Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials

Reproductive Biology and Endocrinology

Review

Anna E. Juhász¹  Dorina Greff²  Julia Szinte²  Sunjune Park³  Szilárd Váncsa⁴  Péter Hegyi⁴  Nándor Ács⁵  Szabolcs Várbíró⁶  Eszter M. Horváth⁷  Péter Nyirády⁸  Zoltán Sipos⁹  Alex Váradi⁹ 

[1] Centre for Translational Medicine, Semmelweis University, Budapest, Hungary;Department of Dietetics and Nutrition Sciences, Semmelweis University, Budapest, Hungary;Centre for Translational Medicine, Semmelweis University, Budapest, Hungary;Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary;Department of Physiology, Semmelweis University, Budapest, Hungary;Centre for Translational Medicine, Semmelweis University, Budapest, Hungary;Department of Physiology, Semmelweis University, Budapest, Hungary;Centre for Translational Medicine, Semmelweis University, Budapest, Hungary;Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary;Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary;Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary;Department of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary;Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest, Hungary;Department of Physiology, Semmelweis University, Budapest, Hungary;Department of Urology, Semmelweis University, Budapest, Hungary;Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary;

关键词: Cycle length;    Testosterone;    Insulin;    BMI;    Metabolic syndrome;    PCOS;    Inositol;    Metformin;   

DOI  :  10.1186/s12958-023-01055-z

 received in 2022-12-02, accepted in 2023-01-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMetformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects.ObjectiveInositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS.MethodsThe present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs).ResultsTwenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85).ConclusionInositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin.Trial registrationPROSPERO registration number: CRD42021283275.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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