Effects of metformin on pregnancy outcome, metabolic profile, and sex hormone levels in women with polycystic ovary syndrome and their offspring: a systematic review and meta-analysis.
Effects of metformin on pregnancy outcome, metabolic profile, and sex hormone levels in women with polycystic ovary syndrome and their offspring: a systematic review and meta-analysis.
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DOI：
10.21037/atm-22-909
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发表时间：
2022-04
影响因子：
--
通讯作者：
Xu, Liangzhi
中科院分区：
文献类型：
--
作者：
Zhu, Daiyu;Chen, Yan;Huang, Jianfeng;Deng, Hongxia;Shen, Xiaoyang;Lu, Danhua;Xu, Liangzhi
关于二甲双胍对长期妊娠结局的有效性和安全性的研究仍然存在争议。我们进行了更新的系统评价和荟萃分析，系统地研究二甲双胍治疗对多囊卵巢综合征 (PCOS) 女性及其后代妊娠结局、代谢特征和性激素特征的影响。使用关键词“二甲双胍”、“PCOS”和“妊娠”对 PubMed、Embase 和 Cochrane 图书馆数据库进行了从建库到 2021 年 7 月 10 日的检索。随机对照研究报告了 PCOS 女性中二甲双胍干预后的妊娠相关结果，但排除了摘要和评论。两位作者独立鉴定试验、提取数据并使用 Cochrane 审稿人手册 5.0 评估偏倚风险。使用随机效应模型来评估妊娠结局、代谢特征和性激素水平的汇总风险比 (RR) 和 95% 置信区间 (95% CI)。纳入了十八项研究。大多数试验的方法学质量为中等。就 PCOS 女性的妊娠并发症而言，二甲双胍治疗可显着降低早产风险（RR = 0.37，95% CI：0.23-0.61）、妊娠高血压（PIH）和先兆子痫（RR = 0.45，95% CI：0.24-0.83）和巨大儿（RR = 0.26，95% CI： 0.11–0.64）。就后代而言，二甲双胍与较大的头围（MD = 0.29，95% CI：0.13-0.45）和较高的长期体重指数（BMI）测量（MD = 0.37，95% CI：0.17-0.56）显着相关。在代谢特征和性激素特征方面，母亲的胰岛素抵抗稳态模型评估（HOMA2-IR）评分显着下降（MD = -0.32，95％CI：-0.63至-0.02），而后代的性激素结合球蛋白（SHBG）水平显着增加（MD = 0.33，95％CI：0.01-0.65）。尽管随机对照试验（RCT）质量相对较低且结果有限，很难得出明确的结论，但我们的研究表明，妊娠期间二甲双胍治疗可以降低妊娠并发症的风险，但可能对后代性激素结合球蛋白（SHBG）水平和长期体重指数（BMI）的增加产生影响。
Researches of the efficacy and safety of metformin on long-term pregnancy outcomes remains conflicted. We performed an updated systematic review and meta-analysis to systematically investigate the effect of metformin treatment on pregnancy outcome, metabolic profile, and sex hormone characteristics in women with polycystic ovary syndrome (PCOS) and their offspring. The PubMed, Embase, and Cochrane Library databases were searched from inception to July 10, 2021 with the keywords “metformin”, “PCOS”, and “pregnancy”. Randomized controlled studies reported pregnant related outcomes after metformin intervention among PCOS women were included, while abstracts and reviews were excluded. Two authors independently identified trials, extracted data and assessed risk of bias with Cochrane Reviewer’s Handbook 5.0. Random effects models were used to evaluate the pooled risk ratios (RR) and 95% confidence intervals (95% CI) of pregnancy outcome, metabolic profile, and sex hormone levels. Eighteen studies were included. The majority of trials were in medium methodological quality. In terms of pregnancy complications among women with PCOS, metformin treatment was associated with a significantly reduced risk of preterm delivery (RR =0.37, 95% CI: 0.23–0.61), pregnancy-induced hypertension (PIH) and preeclampsia (RR =0.45, 95% CI: 0.24–0.83) and macrosomia (RR =0.26, 95% CI: 0.11–0.64). In terms of offspring, metformin significantly associated with larger head circumference (MD =0.29, 95% CI: 0.13–0.45) and higher long-term body mass index (BMI) measures (MD =0.37, 95% CI: 0.17–0.56). In terms of metabolic profile and sex hormone characteristics, a significant decrease in homeostatic model assessment for insulin resistance (HOMA2-IR) scores was found in mothers (MD =−0.32, 95% CI: −0.63 to −0.02), whereas a significant increase of sex hormone binding globulin (SHBG) levels was detected in offspring (MD =0.33, 95% CI: 0.01–0.65). Although the relative low quality of randomized controlled trials (RCTs) and limited results made it difficult to draw a definite conclusion, our study showed that metformin treatment during pregnancy can reduce the risk of pregnancy complications but may have impacts on increasing SHBG levels and long-term BMI in offspring.
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DOI：
10.1080/00365510802254620
发表时间：
2008-01-01
影响因子：
2.1
作者：
Fougner, K. J.;Vanky, E.;Carlsen, S. M.
通讯作者：
Carlsen, S. M.
影响因子：
3.7
作者：
Hanem LGE;Salvesen Ø;Madsen A;Sagen JV;Mellgren G;Juliusson PB;Carlsen SM;Vanky E;Ødegård R
通讯作者：
Ødegård R
影响因子：
2
作者：
Khattab, S.;Mohsen, I. A.;Youssef, M. Af.
通讯作者：
Youssef, M. Af.
影响因子：
44.5
作者：
Lovvik, Tone S.;Carlsen, Sven M.;Vanky, Eszter
通讯作者：
Vanky, Eszter
影响因子：
8.2
作者：
Lindsay RS;Loeken MR
通讯作者：
Loeken MR