ABSTRACT
Objective:The study was designed to evaluate the efficacy in polycystic ovary syndrome (PCOS) of glucagon-like peptide-1 receptor agonists (GLP-1RA), metformin combined with thiazolidinediones, α-glucosidase inhibitor, and inositol.Methods:Eligible studies were searched in databases of PubMed, EMBase, Cochrane Library, Wanfang data, and CNKI based on population, interventions, comparisons, outcomes, and study design (PICOS) principle (inception to Nov 2020). Two researchers independently screened randomized controlled trials in strict accordance with the inclusion and exclusion criteria, extracted basic information and outcomes of included studies, and used Cochrane risk of bias tool to evaluate the methodological quality of the literature. Network meta-analysis was conducted by STATA 14.0. Continuous variables without dimensional differences were calculated by weighted mean difference and 95% CI, and continuous variables with dimensional differences were calculated using standardized mean difference and 95% CI. Results:A total of 27 studies with 1 445 patients were included in this study. Network meta-analysis showed that acarbose presented a better efficacy than other interventions in reducing total testosterone [surface under the cumulative ranking curve (SUCRA): 89.4%]. GLP-1RAs may have the best efficacy in reducing body mass index and homeostasis model assessment for insulin resistance (HOMA-IR; SUCRA: 99.1%, 89.2%, respectively), while using inositol may be a good choice to reduce serum fasting insulin, HOMA-IR, blood total cholesterol, and blood triglycerides (SUCRA: 94.5%, 85.4%, 96.6%, and 82.8%, respectively).Conclusions:Acarbose may have advantages over other antihyperglycemic drugs in lowering blood testosterone. GLP-1RAs are more helpful to improve body mass index and HOMA-IR in PCOS patients. Inositol, as an insulin sensitizer, has a favorable effect on reducing fasting insulin, HOMA-IR, blood total cholesterol, and blood triglycerides, and there are no reports of side effects in current researches. Further study is still needed to confirm its efficacy.
ABSTRACT
The etiology of polycystic ovary syndrome(PCOS) is unknown, which is closely related to insulin resistance and hyperinsulinemia. There are several controversies on PCOS diagnosis because of its diversity and heterogeneity in clinical manifestations. PCOS biomarkers have become a research hotspot. The methods of treatment include lifestyle interventions and improving metabolic dysfunction, hyperandrogenism, and reproduction abnormality. This article reviews the latest research progress in the morbidity characteristics, diagnostic criteria, and the therapy of PCOS.
ABSTRACT
The etiology of polycystic ovary syndrome(PCOS) is unknown, which is closely related to insulin resistance and hyperinsulinemia. There are several controversies on PCOS diagnosis because of its diversity and heterogeneity in clinical manifestations. PCOS biomarkers have become a research hotspot. The methods of treatment include lifestyle interventions and improving metabolic dysfunction, hyperandrogenism, and reproduction abnormality. This article reviews the latest research progress in the morbidity characteristics, diagnostic criteria, and the therapy of PCOS.