Meta-Analysis: Metformin for PCOS Weight Management
BACKGROUND AND PURPOSE:
- Melin et al. (European Journal of Endocrinology, 2023) examined the effectiveness of metformin and lifestyle modification for the management of PCOS
METHODS:
- Systematic review and meta-analysis
- Inclusion criteria
- Randomized controlled trials
- Studies that assessed the effectiveness of metformin and lifestyle compared to placebo for the management of hormonal and clinical features of PCOS
- Primary outcomes
- Outcomes related to weight management and insulin sensitivity
RESULTS:
- 32 RCTs
- There was moderate certainty evidence that metformin vs placebo improved
- BMI with or without lifestyle change
- MD −0.53 kg/m2 (95% CI, −0.95 to −0.12)
- MD −0.50 (95% CI, −0.91 to −0.09)
- Fasting glucose
- MD −0.13 mmol/L (95% CI, −0.19 to −0.07)
- BMI with or without lifestyle change
- Compared to placebo, there were increased mild gastrointestinal adverse effects with metformin
- OR 7.67 (95% CI, 2.74 to 21.46)
- There was low certainty evidence to support metformin improving
- Reduction of waist-hip ratio
- MD −0.02 (95% CI, −0.03 to −0.00)
- Total cholesterol
- MD −0.24 mmol/L (95% CI, −0.43 to −0.05)
- Low-density lipoprotein
- MD −0.16 mmol/L (95% CI, −0.30 to −0.01)
- Triglycerides
- MD −0.11 mmol/L (95% CI, −0.20 to −0.02)
- Reduction of waist-hip ratio
CONCLUSION:
- For individuals with PCOS, metformin can effectively improve weight management, insulin tolerance, and lipids
- The authors state
Metformin should be considered in adult women with PCOS and BMI ≥25 kg/m2 for prevention of weight gain and management of weight and metabolic disorders
Metformin may be considered in adults with BMI < 25 kg/m2 and adolescents with PCOS, acknowledging more limited evidence
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