TY - JOUR
T1 - Inositol for Polycystic Ovary Syndrome
T2 - A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines
AU - Fitz, Victoria
AU - Graca, Sandro
AU - Mahalingaiah, Shruthi
AU - Liu, Jing
AU - Lai, Lily
AU - Butt, Ali
AU - Armour, Mike
AU - Rao, Vibhuti
AU - Naidoo, Dhevaksha
AU - Maunder, Alison
AU - Yang, Guoyan
AU - Vaddiparthi, Vaishnavi
AU - Witchel, Selma F
AU - Pena, Alexia
AU - Spritzer, Poli Mara
AU - Li, Rong
AU - Tay, Chau
AU - Mousa, Aya
AU - Teede, Helena
AU - Ee, Carolyn
PY - 2024/6
Y1 - 2024/6
N2 - Context: Insulin resistance is common in women with polycystic ovary syndrome (PCOS). Inositol may have insulin sensitizing effects; however, its efficacy in the management of PCOS remains indeterminate. Objective: To inform the 2023 international evidence-based guidelines in PCOS, this systematic review and meta-analysis evaluated the efficacy of inositol, alone or in combination with other therapies, in the management of PCOS. Data Sources: Medline, PsycInfo, EMBASE, All EBM, and CINAHL from inception until August 2022. Study Selection: Thirty trials (n = 2230; 1093 intervention, 1137 control), with 19 pooled in meta-analyses were included. Data Extraction: Data were extracted for hormonal, metabolic, lipids, psychological, anthropometric, reproductive outcomes, and adverse effects by 1 reviewer, independently verified by a second. Data Synthesis: Thirteen comparisons were assessed, with 3 in meta-analyses. Evidence suggests benefits for myo-inositol or D-chiro-inositol (DCI) for some metabolic measures and potential benefits from DCI for ovulation, but inositol may have no effect on other outcomes. Metformin may improve waist-hip ratio and hirsutism compared to inositol, but there is likely no difference for reproductive outcomes, and the evidence is very uncertain for body mass indexI. Myo-inositol likely causes fewer gastrointestinal adverse events compared with metformin; however, these are typically mild and self-limited. Conclusion: The evidence supporting the use of inositol in the management of PCOS is limited and inconclusive. Clinicians and their patients should consider the uncertainty of the evidence together with individual values and preferences when engaging in shared decision-making regarding the use of inositol for PCOS.
AB - Context: Insulin resistance is common in women with polycystic ovary syndrome (PCOS). Inositol may have insulin sensitizing effects; however, its efficacy in the management of PCOS remains indeterminate. Objective: To inform the 2023 international evidence-based guidelines in PCOS, this systematic review and meta-analysis evaluated the efficacy of inositol, alone or in combination with other therapies, in the management of PCOS. Data Sources: Medline, PsycInfo, EMBASE, All EBM, and CINAHL from inception until August 2022. Study Selection: Thirty trials (n = 2230; 1093 intervention, 1137 control), with 19 pooled in meta-analyses were included. Data Extraction: Data were extracted for hormonal, metabolic, lipids, psychological, anthropometric, reproductive outcomes, and adverse effects by 1 reviewer, independently verified by a second. Data Synthesis: Thirteen comparisons were assessed, with 3 in meta-analyses. Evidence suggests benefits for myo-inositol or D-chiro-inositol (DCI) for some metabolic measures and potential benefits from DCI for ovulation, but inositol may have no effect on other outcomes. Metformin may improve waist-hip ratio and hirsutism compared to inositol, but there is likely no difference for reproductive outcomes, and the evidence is very uncertain for body mass indexI. Myo-inositol likely causes fewer gastrointestinal adverse events compared with metformin; however, these are typically mild and self-limited. Conclusion: The evidence supporting the use of inositol in the management of PCOS is limited and inconclusive. Clinicians and their patients should consider the uncertainty of the evidence together with individual values and preferences when engaging in shared decision-making regarding the use of inositol for PCOS.
KW - inositol
KW - nutrients
KW - polycystic ovary syndrome
UR - http://www.scopus.com/inward/record.url?scp=85186724355&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1171592
U2 - 10.1210/clinem/dgad762
DO - 10.1210/clinem/dgad762
M3 - Review article
C2 - 38163998
AN - SCOPUS:85186724355
SN - 0021-972X
VL - 109
SP - 1630
EP - 1655
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -
