Evidence map›Paper›PMID 36703143›Full record

SynthesisReproductive biology and endocrinology : RB&E2023

Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials.

Dorina Greff, Anna E Juhász, Szilárd Váncsa, Alex Váradi, Zoltán Sipos, Julia Szinte, Sunjune Park, Péter Hegyi, Péter Nyirády, Nándor Ács and 2 more

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Reproductive biology and endocrinology : RB&E, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06836128 (The Combined Effect of N-Acetyl Cysteine and Metformin in Polycystic Ovary Syndrome Patients), which is not on this map. Cited by 65 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 9 pooled it
32.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06836128 phase3recruitingnot on this mapstarted 2025, after this paper: background citation

The Combined Effect of N-Acetyl Cysteine and Metformin in Polycystic Ovary Syndrome Patients

TypeinterventionalSponsorCairo UniversityRan2025 to 2026Enrolled102ConditionsPolycystic Ovary SyndromeArmsN-acetyl cysteine, Metfomin
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 9 syntheses or guidelines pooled it, 119 citations in OpenAlex.

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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Dorina GreffCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Anna E JuhászCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Szilárd VáncsaCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Alex VáradiInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.
Zoltán SiposInstitute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.
Julia SzinteCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Sunjune ParkCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Péter HegyiCentre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Péter NyirádyDepartment of Urology, Semmelweis University, Budapest, Hungary.
Nándor ÁcsDepartment of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary.
Szabolcs VárbíróDepartment of Obstetrics and Gynecology, Semmelweis University, 1182, Budapest, Üllői Út 78/A, Hungary. varbiro.szabolcs@med.semmelweis-univ.hu.
Eszter M HorváthDepartment of Physiology, Semmelweis University, Budapest, Hungary.
Semmelweis University · HUUniversity of Pecs · HU

Funding

National Research, Development, and Innovation Office NKFIH-FK129206
6 · The paper itself

Abstract

backgroundMetformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects.

objectiveInositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS.

methodsThe present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs).

resultsTwenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85).

conclusionInositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin.

trial registrationPROSPERO registration number: CRD42021283275.

Indexed as

InsulinsMetforminPolycystic Ovary SyndromeFemaleHumansHypoglycemic AgentsInositolRandomized Controlled Trials as TopicTestosteroneHypoglycemic AgentsInositolInsulinsMetforminTestosteroneBMICycle lengthInositolInsulinMetabolic syndromeMetforminPCOSTestosterone

Identifiers

PMID36703143
PMCPMC9878965
OpenAlexW4318054803

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.