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Meta-Analysis
. 2023 Jan 26;21(1):10.
doi: 10.1186/s12958-023-01055-z.

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

Dorina Greff  1   2   3 , Anna E Juhász  1   4 , Szilárd Váncsa  1   5   6 , Alex Váradi  5 , Zoltán Sipos  5 , Julia Szinte  1   2   3 , Sunjune Park  1   3 , Péter Hegyi  1   5   6 , Péter Nyirády  7 , Nándor Ács  2 , Szabolcs Várbíró  8   9 , Eszter M Horváth  3
Affiliations
Meta-Analysis

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

Dorina Greff et al. Reprod Biol Endocrinol. .

Abstract

Background: Metformin 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.

Objective: Inositols 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.

Methods: The 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).

Results: Twenty-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).

Conclusion: Inositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin.

Trial registration: PROSPERO registration number: CRD42021283275.

Keywords: BMI; Cycle length; Inositol; Insulin; Metabolic syndrome; Metformin; PCOS; Testosterone.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flowchart representing the study selection process
Fig. 2
Fig. 2
Forest plots representing the risk of cycle normalization in the groups treated with inositols compared to placebo or metformin
See this image and copyright information in PMC

References

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