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Review
. 2020 Sep 16:2020:5150684.
doi: 10.1155/2020/5150684. eCollection 2020.

The Effect of Metformin on Polycystic Ovary Syndrome in Overweight Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Yuanyuan Guan  1 , Dongjun Wang  1 , Huaien Bu  2 , Tieniu Zhao  2 , Hongwu Wang  2
Affiliations
Review

The Effect of Metformin on Polycystic Ovary Syndrome in Overweight Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Yuanyuan Guan et al. Int J Endocrinol. .

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study selection procedure according to the PRISMA statement.
Figure 2
Figure 2
Risk of bias summary: review of authors' judgements about each risk of bias item for each included study.
Figure 3
Figure 3
Effect of metformin on (a) body mass index; (b) waist circumference; (c) fasting insulin; (d) testosterone; (e) follicle-stimulating hormone; (f) luteinizing hormone; and (g) low-density lipoprotein.
Figure 4
Figure 4
Effect of metformin on (a) homeostasis model assessment of insulin resistance; (b) sex hormone-binding globulin; (c) high-density lipoprotein; (d) total plasma cholesterol; (e) triglycerides; (f) fasting blood glucose; and (g) androstenedione.
Figure 5
Figure 5
Funnel plot of publication bias.
See this image and copyright information in PMC

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