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Effects of myo-inositol vs. metformin on hormonal and metabolic parameters in women with PCOS: a meta-analysis

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Abstract

Objective

Polycystic Ovary Syndrome is the most prevalent hormonal disorder in females. Over the years, metformin (MET) has become the first-line choice of treatment; however, due to its gastrointestinal side effects, a more recent drug, myo-inositol (MI), has been introduced. We aim to conduct a systematic review and meta-analysis to compare the effects of MET and MI on hormonal and metabolic parameters.

Materials and methods

Authors extensively searched PubMed, Scopus, Cochrane Library, Google Scholar, and Web of Science for randomized clinical trials (RCTs) until August 2021. Eight (n = 8) articles were included, with a total sample size of 1088, of which 460 patients received MET, 436 received MI, and 192 received a combination of both. Standard mean differences (SMDs) and Confidence Intervals (CIs) were used for data synthesis, and forest plots were made using Review Manager 5.4 for Statistical Analysis using the random-effect model.

Results

The meta-analysis indicates that there is no significant difference between MET and MI in terms of their effects on BMI (SMD = 0.16, 95% CI: − 0.11 to 0.43, p = 0.24), fasting insulin (SMD = 0.00, 95% CI: − 0.26 to 0.27, p = 0.97), fasting blood sugar (SMD = 0.11, 95% CI: − 0.31to 0.53, p = 0.60), HOMA index (SMD = 0.09, 95% CI: − 0.20 to 0.39, p = 0.50), and LH/FSH (SMD = 0.20, 95% CI: − 0.24 to 0.64, p = 0.37). BMI, fasting blood sugar, and LH/FSH ratio reported moderate heterogeneity because of the varying number of study participants.

Conclusion

Our meta-analysis comparing hormonal and metabolic parameters between MET and MI did not show much significant difference, indicating both drugs are equally beneficial in improving metabolic and hormonal parameters in patients with PCOS.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to acknowledge the Research Council of Pakistan (RCOP) for their support along all aspects of conducting this study.

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Authors and Affiliations

  1. Department of Medicine, Dow University Of Health Sciences, Karachi, Pakistan

    Kaneez Fatima, Zainab Jamil, Samar Faheem, Hafsa Naeem, Neha Mohiuddin & Anosha Sajid

  2. Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan

    Alishba Adnan

  3. Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan

    Syed Sarmad Javaid

  4. Department of Medicine, Khairpur Medical College, Khairpur Mir’s, Sindh, 66020, Pakistan

    Sidhant Ochani

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Contributions

K.F: conceptualization, resources, writing—review and editing, and project administration. Z.J: supervision, methodology, formal analysis, and writing—original draft preparation. S.F: conceptualization, formal analysis, data curation, and writing—original draft preparation. A.A: formal analysis, investigation, and writing—original draft preparation. S.S.J: supervision, writing—review and editing, and validation formatting and referencing. H.N: writing—original draft preparation, formal analysis, and methodology. N.M: formal analysis, investigation, and writing—original draft preparation. A.S: data curation, writing—original draft preparation, and formal analysis. S.O: writing—original draft preparation, writing-review and editing, methodology, formal analysis, investigation, and formatting and referencing.

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Correspondence to Sidhant Ochani.

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Fatima, K., Jamil, Z., Faheem, S. et al. Effects of myo-inositol vs. metformin on hormonal and metabolic parameters in women with PCOS: a meta-analysis. Ir J Med Sci 192, 2801–2808 (2023). https://doi.org/10.1007/s11845-023-03388-5

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