| Objectives: To evaluate the effects of probiotics or synbiotics on clinical parameters,glucose and lipid metabolism,sex hormone and inflammation in the treatment of patients with polycystic ovarian syndrome(PCOS).Methods: By searching Pub Med,Medline,Cochrane Library,Web of science,Springer,Embase,Elsevier,CBM,CNKI,Wan Fang,VIP database,or manual searching magazines of related fields,and finding relevant documents with Google,Baidu academic on the Internet,the relevant research might be found.The timeframe was the establishment date to March 2021.The search terms included: Polycystic ovarian syndrome,Polycystic ovary syndrome,PCOS,Probiotics,and Synbiotics in English and Chinese.First of all,according to the inclusion criteria and exclusion criteria,the literatures were screened,the quality of the included literatures subsequently were assessed,then the relevant data was extracted,and finally Rev Man 5.3 software was used to meta-analysis.Results: A total of twelve articles,including ten randomized controlled trials investigated the effects of probiotics or synbiotics versus placebo on anthropometric parameters,glucose metabolism,lipid metabolism,sex hormone or inflammation levels in the treatment of polycystic ovary syndrome were included,involving 599 patients.The meta-analysis demonstrated that: compared with placebo,probiotics or synbiotics significantly improved fasting plasma glucose(FPG)[MD =-2.64,95%CI(-4.92,-0.36),P = 0.02],fasting serum insulin(FBI)[MD =-2.47,95%CI(-3.85,-1.09),P = 0.0004],homeostatic model assessment of insulin resistance(HOMA-IR)[MD =-0.6,95%CI(-0.99,-0.21),P = 0.003],quantitative insulin-sensitivity check index(QUICKI)[MD = 0.01,95%CI(0.00,0.02),P = 0.03],triglycerides(TG)[MD =-16.54,95%CI(-23.96,-9.13),P < 0.0001],high density lipoprotein cholesterol(HDL-C)[MD = 1.52,95%CI(0.32,2.72),P = 0.01],very low density lipoprotein cholesterol(VLDL-C)[MD =-3.8,95%CI(-5.45,-2.16),P < 0.00001],total testosterone serum(TT)[MD =-0.23,95%CI(-0.36,-0.11),P = 0.0002],sex hormone binding globulin(SHBG)[MD = 23.18,95%CI(12.89,33.46),P <0.0001],hirsutism(modified Ferriman-Gallway score,m F-G scores)[MD =-1.00,95%CI(-1.75,-0.26),P = 0.008],high-sensitive C-reactive protein(hs-CRP)[MD =-0.95,95%CI(-1.55,-0.35),P = 0.002],glutathione(GSH)[MD = 23.19,95%CI(21.32,25.06),P < 0.00001],nitric oxide(NO)[MD = 2.73,95%CI(0.59,4.87),P = 0.01],malondialdehyde(MDA)[MD =-0.90,95%CI(-1.25,-0.54),P <0.00001],and total antioxidant capacity(TAC)[MD = 79.58,95%CI(74.16,85.01),P < 0.00001],but had no obvious advantage on weight [MD =-0.56,95%CI(-1.33,0.2),P = 0.15],body mass index(BMI)[MD =-0.2,95%CI(-0.45,0.04),P = 0.11],total cholesterol(TC)[MD =-3.76,95%CI(-13.25,5.74),P = 0.44],low density lipoprotein cholesterol(LDL-C)[MD =-4.31,95%CI(-12.52,3.9),P = 0.3],dehydroepiandrosterone sulfate(DHEA-S)[MD =-0.03,95%CI(-0.48,0.43),P =0.91],and free androgen index(FAI)[MD =-0.05,95%CI(-0.13,0.03),P = 0.19].Conclusion: Probiotics or synbiotics supplements,ameliorated these disorders of the gut microbiota in patients with polycystic ovarian syndrome,could significantly improve glucose metabolism,hirsutism,and inflammation,meanwhile,partially improved lipid metabolism and sex hormones level,but had no significant effects on anthropometric parameters. |
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