scholarly journals The Role of Vitamin D Oral Supplementation in Insulin Resistance in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1637 ◽  
Author(s):  
Karolina Łagowska ◽  
Joanna Bajerska ◽  
Małgorzata Jamka
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Vitamin D ◽  
Polycystic Ovary Syndrome ◽  
Fasting Glucose ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Ovary Syndrome ◽  
Randomized Controlled

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).

scholarly journals Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Maryam Kazemi ◽  
Amir Hadi ◽  
Roger A Pierson ◽  
Marla E Lujan ◽  
Gordon A Zello ◽  
...  
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Glycemic Index ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Glycemic Load ◽  
Controlled Trials ◽  
Ovary Syndrome ◽  
Randomized Controlled ◽  
Dietary Glycemic Index

ABSTRACT Women with polycystic ovary syndrome (PCOS) exhibit cardiometabolic (e.g., insulin resistance) and associated reproductive disruptions. Lifestyle modification (e.g., diet) is recommended as the first-line therapy to manage PCOS; however, a favorable dietary regimen remains unclear beyond energy restriction. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize evidence on impacts of dietary glycemic index (GI) or glycemic load (GL) on cardiometabolic and reproductive profiles to update the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Cochrane, Web of Science, and Scopus were searched through 30 October 2019, and confirmed on 25 March 2020, to identify RCTs (≥8 wk) comparing the effects of diets with lower (LGI/LGL) and higher (HGI/HGL) GI/GL on glucoregulatory outcomes, lipid profile, anthropometrics, and androgen status in PCOS. The primary outcome was HOMA-IR. Data were pooled by random-effects models and expressed as weighted mean differences and 95% CIs. The risk of bias was assessed by the Cochrane tool. Ten RCTs (n = 403) were eligible. Eight evaluated LGI and 2 LGL diets. LGI diets decreased HOMA-IR (−0.78; −1.20, −0.37; I2 = 86.6%), fasting insulin (−2.39; −4.78, 0.00 μIU/mL; I2 = 76.8%), total cholesterol (−11.13; −18.23, −4.04 mg/dL; I2 = 0.0%), LDL cholesterol (−6.27; −12.01, −0.53 mg/dL; I2 = 0.0%), triglycerides (−14.85; −28.75, −0.95 mg/dL; I2 = 31.0%), waist circumference (−2.81; −4.40, −1.23 cm; I2 = 53.9%), and total testosterone (−0.21; −0.32, −0.09 nmol/L; I2 = 8.6%) compared with HGI diets (all: P ≤ 0.05) without affecting fasting glucose, HDL cholesterol, weight, or free androgen index (all: P ≥ 0.07). Some results were contradictory and only described narratively for 2 RCTs that evaluated LGL diets, since inclusion in meta-analyses was not possible. LGI diets improved glucoregulatory outcomes (HOMA-IR, insulin), lipid profiles, abdominal adiposity, and androgen status, conceivably supporting their inclusion for dietary management of PCOS. Further RCTs should confirm these observations and address whether LGI diets improve more patient-pressing complications, including ovulatory cyclicity, infertility, and cardiovascular disease risk in this high-risk population. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42020175300.

scholarly journals Effect of high-intensity interval training on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245023
Author(s):  
Isis Kelly dos Santos ◽  
Fernando Antônio Santana de Souza Nunes ◽  
Victor Sabino Queiros ◽  
Ricardo Ney Cobucci ◽  
Pedro Bruch Dantas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Insulin Resistance ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Interval Training ◽  
Controlled Trials ◽  
High Intensity Interval Training ◽  
Ovary Syndrome ◽  
Randomized Controlled ◽  
High Intensity Interval

Background Our aim was to assess the effect of high-intensity interval training (HIIT) on metabolic parameters and body composition in women with polycystic ovary syndrome (PCOS). Methods and analysis A systematic review and meta-analysis of randomized controlled trials was conducted using Embase, MEDLINE (via Ovid), PubMed, Sport Discus, Scopus, Web of Science, Cochrane Library and Google Scholar (advanced feature) up to September 2020. Two authors independently screened citations and determined the risk of bias and quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were conducted using random effects model. Results Seven trials (n = 423) were included in the systematic review. The studies included HIIT interventions vs. moderate exercise or control groups. Most studies were small (average 32, range 24–110 participants) and of relatively short duration (10–16 weeks). The training intensity was performed between 90% and 95% of the maximum heart rate, three times a week, for at least 10 weeks. Insulin resistance, measured using homeostatic model assessment for insulin resistance (HOMA-IR), and body mass index (BMI) showed a significant decrease (MD −0.57; 95% CI, −0.98 to −0.16, p = 0.01), (MD −1.90, 95% CI −3.37, −0.42, p = 0.01) with moderate and high certainty of evidence, respectively. Conclusion Results support that HIIT alone is effective for reducing HOMA-IR and BMI in women with PCOS. However, evidence is limited to discern the effect of HIIT on other outcomes. Future studies with a longer duration (> 16 weeks), larger sample sizes and other outcomes are needed.

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

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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