Impact of metformin on C-reactive protein levels in women with polycystic ovary syndrome: a meta-analysis

Chen, Yong; Li, Meng; Deng, Hongli; Wang, Sheying; Chen, Lihua; Li, Ningsha; Xu, Dan; Wang, Qiguang

doi:10.18632/oncotarget.16019

Cited by 10 publications

(6 citation statements)

References 45 publications

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“…In the present study, subgroup analyses indicated that there was no significant effect of dose of metformin (<2000 and ≥2000 mg/d) on the levels of CRP, TNF-α, and IL-6 in patients with T2D. In contrast to our findings, the evidence from Chen et al 39 showed decreased CRP levels in the subgroup with a dose of <2000 mg/d compared with the ≥2000-mg/d subgroup. Lin et al 40 demonstrated that addition of 1500 mg metformin daily for 3 months lowered the levels of IL-6 in women with polycystic ovary syndrome (PCOS).…”

Section: Discussioncontrasting

confidence: 99%

Effect of Metformin on Circulating Levels of Inflammatory Markers in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2021

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Background: Emerging evidence indicates that metformin has anti-inflammatory effect; however, the results differ concerning randomized controlled trails of the effect of metformin on inflammatory markers in type 2 diabetes (T2D) patients. Objective: This study reassessed the data on the effect of metformin treatment on inflammatory markers in T2D patients through a systematic review and meta-analysis. Methods: A systematic search was performed in the PubMed, ISI Web of Science, EMBASE, Cochrane Library and Scopus databases to collect relevant published data up to September 2020. Data of each study was combined using random-effects model. Subgroup analysis was performed based on subgroups of the treatment duration, dose and target population. Results: Thirteen RCTs including 1776 participants with T2D were analyzed. Although CRP levels significantly decreased [SMD: –0.76 mg/L; 95% CI (–1.48, –0.049); P = 0.036] in patients with T2D following metformin treatment, circulating levels of TNF-α [SMD: –0.17 pg/mL; 95% CI (–0.55, 0.20); P = 0.37] and IL-6 [SMD: –0.06 pg/mL; 95% CI (–0.38, 0.25); P = 0.69] were insignificant after metformin treatment. Compared to treatment duration of less than 24 weeks, longer treatment duration (more than 24 weeks) was associated with reduced level of CRP. Relevance to Patient Care and Clinical Practice: Based on available evidence from RCTs in this meta-analysis, metformin decreased CRP level. However, strategies for the treatment of inflammation should focus on metformin in patients with T2D. Conclusion: The present study evidences that therapy with metformin can reduces CRP level significantly in T2D patients compared to other inflammatory markers.

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Section: Discussioncontrasting

confidence: 99%

Effect of Metformin on Circulating Levels of Inflammatory Markers in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials

et al. 2021

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“…In consistent with a study, it proved that higher dose metformin may be more efficient for BMI reduction in women with PCOS. [ 45 ] However, Chen et al [ 46 ] observed that CRP levels decreased more in the subgroup with a dose of <2000 mg/day than that of ≥2000 mg/day. The explanation could be that BMI, age, and clinical phenotypes influence the effect of metformin in PCOS.…”

Section: Discussionmentioning

confidence: 99%

Effects of metformin treatment on serum levels of C-reactive protein and interleukin-6 in women with polycystic ovary syndrome

