Impact of pharmacological interventions on anthropometric indices in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials.

ABSTRACT

CONTEXT Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age and is associated with increased body weight. OBJECTIVE: To review the literature on the effect of different pharmacological interventions on the anthropometric indices in women with PCOS. DATA SOURCES We searched PubMed, MEDLINE, Scopus, Embase, Cochrane library, and the Web of Science in April 2020 with an update in PubMed in March 2021. STUDY SELECTION The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)2020. DATA EXTRACTION Reviewers extracted data and assessed the risk of bias using the Cochrane risk of bias tool. RESULTS: 80 RCTs were included in the meta-analysis. Metformin vs placebo showed significant reduction in the mean body weight (MD -3.13 kg; 95% confidence interval [CI] -5.33 to -0.93, I² = 5%) and the mean body mass index (BMI) (MD -0.75 kg/m2 ; 95% CI -1.15 to -0.36, I² = 0%). There was a significant reduction in the mean BMI with orlistat versus placebo (MD -1.33 kg/m²; 95% CI -2.16 to -0.66, I² = 0.0%), acarbose versus metformin (MD -1.26 kg/m²; 95% CI -2.13 to -0.38, I² = 0%), and metformin versus pioglitazone (MD -0.91 kg/m²; 95% CI -1.62 to -0.19, I² = 0%). A significant increase in the mean BMI was also observed in pioglitazone versus placebo (MD + 2.59 kg/m²; 95% CI 1.78-3.38, I² = 0%) and in rosiglitazone versus metformin (MD + 0.80 kg/m²; 95% CI 0.32-1.27, I² = 3%). There was a significant reduction in the mean waist circumference (WC) with metformin versus placebo (MD -1.21 cm; 95% CI -3.71 to 1.29, I² = 0%) while a significant increase in the mean WC with pioglitazone versus placebo (MD + 5.45 cm; 95% CI 2.18-8.71, I² = 0%). CONCLUSION: Pharmacological interventions including metformin, sitagliptin, pioglitazone, rosiglitazone orlistat, and acarbose have significant effects on the anthropometric indices in women with PCOS.