Efficacy of Myo-inositol on Anthropometric, Metabolic, and Endocrine Outcomes in PCOS Patients: a Meta-analysis of Randomized Controlled Trial

Reprod Sci. 2022 Aug;29(8):2282-2298. doi: 10.1007/s43032-022-00933-y. Epub 2022 Apr 27.

Abstract

Polycystic ovary syndrome (PCOS) is a common cause of female infertility, affecting 5-10% of women of reproductive age. Many studies have reported improvement in insulin resistance and thereby intracellular glucose uptake after myo-inositol treatment in PCOS patients, but these studies have a small sample size, varying methodology, and outcome analysis. Therefore, we designed a present meta-analysis of randomized controlled trials to explore the effect of myo-inositol supplementation on anthropometric, metabolic, and endocrine outcomes in PCOS patients. Randomized controlled trials assessing the effectiveness of myo-inositol were identified in electronic databases like PubMed, Cochrane, Embase, MEDLINE, CINAHL, and AMED. Listed references and citations of related articles were also screened manually to identify additional studies. Research papers for which full-text copies were not available on scientific databases were procured from respective authors. Thereafter, data were extracted from included studies and analyzed using RevMan 5.3 of the Cochrane Collaboration. A total of 17 randomized controlled trials with 1083 PCOS patients were included in this meta-analysis. Among the 17 trials, 7 trials compared myo-inositol with folic acid, 8 trials compared myo-inositol with metformin, and 2 trials compared myo-inositol with oral contraceptives. No significant improvement in body mass index, waist-to-hip ratio, fasting insulin, fasting glucose, HOMA, LH, FSH, estradiol, sex hormone-binding globulin, dehydroepiandrosterone, and total testosterone levels were observed after myo-inositol treatment in PCOS patients except androstenedione and prolactin levels. Clinically significant improvement was not observed in anthropometric, metabolic, and endocrine outcomes after myo-inositol treatment in PCOS patients. However, heterogeneity between studies was high.

Keywords: Anthropometric; Endocrine; Meta-analysis; Metabolic; Myo-inositol; PCOS.

Publication types

  • Meta-Analysis

MeSH terms

  • Female
  • Folic Acid / therapeutic use
  • Humans
  • Inositol / therapeutic use
  • Insulin / metabolism
  • Insulin Resistance*
  • Metformin*
  • Polycystic Ovary Syndrome* / drug therapy
  • Polycystic Ovary Syndrome* / metabolism
  • Randomized Controlled Trials as Topic

Substances

  • Insulin
  • Inositol
  • Metformin
  • Folic Acid