Comparison of nutritional supplements in improving glycolipid metabolism and endocrine function in polycystic ovary syndrome: a systematic review and network meta-analysis

Xinyin Hu; Wanyi Wang; Xuhan Su; Haoye Peng; Zuolin Tan; Yunqing Li; Yuhua Huang

doi:10.7717/peerj.16410

Comparison of nutritional supplements in improving glycolipid metabolism and endocrine function in polycystic ovary syndrome: a systematic review and network meta-analysis

PeerJ. 2023 Nov 13:11:e16410. doi: 10.7717/peerj.16410. eCollection 2023.

Authors

Xinyin Hu¹, Wanyi Wang¹, Xuhan Su¹, Haoye Peng¹, Zuolin Tan¹, Yunqing Li², Yuhua Huang³

Affiliations

¹ Beijing University of Chinese Medicine, Beijing, China.
² Capital Medical University, Beijing, China.
³ Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

Abstract

Objective: To explore the comparative effectiveness of nutritional supplements in improving glycolipid metabolism and endocrine function in patients with polycystic ovary syndrome (PCOS).

Method: 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).

Result: 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.

Conclusion: 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.

Keywords: Endocrine function; Glycolipid metabolism; Network meta-analysis; Nutritional supplements; Polycystic ovary syndrome.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Carnitine
Cholesterol, HDL
Chromium
Female
Glycolipids / therapeutic use
Humans
Lipid Metabolism
Network Meta-Analysis
Polycystic Ovary Syndrome* / drug therapy
Randomized Controlled Trials as Topic
Selenium* / therapeutic use

Substances

Selenium
Carnitine
Cholesterol, HDL
Chromium
Glycolipids

Grants and funding

This study was supported by the Beijing Traditional Chinese Medicine Science and Technology Development Fund project (JJ-2020-47). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.