Impact of pharmacological interventions on insulin resistance in women with polycystic ovary syndrome: A systematic review and meta‐analysis of randomized controlled trials

Objective: To evaluate the effect of vitamin D supplementation (alone or with co-supplementation) on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods: We performed a literature search of databases (Medline, Scopus, Web of Knowledge, Cochrane Library) and identified all reports of randomized controlled trials (RCTs) published prior to April 2018. We compared the effects of supplementation with vitamin D alone (dose from 1000 IU/d to 60,000 IU/week) or with co-supplements to the administration of placebos in women diagnosed with PCOS. The systematic review and meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (Prospero) as number CRD42018090572. Main results: Eleven of 345 identified studies were included in the analysis; these involved 601women diagnosed with PCOS. Vitamin D as a co-supplement was found to significantly decrease fasting glucose concentrations and the HOMA-IR value. HOMA-IR also declined significantly when vitamin D was supplemented with a dose lower than 4000 IU/d. Conclusions: Evidence from RCTs suggests that the supplementation of PCOS patients with continuous low doses of vitamin D (<4000 IU/d) or supplementation with vitamin D as a co-supplement may improve insulin sensitivity in terms of the fasting glucose concentration (supplementation with vitamin D in combination with other micronutrients) and HOMA-IR (supplementation with vitamin D in continuous low daily doses or as co-supplement).

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The Effects of Statins on Hyperandrogenism In Women With Polycystic Ovary Syndrome: A Systematic Review And Meta-analysis of Randomized Controlled Trials

10.21203/rs.3.rs-649830/v1 ◽

2021 ◽

Author(s):

Jianguo Chen ◽

Chaoran Huan ◽

Tongtong Zhang ◽

Wuqing Gong ◽

Xiaofeng Deng ◽

...

Keyword(s):

Systematic Review ◽

Sensitivity Analysis ◽

Polycystic Ovary Syndrome ◽

Randomized Controlled Trials ◽

Subgroup Analysis ◽

Polycystic Ovary ◽

Meta Analysis ◽

Controlled Trials ◽

Ovary Syndrome ◽

Randomized Controlled

Abstract Several clinical studies showed that statins were potential to treat polycystic ovary syndrome (PCOS). Through comprehensive search PubMed, EMBASE, the Web of Science, BIOSIS, the ClinialTrails.gov, and the Cochrane Library database up to 14 Feb 2020, we identified the randomized controlled trials about the treatment of statins on hyperandrogenism in PCOS women, and performed a systematic review and meta-analysis. The quality of the included studies was assessed by the Cochrane risk of bias tool and the Jadda score. Subgroup analysis and sensitivity analysis were conducted to analyze the pooled results. Nine trials included 682 PCOS patients were identified. Statins showed a significant potential to reduce testosterone (SMD=-0.47; 95% CI, -0.76−-0.18; P = 0.002) and dehydroepiandrosterone (SMD=-0.51; 95% CI, -0.97−-0.05; P = 0.03) levels, compared to the control treatments. The cutaneous symptoms hirsutism (SMD=-0.61; 95% CI, -1.13−-0.10; P = 0.02) and acne (SMD=-0.92; 95% CI, -1.49−-0.34; P = 0.002) were significantly improved by statins in PCOS women. Subgroup analysis showed that the two types of statins, and the different control treatments as well, presented no significantly different effect on testosterone and dehydroepiandrosterone. Sensitivity analysis confirmed the stability of the findings from the meta-analysis. In conclusion, statin treatment could significantly reduce androgen levels and improve cutaneous manifestations of hyperandrogenism of PCOS.

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