Abstract
Objective Metformin is an important component of PCOS treatment. At present, the effect of metformin in overweight women with PCOS has not been evaluated. Therefore, we conducted a systematic review to assess the effects of metformin in overweight women with PCOS and to analyze the effects of metformin in overweight women with PCOS. Methods We searched the PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases for studies published before March 2020. Randomized controlled trials were identified to study the effects of metformin in overweight women with PCOS. Data from studies including body mass index (BMI), waist circumference (WC), follicle-stimulating hormone (FSH), homeostasis model assessment of insulin resistance (HOMA-IR), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol (TC), triglycerides (TG), fasting blood glucose (FBG), fasting insulin, testosterone, and androstenedione were pooled. Qualified trials were selected, and methodological quality was strictly assessed. Two reviewers chose the studies independently of each other. Results Twelve trials were included. The intervention group and the control group had significant differences in the changes in body mass index (BMI) (WMD = −1.25, 95% CI (−1.60, −0.91), p < 0.00001) and waist circumference (WC) (WMD = −1.41, 95% CI (−2.46, −0.37), p=0.008) after metformin. The comprehensive results show that, in all studies, overweight women with polycystic ovary syndrome treated with metformin had significantly improved endocrine and metabolic indicators, including testosterone, follicle-stimulating hormone, luteinizing hormone, and low-density lipoprotein cholesterol. However, metformin did not regulate the secretion indexes of fasting insulin, homeostasis model assessment of insulin resistance, sex hormone-binding globulin, high-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting blood glucose, and androstenedione. Conclusions Compared with control interventions, metformin appears to be an effective intervention for overweight women with PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a common gynaecological endocrine disease in women of childbearing age [1]
Combined with our research results, we found that taking metformin can reduce body mass index, waist circumference, follicle-stimulating hormone (FSH), luteinizing hormone (LH), low-density lipoprotein (LDL) cholesterol, and testosterone levels in overweight women with PCOS
Our current results suggest that metformin may be the most effective intervention for PCOS in overweight women [47]. e results show that the improvement of body mass index, waist circumference, and LDL cholesterol may be the direct regulation effect of metformin on the production of ovarian steroids [11, 48]
Summary
Polycystic ovary syndrome (PCOS) is a common gynaecological endocrine disease in women of childbearing age [1]. E morbidity rate is 6% to 15% among women during the childbearing period, and to date, the cause is not completely clear. Overweight women with PCOS suffer more severe endocrine and metabolic disorders than nonoverweight patients [4]. Studies have found that being overweight enhances insulin secretion but weakens the metabolism of insulin secretion in the liver, skeletal muscle, and fat. In addition to impaired insulin responsiveness of adipocytes, being overweight may cause lipodystrophy and insulin resistance by reducing the expression of lipid droplet proteins in adipocytes [5, 6]. Karimi et al [7] and Heshmati et al [8] suggest that patients with polycystic ovary syndrome
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