Impact of metformin on C-reactive protein levels in women with polycystic ovary syndrome: a meta-analysis
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Yong Chen1,*, Meng Li2,*, Hongli Deng3, Sheying Wang1, Lihua Chen1 , Ningsha Li1, Dan Xu1 and Qiguang Wang4
1 Department of Clinical Laboratory, The First Hospital of Changsha City, Hunan, People’s Republic of China
2 Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Guangxi, People’s Republic of China
3 Department of Clinical Laboratory, People’s Hospital of Liuyang City, Hunan, People’s Republic of China
4 Department of Clinical Laboratory, The First Affiliated Hospital of Hunan Normal University, People’s Hospital of Hunan, Hunan, People’s Republic of China
* Thesse authors have contributed equally to the article
Qiguang Wang, email:
Keywords: metformin, CRP, polycystic ovary syndrome, meta-analysis
Received: August 31, 2016 Accepted: January 27, 2017 Published: March 08, 2017
The impact of the recommended first-line treatment with metformin on C-reactive protein (CRP) levels in patients with polycystic ovary syndrome (PCOS) is still controversial. We conducted a meta-analysis of studies reporting the impact of metformin on serum CRP levels in women with PCOS. The weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs) were used to assesse the effects. GRADE approach was used to assesse the quality of the evidence. A total of 20 studies that included 433 women with PCOS were analyzed. CRP levels significantly decreased after metformin treatment (WMD = -1.23mg/L, 95%CI: -1.65 to -0.81, I2 = 93% and P < 0.001 for heterogeneity). The decreased levels of CRP were observed both in lean (BMI<25 kg/m2) and obese (BMI>25 kg/m2) patients. Interestingly, the degree of decreased CRP levels was not depended on metformin dosage, but more significantly in patients treated beyond 6 months (WMD≥6months = -1.47mg/L vs. WMD<6months = -0.94 mg/L). Decreased CRP levels are not associated with the status of IR and androgen in patients with PCOS. However, the quality of evidence was very low because of the limitations and inconsistency of the included studies. Therefore, metformin shows the potential effects on CRP levels in women with PCOS. However, considering the very low quality of evidence for the analysis, the effect of metformin on CRP levels are still very uncertain, and large-scale randomized-controlled study is needed to ascertain the long-term effects of metformin in PCOS.
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