■探讨营养补充剂在改善多囊卵巢综合征(PCOS)患者糖脂代谢和内分泌功能方面的比较有效性。
■在PubMed,Embase,科克伦图书馆,和WebofScience从他们的机构到2023年3月15日。然后,文献筛选,数据提取,并进行网络荟萃分析。本研究在PROSPERO注册(注册号CRD42023441257)。
■本研究纳入了41篇涉及2,362例患者的文章。网络荟萃分析表明,肉碱,肌醇,与安慰剂相比,益生菌降低了体重和体重指数(BMI),和肉碱优于其他补充剂(SUCRAs:96.04%,97.73%,分别)。Omega-3降低空腹血糖(FBG)(SUCRAs:93.53%),和铬降低空腹胰岛素(FINS)(SUCRAs:72.90%);两者在改善胰岛素抵抗指数(HOMA-IR)方面均优于安慰剂,铬比Omega-3更有效(SUCRAs:79.99%)。硒可有效提高定量胰岛素敏感性指数(QUICKI)(SUCRAs:87.92%)。辅酶Q10在降低甘油三酯(TG)方面最有效,总胆固醇(TC),和低密度脂蛋白胆固醇(LDL-C)水平(SUCRAs:87.71%,98.78%,98.70%,分别)。铬和益生菌降低TG水平,而铬和维生素D降低TC水平。高密度脂蛋白胆固醇(HDL-C)无显著差异,总睾酮(TT),性激素结合球蛋白(SHBG),营养补充剂和安慰剂之间的C反应蛋白(CRP)。
■肉碱在减轻体重方面相对有效,而铬,Omega-3和硒有利于改善糖代谢。同时,辅酶Q10对改善脂质代谢更有效。然而,可能存在出版偏见,需要更多高质量的临床随机对照试验。
UNASSIGNED: To explore the comparative effectiveness of nutritional supplements in improving glycolipid metabolism and endocrine function in patients with polycystic ovary syndrome (PCOS).
UNASSIGNED: Randomized controlled clinical trials on the effects of nutritional supplements in PCOS patients were searched in PubMed, Embase, Cochrane Library, and Web of Science from their establishments to March 15, 2023. Then, literature screening, data extraction, and network meta-analysis were performed. This study was registered at PROSPERO (registration number CRD 42023441257).
UNASSIGNED: Forty-one articles involving 2,362 patients were included in this study. The network meta-analysis showed that carnitine, inositol, and probiotics reduced body weight and body mass index (BMI) compared to placebo, and carnitine outperformed the other supplements (SUCRAs: 96.04%, 97.73%, respectively). Omega-3 lowered fasting blood glucose (FBG) (SUCRAs: 93.53%), and chromium reduced fasting insulin (FINS) (SUCRAs: 72.90%); both were superior to placebo in improving insulin resistance index (HOMA-IR), and chromium was more effective than Omega-3 (SUCRAs: 79.99%). Selenium was potent in raising the quantitative insulin sensitivity index (QUICKI) (SUCRAs: 87.92%). Coenzyme Q10 was the most effective in reducing triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels (SUCRAs: 87.71%, 98.78%, and 98.70%, respectively). Chromium and probiotics decreased TG levels, while chromium and vitamin D decreased TC levels. No significant differences were observed in high-density lipoprotein cholesterol (HDL-C), total testosterone (TT), sex-hormone binding globulin (SHBG), and C-reactive protein (CRP) between nutritional supplements and placebo.
UNASSIGNED: Carnitine was relatively effective in reducing body mass, while chromium, Omega-3, and selenium were beneficial for improving glucose metabolism. Meanwhile, coenzyme Q10 was more efficacious for improving lipid metabolism. However, publication bias may exist, and more high-quality clinical randomized controlled trials are needed.