The Effects of Probiotic Supplementation on Clinical Symptom, Weight Loss, Glycemic Control, Lipid and Hormonal Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Reza Tabrizi
  • Vahidreza Ostadmohammadi
  • Maryam Akbari
  • Kamran B. Lankarani
  • Sina Vakili
  • Payam Peymani
  • Maryam Karamali
  • Fariba Kolahdooz
  • Zatollah AsemiEmail author


The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to determine the effectiveness of probiotic supplementation on clinical symptoms, weight loss, glycemic control, lipid and hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome (PCOS). Eligible studies were systematically searched from Cochrane Library, Embase, Medline, and Web of Science databases until January 2019. Cochran (Q) and I-square statistics were used to measure heterogeneity among included studies. Data were pooled by using random-effect model and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). Eleven articles were included in this meta-analysis. Probiotic supplementation significantly decreased weight (SMD − 0.30; 95% CI, − 0.53, − 0.07; P = 0.01), body mass index (BMI) (SMD − 0.29; 95% CI, − 0.54, − 0.03; P = 0.02), fasting plasma glucose (FPG) (SMD − 0.26; 95% CI, − 0.45, − 0.07; P < 0.001), insulin (SMD − 0.52; 95% CI, − 0.81, − 0.24; P < 0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD − 0.53; 95% CI, − 0.79, − 0.26; P < 0.001), triglycerides (SMD − 0.69; 95% CI, − 0.99, − 0.39; P < 0.001), VLDL-cholesterol (SMD − 0.69; 95% CI, − 0.99, − 0.39; P < 0.001), C-reactive protein (CRP) (SMD − 1.26; 95% CI, − 2.14, − 0.37; P < 0.001), malondialdehyde (MDA) (SMD − 0.90; 95% CI, − 1.16, − 0.63; P < 0.001), hirsutism (SMD − 0.58; 95% CI, − 1.01, − 0.16; P < 0.001), and total testosterone levels (SMD − 0.58; 95% CI, − 0.82, − 0.34; P < 0.001), and also increased the quantitative insulin sensitivity check index (QUICKI) (SMD 0.41; 95% CI, 0.11, 0.70; P < 0.01), nitric oxide (NO) (SMD 0.33; 95% CI 0.08, 0.59; P = 0.01), total antioxidant capacity (TAC) (SMD 0.64; 95% CI, 0.38, 0.90; P < 0.001), glutathione (GSH) (SMD 0.26; 95% CI, 0.01, 0.52; P = 0.04), and sex hormone binding globulin (SHBG) levels (SMD 0.46; 95% CI, 0.08, 0.85; P = 0.01). Probiotic supplementation may result in an improvement in weight, BMI, FPG, insulin, HOMA-IR, triglycerides, VLDL-cholesterol, CRP, MDA, hirsutism, total testosterone, QUICKI, NO, TAC, GSH, and SHBG but did not affect dehydroepiandrosterone sulfate levels, and total, LDL, and HDL cholesterol levels in patients with PCOS.


Probiotic Weight loss Glycemic control Lipids profiles Inflammation Oxidative markers Meta-analysis Polycystic ovary syndrome 



The current study was founded by a grant number (97-01-106-19022) from the Vice-chancellor for Research, SUMS, in Iran.

Compliance with Ethics Requirements

Conflict of Interest

The authors declare that they have no conflict of interest.

For Studies with Human Subjects

All procedures utilized in the selected papers were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Authors of the selected papers obtained informed consent from all patients for being included in their studies.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Reza Tabrizi
    • 1
  • Vahidreza Ostadmohammadi
    • 2
  • Maryam Akbari
    • 1
  • Kamran B. Lankarani
    • 3
  • Sina Vakili
    • 4
  • Payam Peymani
    • 3
  • Maryam Karamali
    • 5
  • Fariba Kolahdooz
    • 6
  • Zatollah Asemi
    • 2
    Email author
  1. 1.Health Policy Research Center, Institute of Health, Student Research CommitteeShiraz University of Medical SciencesShirazIran
  2. 2.Research Center for Biochemistry and Nutrition in Metabolic DiseasesKashan University of Medical SciencesKashanIslamic Republic of Iran
  3. 3.Health Policy Research CenterShiraz University of Medical SciencesShirazIran
  4. 4.Department of BiochemistryShiraz University of Medical SciencesShirazIran
  5. 5.Department of Gynecology and Obstetrics, School of MedicineIran University of Medical SciencesTehranIran
  6. 6.Indigenous and Global Health Research, Department of MedicineUniversity of AlbertaEdmontonCanada

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