Abstract：
This systematic review and meta-analysis evaluated the efficacy of anti-obesity agents for hormonal, reproductive, metabolic, and psychological outcomes in polycystic ovary syndrome (PCOS) to inform the 2023 update of the International Evidence-based Guideline on PCOS. We searched Medline, EMBASE, PsycInfo, and CINAHL until July 2022 with a 10-year limit to focus on newer agents. Eleven trials (545 and 451 participants in intervention and control arms respectively, 12 comparisons) were included. On descriptive analyses, most agents improved anthropometric outcomes; liraglutide, semaglutide and orlistat appeared superior to placebo for anthropometric outcomes. Meta-analyses were possible for two comparisons (exenatide vs. metformin and orlistat + combined oral contraceptive pill [COCP] vs. COCP alone). On meta-analysis, no differences were identified between exenatide versus metformin for anthropometric, biochemical hyperandrogenism, and metabolic outcomes, other than lower fasting blood glucose more with metformin than exenatide (MD: 0.10 mmol/L, CI 0.02-0.17, I2 = 18%, 2 trials). Orlistat + COCP did not improve metabolic outcomes compared with COCP alone (fasting insulin MD: -8.65 pmol/L, -33.55 to 16.26, I2 = 67%, 2 trials). Published data examining the effects of anti-obesity agents in women with PCOS are very limited. The role of these agents in PCOS should be a high priority for future research.
摘要：
这项系统评价和荟萃分析评估了抗肥胖药物对激素，生殖,新陈代谢，和多囊卵巢综合征（PCOS）的心理结局，以告知2023年国际PCOS循证指南的更新。我们搜查了Medline,EMBASE,PsycInfo,和CINAHL，直到2022年7月，10年限制专注于新的代理商。11项试验(干预和控制组分别有545名和451名参与者，包括12个比较）。在描述性分析中，大多数药物改善人体测量结果；利拉鲁肽，塞马鲁肽和奥利司他的人体测量结果优于安慰剂.Meta分析可能用于两种比较（艾塞那肽与二甲双胍和奥利司他+联合口服避孕药[COCP]与单独使用COCP）。在荟萃分析中，艾塞那肽与二甲双胍的人体测量没有差异,生化高雄激素血症，和代谢结果，二甲双胍组的空腹血糖低于艾塞那肽组（MD：0.10mmol/L，CI0.02-0.17，I2=18%，2试验）。与单独使用COCP相比，奥利司他+COCP并不能改善代谢结果（空腹胰岛素MD：-8.65pmol/L，-33.55至16.26，I2=67%，2试验）。研究抗肥胖药物在PCOS女性中的作用的公开数据非常有限。这些药物在PCOS中的作用应该是未来研究的重点。
