PDF(Pubmed)
Abstract：
BACKGROUND: This study aims to analyze the efficacy of metformin on carotid intima media thickness (CIMT) and flow-mediated dilation (FMD) for patients with polycystic ovary syndrome (PCOS).
METHODS: A literature search of PubMed, Embase, and the Cochrane Library from inception to December 2023 was conducted. Then, after studies selection and data extraction, the mean difference (MD) with a 95% confidence interval (CI) was used to evaluate metformin efficacy in CIMT and FMD for PCOS patients. Heterogeneity was investigated through subgroup and sensitivity analysis. The protocol of our study has been registered in PROSPERO (CRD42024497239).
RESULTS: A total of 12 studies with 248 patients were included. CIMT was lower in the endpoint group (after metformin) compared with the baseline group (before metformin) (MD = -0.11, 95% CI = -0.21 to -0.01, p = 0.04). FMD was higher in the endpoint group compared with the baseline group (MD = 3.25, 95% CI = 1.85 to 4.66, p < 0.01). No statistically significant difference was observed in nitroglycerin-mediated dilation (NMD) between the two groups (MD = 0.65, p = 0.51). Subgroup analysis showed that a relatively lower MD of CIMT in PCOS patients from Europe in the endpoint group compared with the baseline group (MD = -0.09, 95% CI = -0.14 to -0.04, p < 0.001). However, the MD in CIMT was not significantly different between the endpoint group and baseline group in PCOS patients from Asia (p = 0.270).
CONCLUSIONS: Metformin may have a beneficial effect on CIMT and FMD, but not on NMD, suggesting that metformin may help reduce cardiovascular events in PCOS patients. Notably, the clinical efficacy of metformin can be influenced by regional differences and study types.
METHODS: A literature search of PubMed, Embase, and the Cochrane Library from inception to December 2023 was conducted. Then, after studies selection and data extraction, the mean difference (MD) with a 95% confidence interval (CI) was used to evaluate metformin efficacy in CIMT and FMD for PCOS patients. Heterogeneity was investigated through subgroup and sensitivity analysis. The protocol of our study has been registered in PROSPERO (CRD42024497239).
RESULTS: A total of 12 studies with 248 patients were included. CIMT was lower in the endpoint group (after metformin) compared with the baseline group (before metformin) (MD = -0.11, 95% CI = -0.21 to -0.01, p = 0.04). FMD was higher in the endpoint group compared with the baseline group (MD = 3.25, 95% CI = 1.85 to 4.66, p < 0.01). No statistically significant difference was observed in nitroglycerin-mediated dilation (NMD) between the two groups (MD = 0.65, p = 0.51). Subgroup analysis showed that a relatively lower MD of CIMT in PCOS patients from Europe in the endpoint group compared with the baseline group (MD = -0.09, 95% CI = -0.14 to -0.04, p < 0.001). However, the MD in CIMT was not significantly different between the endpoint group and baseline group in PCOS patients from Asia (p = 0.270).
CONCLUSIONS: Metformin may have a beneficial effect on CIMT and FMD, but not on NMD, suggesting that metformin may help reduce cardiovascular events in PCOS patients. Notably, the clinical efficacy of metformin can be influenced by regional differences and study types.
摘要：
背景：本研究旨在分析二甲双胍对多囊卵巢综合征（PCOS）患者颈动脉内膜中层厚度（CIMT）和血流介导扩张（FMD）的影响。
方法：PubMed的文献检索，Embase,和Cochrane图书馆从成立到2023年12月进行。然后，经过研究选择和数据提取，采用平均差(MD)和95%置信区间(CI)评估二甲双胍对PCOS患者CIMT和FMD的疗效.通过亚组和敏感性分析研究异质性。我们的研究方案已在PROSPERO（CRD42024497239）中注册。
结果：共纳入12项研究，共248例患者。与基线组（二甲双胍前）相比，终点组（二甲双胍后）的CIMT较低（MD=-0.11，95％CI=-0.21至-0.01，p=0.04）。与基线组相比，终点组的FMD较高（MD=3.25，95％CI=1.85至4.66，p<0.01）。两组之间的硝酸甘油介导的扩张（NMD）无统计学差异（MD=0.65，p=0.51）。亚组分析显示，与基线组相比，终点组欧洲PCOS患者的CIMTMD相对较低（MD=-0.09，95％CI=-0.14至-0.04，p<0.001）。然而,来自亚洲的PCOS患者的MDinCIMT在终点组和基线组之间无显著差异(p=0.270).
结论：二甲双胍可能对CIMT和FMD有有益作用，但不是在NMD上，提示二甲双胍可能有助于减少PCOS患者的心血管事件.值得注意的是,二甲双胍的临床疗效可能受到地区差异和研究类型的影响。
方法：PubMed的文献检索，Embase,和Cochrane图书馆从成立到2023年12月进行。然后，经过研究选择和数据提取，采用平均差(MD)和95%置信区间(CI)评估二甲双胍对PCOS患者CIMT和FMD的疗效.通过亚组和敏感性分析研究异质性。我们的研究方案已在PROSPERO（CRD42024497239）中注册。
结果：共纳入12项研究，共248例患者。与基线组（二甲双胍前）相比，终点组（二甲双胍后）的CIMT较低（MD=-0.11，95％CI=-0.21至-0.01，p=0.04）。与基线组相比，终点组的FMD较高（MD=3.25，95％CI=1.85至4.66，p<0.01）。两组之间的硝酸甘油介导的扩张（NMD）无统计学差异（MD=0.65，p=0.51）。亚组分析显示，与基线组相比，终点组欧洲PCOS患者的CIMTMD相对较低（MD=-0.09，95％CI=-0.14至-0.04，p<0.001）。然而,来自亚洲的PCOS患者的MDinCIMT在终点组和基线组之间无显著差异(p=0.270).
结论：二甲双胍可能对CIMT和FMD有有益作用，但不是在NMD上，提示二甲双胍可能有助于减少PCOS患者的心血管事件.值得注意的是,二甲双胍的临床疗效可能受到地区差异和研究类型的影响。
