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Impact of metformin on the clinical and metabolic parameters of women with polycystic ovary syndrome: a systematic review and meta-analysis of randomised controlled trials

Abdalla, Mohammed Altigani; Shah, Najeeb; Deshmukh, Harshal; Sahebkar, Amirhossein; Östlundh, Linda; Al-Rifai, Rami H.; Atkin, Stephen L.; Sathyapalan, Thozhukat

Authors

Mohammed Altigani Abdalla

Najeeb Shah

Amirhossein Sahebkar

Linda Östlundh

Rami H. Al-Rifai

Stephen L. Atkin



Abstract

Context: Polycystic ovary syndrome (PCOS) is one of the commonest endocrine disorders affecting women of reproductive age, and metformin is a widely used medication in managing this condition. Aim: To review the available literature comprehensively on the therapeutic impact of metformin on the clinical and metabolic parameters of women with PCOS. Data source: We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library and the Web of Science and selected sources for grey literature from their inception to April 2020. An updated search in PubMed was performed in June 2022. Data synthesis: Two reviewers selected eligible studies and extracted data, and the review is reported following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: In 24 eligible randomised controlled trials (RCTs) involving 564 participants who received metformin therapy, metformin was associated with significant reduction in body weight by 3.13 kg (95% CI: −5.33, −0.93), body mass index (BMI) by 0.82 kg/m² (95% CI: −1.22, −0.41), fasting blood glucose [standardised mean difference (SMD): −0.23; 95% CI: −0.40, −0.06], low-density lipoprotein cholesterol (LDL-C) (SMD: −0.41; 95% CI: −0.85, 0.03), total testosterone (SMD: −0.33; 95% CI: −0.49, −0.17), androstenedione (SMD: −0.45; 95% CI: −0.70, −0.20), 17-hydroxyprogesterone (17-OHP) (SMD: −0.58; 95% CI: −1.16, 0.00) and increase the likelihood of clinical pregnancy rate [odds ratio (OR): 3.00; 95% CI: 1.95, 4.59] compared with placebo. Conclusion: In women with PCOS, metformin use has shown a positive impact in reducing body weight, BMI, total testosterone, androstenedione, 17-OHP, LDL-C, fasting blood glucose and increasing the likelihood of pregnancy in women with PCOS.

Citation

Abdalla, M. A., Shah, N., Deshmukh, H., Sahebkar, A., Östlundh, L., Al-Rifai, R. H., …Sathyapalan, T. (2022). Impact of metformin on the clinical and metabolic parameters of women with polycystic ovary syndrome: a systematic review and meta-analysis of randomised controlled trials. Therapeutic Advances in Endocrinology and Metabolism, 13, https://doi.org/10.1177/20420188221127142

Journal Article Type Review
Acceptance Date Sep 1, 2022
Online Publication Date Oct 7, 2022
Publication Date 2022
Deposit Date Nov 6, 2022
Publicly Available Date Nov 7, 2022
Journal Therapeutic Advances in Endocrinology and Metabolism
Print ISSN 2042-0188
Electronic ISSN 2042-0196
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 13
DOI https://doi.org/10.1177/20420188221127142
Public URL https://hull-repository.worktribe.com/output/4100937

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Publisher Licence URL
http://creativecommons.org/licenses/by-nc/4.0

Copyright Statement
© The Author(s), 2022.
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).





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