Wang

Zhu

et al. 2017

Medicine

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Background:Metformin is effective for the treatment of polycystic ovary syndrome (PCOS), but conflicting results regarding its impact on serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in women with PCOS have been reported. To provide high-quality evidence about the effect of treatment with metformin on CRP and IL-6 in PCOS, relevant studies that assessed the serum levels of CRP and IL-6 in women with PCOS receiving metformin treatment were reviewed and analyzed.Methods:A literature search was conducted in the Science Citation Index, PubMed, Embase, and Cochrane Library databases, and personal contact was made with the authors. Random-effects model was used to estimate the standardized mean differences (SMDs) with 95% confidence intervals (95% CIs). To ensure synthesis of the best available evidence, subgroup analysis, sensitivity analysis, meta-regression analysis, and publication bias were performed.Results:Of 216 studies identified, 20 were included in the meta-analysis (7 prospective, nonrandomized studies, and 13 randomized control trials). Data suggest that serum levels of CRP were decreased after metformin treatment in PCOS patients with an SMD (95% CI) of −0.86 [−1.24 to −0.48] and P = .000 (random-effects). However, significant heterogeneity was detected across studies (I2 = 84.6% and P = .000). Unfortunately, the sources of heterogeneity were not found by subgroup analysis and meta-regression analysis. Serum IL-6 concentrations were not significantly changed after metformin treatment in PCOS with an SMD (95% CI) of −0.48 [−1.26 to 0.31] and P > .05 (random-effects). Significant heterogeneity was also detected across studies (I2 = 90.9% and P = .000). The subgroup analysis suggested that treatment-related reductions in serum IL-6 levels were significantly correlated with BMI, whereas the sources of heterogeneity were not found. In addition, we noticed that metformin treatment could decrease BMI in the CRP and IL-6 related studies (SMD = −0.45, 95% CI: −0.68 to −0.23; SMD = −0.44, 95% CI: −0.73 to −0.16).Conclusion:This meta-analysis showed a significant decrease of serum CRP levels, especially in obese women, but no significant changes in IL-6 levels after metformin treatment in women with PCOS. In general, the data support that early metformin therapy may ameliorate the state of chronic inflammation in women with PCOS. Considering the obvious heterogeneity reported in the literature, further well-designed investigations with larger samples are needed to ascertain the long-term effects of metformin on chronic inflammation in PCOS.

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“…In a study conducted with large sample size, metformin reduced CRP level after 24 weeks, but the mechanism of its action was not accurately determined (4,27). In a meta-analysis carried out on 20 studies involving 433 women with polycystic ovary syndrome, the decreasing effect of metformin on CRP plasma levels, especially in obese women, was confirmed (28). In another meta-analysis conducted on 216 studies, it was found that metformin significantly reduced CRP in women with polycystic ovary syndrome, but it did not significantly affect the IL-6 (29).…”

Section: Metformin and Inflammatory Markersmentioning

confidence: 97%

Metformin and its anti-inflammatory and anti-oxidative effects; new concepts

et al. 2018

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Metformin is one of the oldest and commonly used blood sugar lowering drugs, having limited side effects and used as the first line treatment in patients suffering from diabetes mellitus. Moreover, various studies have emphasized on the anti-inflammatory and antioxidant role of metformin, with multiple mechanisms, which activation of AMPK by metformin has had a key role in many of them. During the searches on the internet websites of PubMed, Elsevier, Google Scholar, and Science Direct, 76 papers related to the anti-inflammatory and antioxidant role of metformin were selected and reviewed since 2003 to 2017. At the cellular level, metformin suppresses the inflammation in many cases and reduces or eliminates inflammatory factors mainly through dependent mechanisms and sometimes independent of AMPK at the cellular level and through other ways at the systematic levels. It is also effective in reducing the level of oxidative stress factors by regulating the antioxidant system of the cell. All evidence suggests the antioxidant and anti-inflammatory role of metformin in various conditions. Metformin can be an appropriate treatment option for many diseases, which inflammatory processes and oxidative stress play a role in their pathogenesis.

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Impact of metformin on C-reactive protein levels in women with polycystic ovary syndrome: a meta-analysis

Cited by 10 publications

References 45 publications

Effect of Metformin on Circulating Levels of Inflammatory Markers in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Effect of Metformin on Circulating Levels of Inflammatory Markers in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Effects of metformin treatment on serum levels of C-reactive protein and interleukin-6 in women with polycystic ovary syndrome

Metformin and its anti-inflammatory and anti-oxidative effects; new concepts

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