METHODS: This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I for non-RCTs. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked. A random effect model was used and calculated a pooled standardized mean difference (SMD) with a 95% confidence interval (CI).
RESULTS: Seventeen articles were included in the final analysis, varied in quality, ranging from a \"low\" to a \"high risk of bias\". Combined analyses indicated a notable decrease in HRV among individuals with PCOS compared to the control group. Significant changes were observed in SDNN (SMD: -0.763, 95%CI [-1.289 to -0.237], p=0.004), PNN50 (SMD: -1.245, 95%CI [-2.07, -0.419], p=0.003), LF/HF ratio (SMD: 0.670, 95%CI [0.248, 1.091], p=0.002), HFnu (SMD: -0.873, 95%CI [-1.257, -0.489], p=0.000), LFnu (SMD: 0.840, 95%CI [0.428, 1.251], p=0.000) and TP (SMD: -1.997, 95%CI [-3.306, -0.687], p=0.003). The heterogeneity was partially explained by types of study design. Subgroup analysis revealed significant alterations of HRV in normal-weighted and overweight PCOS cases. Conversely, no significant changes in HRV were observed in obese PCOS cases.
CONCLUSIONS: The findings of this meta-analysis provide evidence suggesting diminished HRV in individuals with PCOS compared to non-PCOS control group.
方法:本系统综述使用PRISMA报告指南编制。搜索的数据库是PubMed,Scopus,WebofScience,还有Cochrane.使用ROBINS-I评估非随机对照试验的偏倚风险。采用等级方法来评估每个结果的证据的确定性水平。为了找出高度异质性的根本原因,进行了亚组分析.检查敏感性分析。使用随机效应模型并计算具有95%置信区间(CI)的合并标准化平均差(SMD)。
结果:最终分析包括17篇文章,质量各不相同,从“低”到“高偏见风险”。综合分析表明,与对照组相比,PCOS患者的HRV显着降低。在SDNN中观察到显着变化(SMD:-0.763,95CI[-1.289至-0.237],p=0.004),PNN50(SMD:-1.245,95CI[-2.07,-0.419],p=0.003),LF/HF比(SMD:0.670,95CI[0.248,1.091],p=0.002),HFnu(SMD:-0.873,95CI[-1.257,-0.489],p=0.000),LFnu(SMD:0.840,95CI[0.428,1.251],p=0.000)和TP(SMD:-1.997,95CI[-3.306,-0.687],p=0.003)。异质性部分由研究设计类型解释。亚组分析显示,在正常加权和超重的PCOS病例中,HRV发生了显着变化。相反,在肥胖PCOS病例中,HRV无显著变化.
结论:这项荟萃分析的结果提供的证据表明,与非PCOS对照组相比,PCOS患者的HRV降低。