Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines

作者：Victoria W. Fitz, Sandro Graca, Shruthi Mahalingaiah, Jing Liu, Lily Yuen Wan Lai, Muhammad Ali Butt, Mike Armour, Vibhuti Samarth Rao, Dhevaksha Naidoo, Alison Maunder, Guoyan Yang, Vaishnavi Vaddiparthi, Selma Feldman Witchel, Alexia Sophie Peña, Poli Mara Spritzer, Rong Li, Chau Thien Tay, Aya Mousa, Helena Jane Teede, Carolyn Ee · 发表于：The Journal of Clinical Endocrinology & Metabolism · 年份：2023 · DOI：10.1210/clinem/dgad762 · 被引用次数：57 · 研究领域：Ovarian function and disorders、Reproductive Biology and Fertility、Growth Hormone and Insulin-like Growth Factors

CONTEXT: Insulin resistance is common in women with polycystic ovary syndrome (PCOS). Inositol may have insulin sensitizing effects; however, its efficacy in the management of PCOS remains indeterminate. OBJECTIVE: To inform the 2023 international evidence-based guidelines in PCOS, this systematic review and meta-analysis evaluated the efficacy of inositol, alone or in combination with other therapies, in the management of PCOS. DATA SOURCES: Medline, PsycInfo, EMBASE, All EBM, and CINAHL from inception until August 2022. STUDY SELECTION: Thirty trials (n = 2230; 1093 intervention, 1137 control), with 19 pooled in meta-analyses were included. DATA EXTRACTION: Data were extracted for hormonal, metabolic, lipids, psychological, anthropometric, reproductive outcomes, and adverse effects by 1 reviewer, independently verified by a second. DATA SYNTHESIS: Thirteen comparisons were assessed, with 3 in meta-analyses. Evidence suggests benefits for myo-inositol or D-chiro-inositol (DCI) for some metabolic measures and potential benefits from DCI for ovulation, but inositol may have no effect on other outcomes. Metformin may improve waist-hip ratio and hirsutism compared to inositol, but there is likely no difference for reproductive outcomes, and the evidence is very uncertain for body mass indexI. Myo-inositol likely causes fewer gastrointestinal adverse events compared with metformin; however, these are typically mild and self-limited. CONCLUSION: The evidence supporting the use of ...