Metformin combined with spironolactone vs. metformin alone in polycystic ovary syndrome: a meta-analysis

作者：Huamin Zeng, Ying Zhang, Sikai Huang, Jinghua Wu, Wenrui Ren, Lingru Zhou, Leneng Huang, Yuyin Ye · 发表于：Frontiers in Endocrinology · 年份：2023 · DOI：10.3389/fendo.2023.1223768 · 被引用次数：11 · 研究领域：Ovarian function and disorders、Electrolyte and hormonal disorders、Apelin-related biomedical research

Aims: Due to its high heterogenicity and unclear etiology, there is currently no specific treatment for polycystic ovary syndrome (PCOS). Metformin, as an insulin sensitizer, combined with spironolactone, an antiandrogen medication, may exert complementary effects on PCOS. We therefore performed a meta-analysis of trials in which metformin combined with spironolactone was applied to treat PCOS to evaluate the efficacy and safety of the combination therapy. Methods: We retrieved the PubMed, Embase, Scopus, Cochrane Library, CNKI, CBM, Wangfang, and VIP databases for literatures published from their inception to December 16, 2022 on the effects of metformin combined with spironolactone in the treatment of PCOS. Inclusion criteria according to P.I.C.O.S criteria were: PCOS patients, metformin combined with spironolactone interventions, metformin alone control group, and randomized controlled trials with the following outcome data: body mass index (BMI), hirsutism score, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), fasting blood glucose (FBG), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and side effects including nausea, vomiting, diarrhea and drug withdrawal. Results: Our results revealed that metformin combined with spironolactone significantly reduced BMI and TT, but that it exerted no significant effects on hirsutism score, or on FSH or LH concentrations. Combined treatment also resulted in a significant diminution ...