Effect of pharmacological interventions on lipid profiles and C-reactive protein in polycystic ovary syndrome: A systematic review and meta-analysis.
HDL
LDL
pharmacological therapy
polycystic ovary syndrome (PCOS)
therapeutic agents
total cholesterol
triglycerides
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
revised:
26
10
2021
received:
28
09
2021
accepted:
28
10
2021
pubmed:
16
11
2021
medline:
21
4
2022
entrez:
15
11
2021
Statut:
ppublish
Résumé
Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age. It is associated with dyslipidaemia and elevated plasma C-reactive protein (CRP), which increase the risks of cardiovascular disease (CVD). To review the existing evidence on the effects of different pharmacological interventions on lipid profiles and CRP of women with PCOS. We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library, and Web of Science in April 2020 and updated the results in March 2021. The study included randomized controlled trials (RCTs) and follows the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Two independent researchers extracted data and assessed for risk of bias using the Cochrane risk of bias tool. Covidence systematic review software were used for blinded screening and study selection. In 29 RCTs, there were significant reductions in triglycerides with atorvastatin versus placebo [mean difference (MD): -0.21 mmol/L; 95% confidence interval (CI): -0.39, -0.03, I There were significant reductions in the lipid parameters when metformin, atorvastatin, saxagliptin, rosiglitazone and pioglitazone were compared with placebo or other agents. There was also a significant reduction of CRP with atorvastatin.
Substances chimiques
Cholesterol, LDL
0
C-Reactive Protein
9007-41-4
Metformin
9100L32L2N
Atorvastatin
A0JWA85V8F
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
443-459Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Witchel SF, Oberfield SE, Pena AS. Polycystic ovary syndrome: pathophysiology, presentation, and treatment with emphasis on adolescent girls. J Endocr Soc. 2019;3(8):1545-1573.
Abdalla MA, Deshmukh H, Atkin S, Sathyapalan T. A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome. Ther Adv Endocrinol Metab. 2020;11:2042018820938305.
Balen A. The pathophysiology of polycystic ovary syndrome: trying to understand PCOS and its endocrinology. Best Pract Res Clin Obstet Gynaecol. 2004;18(5):685-706.
Diamanti-Kandarakis E, Papavassiliou AG, Kandarakis SA, Chrousos GP. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab. 2007;18(7):280-285.
Kim JJ, Choi YM. Dyslipidemia in women with polycystic ovary syndrome. Obstet Gynecol Sci. 2013;56(3):137-142.
Le MT, Nguyen VQH, Truong QV, Le DD, Le VNS, Cao NT. Metabolic syndrome and insulin resistance syndrome among infertile women with polycystic ovary syndrome: a cross-sectional study from central Vietnam. Endocrinol Metab (Seoul). 2018;33(4):447-458.
Göbl CS, Ott J, Bozkurt L, et al. To Assess the association between glucose metabolism and ectopic lipid content in different clinical classifications of PCOS. PLoS One. 2016;11(8):e0160571.
Boulman N, Levy Y, Leiba R, et al. Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab. 2004;89(5):2160-2165.
Marciniak A, Nawrocka Rutkowska J, Brodowska A, Wisniewska B, Starczewski A. Cardiovascular system diseases in patients with polycystic ovary syndrome-the role of inflammation process in this pathology and possibility of early diagnosis and prevention. Ann Agric Environ Med. 2016;23(4):537-541.
Sathyapalan T, Atkin SL. Recent advances in cardiovascular aspects of polycystic ovary syndrome. Eur J Endocrinol. 2012;166(4):575-583.
Rizzo M, Berneis K, Hersberger M, et al. Milder forms of atherogenic dyslipidemia in ovulatory versus anovulatory polycystic ovary syndrome phenotype. Hum Reprod. 2009;24(9):2286-2292.
Ferri N, Corsini A. Clinical evidence of statin therapy in non-dyslipidemic disorders. Pharmacol Res. 2014;88:20-30.
Gao L, Zhao FL, Li SC. Statin is a reasonable treatment option for patients with Polycystic Ovary Syndrome: a meta-analysis of randomized controlled trials. Exp Clin Endocrinol Diabetes. 2012;120(6):367-375.
Banaszewska B, Pawelczyk L, Spaczynski RZ, Duleba AJ. Effects of simvastatin and metformin on polycystic ovary syndrome after six months of treatment. J Clin Endocrinol Metab. 2011;96(11):3493-3501.
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
Babineau J. Product review: covidence (systematic review software). J Can Health Libr Assoc. 2014;35(2):68-71.
Hupe M. EndNote X9. J Electron Resour Med Libr. 2019;16(3-4):117-119.
Das S, Chatterjee SS. Cabell's blacklist: a new way to tackle predatory journals. Indian J Psychol Med. 2018;40(2):197-198.
