Insulin-like growth factor binding protein-1 and insulin in polycystic ovary syndrome: a systematic review and meta-analysis

Front Endocrinol (Lausanne). 2023 Dec 15:14:1279717. doi: 10.3389/fendo.2023.1279717. eCollection 2023.


Background: Insulin-like growth factor binding protein-1 (IGFBP-1) is considered a decline in polycystic ovary syndrome (PCOS), but it remains controversial that whether such reduction is attributed to obesity.

Aims: This systematic review aims to explore whether IGFBP-1 is reduced in PCOS, and whether such reduction is associated with obesity.

Results: Our pooled study included 12 studies with a total of 450 participants. IGFBP-1 levels in PCOS were significantly lower than that in non-PCOS (SMD (95%CI)=-0.49(-0.89, -0.09), P=0.02). No significant difference in IGFBP-1 levels between patients with or without PCOS classified by BMI. Whilst, stratification by PCOS status revealed a significant decrease in IGFBP-1 in overweight (SMD (95%CI)=-0.92(-1.46, -0.37), P=0.001). When comparing fasting insulin in the same way, PCOS patients had significantly elevated fasting insulin level but not statistically declined IGFBP-1 after classified by BMI.

Conclusion: This meta-analysis provides evidence that the decrease of IGFBP-1 in PCOS was more strongly influenced by comorbid obesity than by PCOS itself. Additionally, contrast to previous findings that insulin significantly suppresses IGFBP-1, our results suggested that the suppression of PCOS-related hyperinsulinemia on IGFBP-1 seemed diminished. Overall, our work may provide a novel perspective on the mechanism between insulin and IGFBP-1 underlying PCOS development.

Keywords: hyperandrogenism; hyperinsulinemia; insulin resistance (IR); insulin-like growth factor binding protein-1 (IGFBP-1); insulin-like growth factor-1 (IGF-1); polycystic ovary syndrom (PCOS).

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Insulin*
  • Insulin-Like Growth Factor Binding Protein 1
  • Insulin-Like Peptides
  • Obesity / complications
  • Polycystic Ovary Syndrome* / complications
  • Polycystic Ovary Syndrome* / drug therapy


  • Insulin
  • Insulin-Like Growth Factor Binding Protein 1
  • Insulin-Like Peptides
  • IGFBP1 protein, human

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of Shaanxi Province, China (Grant No. 2022JM-438; Grant No.2023-JC-YB-742), and the Innovation and Development Project of Tangdu Hospital, China (Grant No. 2021SHRC046; Grant No. 2021SHRC061; Grant No. 2021SHRC007).