Ovarian Cysts ◽  
Therapeutic Approaches ◽  
Ovary Syndrome ◽  
Beneficial Effects

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine pathology among women in reproductive age. Its main symptoms are oligo or amenorrhea, hyperandrogenism and the presence of ovarian cysts. It is also associated with infertility, obesity and insulin resistance. Mainly due to its heterogeneity, PCOS treatments are directed to manage its symptoms and to prevent associated diseases. The correct formation and regression of blood vessels during each ovarian cycle is indispensable for proper follicular development, ovulation and corpus luteum formation. The importance of these processes opened a new and promising field: ovarian angiogenesis. Vascular alterations characterize numerous pathologies, either with increased, decreased or abnormal angiogenesis. In the last years, several anomalies of ovarian angiogenesis have been described in women with PCOS. Therefore, it has been suggested that these alterations may be associated with the decreased – or lack of – ovulation rates and for the formation of cysts in the PCOS ovaries. Restoration of a proper vessel formation in the ovaries may lead to improved follicular development and ovulation in these patients. In the present review, we attempt to summarize the alterations in ovarian angiogenesis that have been described in women with PCOS. We also discuss the therapeutic approaches aimed to correct these alterations and their beneficial effects on the treatment of infertility in PCOS.

scholarly journals Effects of moxibustion on reproduction and metabolism of polycystic ovary syndrome: a protocol for meta-analysis and systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049039
Author(s):  
Kou Xu ◽  
Jiajie Wang ◽  
Feng Hu ◽  
Siying Lv ◽  
Yanji Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Evaluation Method ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Reproductive Age ◽  
Cochrane Library ◽  
Ovary Syndrome ◽  
Complementary And Alternative Therapy

IntroductionPolycystic ovary syndrome (PCOS) is one of the most common endocrinopathy in women of reproductive age. Recently, moxibustion, as a complementary and alternative therapy, has been commonly used in assisted reproduction and improvement of metabolic abnormalities in patients with PCOS. Currently, intervention efficacy of the use of moxibustion in PCOS treatment still remains controversial due to lack of high-quality evidence. Consequently, this study protocol was designed to objectively review and evaluate the effectiveness and safety of moxibustion treatment for PCOS.Methods and analysisElectronic searches will be carried out from inception to May 2021 in the online databases of The Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature, Chongqing VIP Chinese Science and Technology Periodical Database (VIP) and China National Knowledge Infrastructure. The Chinese Clinical Trial Registry Center and Clinical Trials will be used for searching ongoing trials. Randomised controlled trials and the first period in randomised cross-over trials involving any type of moxibustion for patients with PCOS will be included. Primary outcomes will be the ovulation rate, pregnancy rate and sex hormone levels, and secondary outcomes will be changes in clinical symptoms and metabolic indicators, total effective rate and the incidences of side effects and adverse events. Briefly, two reviewers will independently conduct study selection and data extraction, and the risk of bias will be assessed. Prior to the formal meta-analysis, the heterogeneity of included studies will be assessed. Review Manager Statistical Software (RevMan) V.5.3 will be used for data processing. Finally, the Grading of Recommendations Assessment, Development and Evaluation method will be applied to evaluate the quality of evidence.Ethics and disseminationEthical approval is not necessary since this study is designed as a systematic review. This study will be disseminated by a peer-review journal or conference presentation.

scholarly journals Prevalence of Asthma in Polycystic Ovary Syndrome Women: A Meta-analysis

2020 ◽  
Author(s):  
Honghao Sun ◽  
Da Li ◽  
Jiao Jiao ◽  
Qing Liu ◽  
Jiansu Bian ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Random Effects ◽  
Study Design ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Random Effects Model ◽  
China National Knowledge Infrastructure ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Significant Difference

Abstract Background: A few publications have reported the prevalence of asthma in polycystic ovary syndrome (PCOS) patients. But it remains debatable whether PCOS is an independent risk factor of asthma. Thus we carried out this systematic review and meta-analysis to assess the association between PCOS and asthma.Methods：PubMed, Embase, web of science, Scopus, Cochrane trial register, China National Knowledge Infrastructure (CNKI) and Wanfang Databases were searched for studies published from inception to October 2020. We extracted the data and performed the meta-analysis under the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We used a random-effects model and calculated the odds ratios (ORs) and 95% confidence intervals (95% CIs).Results：A total of 6 articles concerning 26876 PCOS women and 156143 healthy controls were included. According to the result of the study, PCOS patients have increased risk of asthma (OR=1.75, 95%CI=1.40–2.19, I2=91.2%, P=0.000, random-effects model). When stratified by region, diagnostic cirteria for asthma and study design, the results did not show significant difference.Conclusions： PCOS leads to higher asthma risk, and this association is independent to region, diagnostic cirteria for asthma and study design.

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