Amiri M, Golsorkhtabaramiri M, Esmaeilzadeh S, et al. Effect of metformin and flutamide on anthropometric indices and laboratory tests in obese/overweight PCOS women under hypocaloric diet. J Reprod Infertil. 2014;15(4):205-213.
Akbari M, Almasi A, Naderi Z, Kouhpayezadeh J, Pourali R, Hossinzadeh Z. The effect of atrovastatin on the ovarian arterial blood flow and serum androgen level in PCOS patient. Biomed Pharmacol J. 2016;9(3):1041-1048.
Brettenthaler N, De Geyter C, Huber PR, Keller U. Effect of the insulin sensitizer pioglitazone on insulin resistance, hyperandrogenism, and ovulatory dysfunction in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2004;89(8):3835-3840.
Elkind-Hirsch KE, Paterson MS, Seidemann EL, Gutowski HC. Short-term therapy with combination dipeptidyl peptidase-4 inhibitor saxagliptin/metformin extended release (XR) is superior to saxagliptin or metformin XR monotherapy in prediabetic women with polycystic ovary syndrome: a single-blind, randomized, pilot. Fertil Steril. 2017;107(1):253-260.
Glintborg D, Hermann AP, Andersen M, et al. Effect of pioglitazone on glucose metabolism and luteinizing hormone secretion in women with polycystic ovary syndrome. Fertil Steril. 2006;86(2):385-397.
Puurunen J, Piltonen T, Puukka K, et al. Statin therapy worsens insulin sensitivity in women with polycystic ovary syndrome (PCOS): a prospective, randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab. 2013;98(12):4798-4807.
Gambineri A, Pelusi C, Genghini S, et al. Effect of flutamide and metformin administered alone or in combination in dieting obese women with polycystic ovary syndrome. Clin Endocrinol. 2004;60(2):241-249.
Heidari B, Lerman A, Lalia AZ, Lerman LO, Chang AY. Effect of metformin on microvascular endothelial function in polycystic ovary syndrome. Mayo Clin Proc. 2019;94(12):2455-2466.
Jensterle M, Sebestjen M, Janez A, et al. Improvement of endothelial function with metformin and rosiglitazone treatment in women with polycystic ovary syndrome. Eur J Endocrinol. 2008;159(4):399-406.
Jensterle M, Kravos NA, Goričar K, Janez A. Short-term effectiveness of low dose liraglutide in combination with metformin versus high dose liraglutide alone in treatment of obese PCOS: randomized trial. BMC Endocr Disord. 2017;17(1):5.
Jensterle Sever M, Kocjan T, Pfeifer M, Kravos NA, Janez A. Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin. Eur J Endocrinol. 2014;170(3):451-459.
Liu X, Zhang Y, Zheng SY, et al. Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight/obese polycystic ovary syndrome. Clin Endocrinol. 2017;87(6):767-774.
Lord J, Thomas R, Fox B, Acharya U, Wilkin T. The effect of metformin on fat distribution and the metabolic syndrome in women with polycystic ovary syndrome--a randomised, double-blind, placebo-controlled trial. BJOG. 2006;113(7):817-824.
Moghetti P, Castello R, Negri C, et al. Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation. J Clin Endocrinol Metab. 2000;85(1):139-146.
Mohiyiddeen L, Watson AJ, Apostolopoulos NV, Berry R, Alexandraki KI, Jude EB. Effects of low-dose metformin and rosiglitazone on biochemical, clinical, metabolic and biophysical outcomes in polycystic ovary syndrome. J Obstet Gynaecol. 2013;33(2):165-170.
Mehrabian F, Ghasemi-Tehrani H, Mohamadkhani M, Moeinoddini M, Karimzadeh P. Comparison of the effects of metformin, flutamide plus oral contraceptives, and simvastatin on the metabolic consequences of polycystic ovary syndrome. J Res Med Sci. 2016;21:7.
Navali N, Pourabolghasem S, Fouladi RF, Nikpour MA. Therapeutic effects of biguanide vs. statin in polycystic ovary syndrome: a randomized clinical trial. Pak J Biol Sci. 2011;14(11):658-663.
Ng EH, Wat NM, Ho PC. Effects of metformin on ovulation rate, hormonal and metabolic profiles in women with clomiphene-resistant polycystic ovaries: a randomized, double-blinded placebo-controlled trial. Hum Reprod. 2001;16(8):1625-1631.
Naka KK, Kalantaridou SN, Kravariti M, et al. Effect of the insulin sensitizers metformin and pioglitazone on endothelial function in young women with polycystic ovary syndrome: a prospective randomized study. Fertil Steril. 2011;95(1):203-209.
