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dc.contributor.authorMelin, Johannapt_BR
dc.contributor.authorForslund, Mariapt_BR
dc.contributor.authorAlesi, Simonpt_BR
dc.contributor.authorPiltonen, Terhi T.pt_BR
dc.contributor.authorRomualdi, Danielapt_BR
dc.contributor.authorSpritzer, Poli Marapt_BR
dc.contributor.authorTay, Chau Thienpt_BR
dc.contributor.authorPeña, Alexia Sophiept_BR
dc.contributor.authorWitchel, Selma Feldmanpt_BR
dc.contributor.authorMousa, Ayapt_BR
dc.contributor.authorTeede, Helena J.pt_BR
dc.date.accessioned2023-11-17T03:23:54Zpt_BR
dc.date.issued2023pt_BR
dc.identifier.issn0804-4643pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/267170pt_BR
dc.description.abstractObjective: Available evidence has shown that metformin improves insulin sensitivity and weight management in polycystic ovary syndrome (PCOS). Nevertheless, key knowledge gaps remain regarding its efficacy and the specific outcomes in this population. This review evaluates the effectiveness of metformin and lifestyle modification compared with placebo in the management of PCOS and will inform the forthcoming, 2023 evidence-based PCOS guidelines. Design: Systematic review and meta-analysis of the literature. Methods: A search was performed in MEDLINE, EMBASE, PsycINFO, All EBM, and CINAHL. The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and included randomized controlled trials published in English through July 2022. Results: Moderate certainty of evidence showed a larger reduction of body mass index (BMI) (mean difference [MD] −0.53, 95% confidence interval [CI] −0.95 to −0.12 kg/m2 ), homeostatic model assessment for insulin resistance (MD −0.50, 95% CI −0.91 to −0.09) (critical outcomes), and fasting glucose (MD −0.13, 95% CI −0.19 to −0.07 mmol/L) with metformin compared to placebo with increased mild gastrointestinal adverse effects (odds ratio [OR] 7.67, 95% CI 2.74–21.46). Low certainty of evidence showed a larger reduction of waist–hip ratio (MD −0.02, 95% CI −0.03 to −0.00), total cholesterol (MD −0.24, 95% CI −0.43 to −0.05 mmol/L), low density lipoprotein (MD −0.16, 95% CI −0.30 to −0.01 mmol/L), and triglycerides (MD −0.11, 95% CI −0.20 to −0.02 mmol/L) with metformin than placebo. Conclusions: Metformin should be considered an efficacious adjunct to lifestyle interventions in adults with PCOS, especially for those with a higher BMI, to improve weight loss, insulin resistance, and lipids.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofEuropean journal of endocrinology. Oslo. Vol. 189, no. 2 (Aug. 2023), p. S37-S63pt_BR
dc.rightsOpen Accessen
dc.subjectSíndrome do ovário policísticopt_BR
dc.subjectPolycystic ovary syndromeen
dc.subjectEstilo de vidapt_BR
dc.subjectMetforminen
dc.subjectLifestyleen
dc.subjectInfertilidadept_BR
dc.subjectMeta-analysisen
dc.subjectMetforminapt_BR
dc.subjectSystematic reviewen
dc.subjectRevisão sistemáticapt_BR
dc.subjectMetanálisept_BR
dc.subjectManagementen
dc.titleThe impact of metformin with or without lifestyle modification versus placebo on polycystic ovary syndrome : a systematic review and meta-analysis of randomized controlled trialspt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001186156pt_BR
dc.type.originEstrangeiropt_BR


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