Ortega-González C, Luna S, Hernández L, et al. Responses of serum androgen and insulin resistance to metformin and pioglitazone in obese, insulin-resistant women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90(3):1360-1365.
Sova H, Puistola U, Morin-Papunen L, Karihtala P. Metformin decreases serum 8-hydroxy-2'-deoxyguanosine levels in polycystic ovary syndrome. Fertil Steril. 2013;99(2):593-598.
Shahebrahimi K, Jalilian N, Bazgir N, Rezaei M. Comparison clinical and metabolic effects of metformin and pioglitazone in polycystic ovary syndrome. Indian J Endocrinol Metab. 2016;20(6):805-809.
Sohrevardi SM, Nosouhi F, Hossein Khalilzade S, et al. Evaluating the effect of insulin sensitizers metformin and pioglitazone alone and in combination on women with polycystic ovary syndrome: an RCT. Int J Reprod Biomed. 2016;14(12):743-754.
Sathyapalan T, Kilpatrick ES, Coady AM, Atkin SL. The effect of atorvastatin in patients with polycystic ovary syndrome: a randomized double-blind placebo-controlled study. J Clin Endocrinol Metab. 2009;94(1):103-108.
Tao T, Wu P, Wang Y, Liu W. Comparison of glycemic control and β-cell function in new onset T2DM patients with PCOS of metformin and saxagliptin monotherapy or combination treatment. BMC Endocr Disord. 2018;18(1):14.
Trolle B, Lauszus FF, Frystyk J, Flyvbjerg A. Adiponectin levels in women with polycystic ovary syndrome: impact of metformin treatment in a randomized controlled study. Fertil Steril. 2010;94(6):2234-2238.
Underdal MO, Stridsklev S, Oppen IH, Høgetveit K, Andersen MS, Vanky E. Does metformin treatment during pregnancy modify the future metabolic profile in women with PCOS? J Clin Endocrinol Metab. 2018;103(6):2408-2413.
Zheng S, Zhang Y & Long T et al. Short term monotherapy with exenatide is superior to metformin in weight loss, improving insulin resistance and inflammation in Chinese overweight/obese PCOS women. Obes Med. 2017;7:15-20.
Ziaee A, Oveisi S, Abedini A, Hashemipour S, Karimzadeh T, Ghorbani A. Effect of metformin and pioglitazone treatment on cardiovascular risk profile in polycystic ovary syndrome. Acta Med Indones. 2012;44(1):16-22.
Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
Higgins JP, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons; 2019.
Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-926.
Rotterdam EA-SPCWG. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.
Anaforoglu I, Algun E, Incecayir O, Ersoy K. Higher metabolic risk with National Institutes of Health versus Rotterdam diagnostic criteria for polycystic ovarian syndrome in Turkish women. Metab Syndr Relat Disord. 2011;9(5):375-380.
Guan Y, Wang D, Bu H, Zhao T, Wang H. The effect of metformin on polycystic ovary syndrome in overweight women: a systematic review and meta-analysis of randomized controlled trials. Int J Endocrinol. 2020;2020:5150684.
Chou KH, von Eye Corleta H, Capp E, Spritzer PM. Clinical, metabolic and endocrine parameters in response to metformin in obese women with polycystic ovary syndrome: a randomized, double-blind and placebo-controlled trial. Horm Metab Res. 2003;35(2):86-91.
Trolle B, Flyvbjerg A, Kesmodel U, Lauszus FF. Efficacy of metformin in obese and non-obese women with polycystic ovary syndrome: a randomized, double-blinded, placebo-controlled cross-over trial. Hum Reprod. 2007;22(11):2967-2973.
Kim HS, Ren G, Kim T, et al. Metformin reduces saturated fatty acid-induced lipid accumulation and inflammatory response by restoration of autophagic flux in endothelial cells. Sci Rep. 2020;10(1):13523.
McFarland AJ, Anoopkumar-Dukie S, Arora DS, et al. Molecular mechanisms underlying the effects of statins in the central nervous system. Int J Mol Sci. 2014;15(11):20607-20637.
Wang J, Zhu L, Hu K, et al. Effects of metformin treatment on serum levels of C-reactive protein and interleukin-6 in women with polycystic ovary syndrome: a meta-analysis: a PRISMA-compliant article. Medicine. 2017;96(39):e8183.
Dawson AJ, Sathyapalan T, Vince R, et al. The effect of exenatide on cardiovascular risk markers in women with polycystic ovary syndrome. Front Endocrinol. 2019;10:189.
Tarkun I, Cetinarslan B, Turemen E, Sahin T, Canturk Z, Komsuoglu B. Effect of rosiglitazone on insulin resistance, C-reactive protein and endothelial function in non-obese young women with polycystic ovary syndrome. Eur J Endocrinol. 2005;153(1):115-121.