Therapeutic effect and safety of curcumin in women with PCOS: A systematic review and meta-analysis

Abstract

BackgroundPolycystic ovary syndrome (PCOS) is a multi-factorial heterogeneous syndrome that has both adverse reproductive and metabolic implications for affected women and its management is a challenging clinical problem. Curcumin, as a phenolic compound with potent anti-inflammatory and antioxidant properties exerting positive effects on the lipid profile and insulin resistance, appears to be a valuable treatment regimen for patients with PCOS.ObjectiveThis study aimed to evaluate the efficacy and safety of curcumin in the treatment of PCOS.MethodsChinese databases (Chinese National Knowledge Infrastructure, China Biology Medicine Databases, VIP database, Wanfang Database, and Chinese Clinical Trial Registry) and English databases (PubMed, Web of Science, Embase, Cochrane Library, Scopus and Clinical trials) were thoroughly investigated through screening randomized controlled trials on curcumin in PCOS published from the date of inception to May 2022. Standardized data search and abstraction were conducted following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Quantitative and qualitative analyses were performed. Heterogeneity was assessed using I2 statistics.ResultsA total of 447 patients from seven randomized controlled trials were included in the meta‐analysis. Results showed that the ingestion of curcumin decreased body mass index (WMD -0.267, 95% CI -0.450 to -0.084, P = 0.004, I2 = 0.0%), fasting plasma glucose (WMD -3.618, 95% CI -5.165 to -2.071, P < 0.001, I2 = 20.4%), insulin (WMD -1.834, 95% CI -2.701 to -0.968, P < 0.001, I2 = 8.4%), homeostatic model assessment for insulin resistance (WMD -0.565, 95% CI -0.779 to -0.351, P < 0.001, I2 = 0.0%), total cholesterol (WMD -15.591, 95% CI -27.908 to -3.273, P = 0.013, I2 = 68.9%), C-reactive protein (WMD -0.785, 95% CI -1.553 to -0.017, P = 0.045, I2 = 23.9%), and increased the quantitative insulin sensitivity check index (WMD 0.011, 95% CI 0.005 to 0.017, P = 0.001, I2 = 39.6%). As for safety, the treatment group did not cause significant adverse reactions than that in the control group.ConclusionIn light of presented findings, curcumin has beneficial effects on serum markers of inflammation, weight loss and glucose and lipid metabolism in patients with PCOS. The incidence of adverse reactions does not increase with the application of curcumin. However, a larger, more definitive study is needed to further investigate these results.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022332394.

Effects of antioxidant supplementation for polycystic ovary syndrome

“…A recent study has shown that the frequency of typical for PCOS menstrual abnormalities such as amenorrhea and oligomenorrhea was significantly reduced after the curcumin administration, compared to the control group [27] . Overall, curcumin was very well-tolerated and seems to be safe [25]. Moreover, the intervention reduced the hs-CRP and hirsutism score.…”

“…Furthermore, it is claimed to have antiinflammatory, anti-cancerous, antimutagenic, cardioprotective, and radioprotective features [20] [23] [24] . For this reason, curcumin was claimed to have therapeutic potential in PCOS treatment [25].…”

“…Equally major improvement was displayed in HOMA-IR, insulin level, and insulin sensitivity check index (QUICKI). Moreover, compared with the control group, patients after the curcumin intervention had a reduced body mass index (BMI), which is highly beneficial for PCOS patients [25] . In other study, it was additionaly proven that curcumin effectively reduced total cholesterol levels, LDL-cholesterol levels, and there was a considerable improvement in HDL-cholesterol levels in comparison with the placebo [26] .…”

Effect of Dietary Approaches to Stop Hypertension (DASH) and Curcumin on Glycemic parameters in Polycystic ovary syndrome: Randomized controlled Clinical Trial

“…In women with PCOS, the level of adiponectin is lower, while this change occurs regardless of adiposity [26]. Another possible mechanism is related to the low-grade in ammation caused by PCOS and antioxidant protective effects of curcumin [30,31]. Given that obesity and unbalanced dietary composition causes more disruption in insulin metabolism and in ammation [32,33], we therefore adjusted for BMI and energy difference and other relevant factors such as age [34] and physical activity [35].…”

Therapeutic Effects and Molecular Mechanism of Chlorogenic Acid on Polycystic Ovarian Syndrome: Role of HIF-1alpha

“…For patients who wish to have immediate fertility, oral ovulation agents should be considered [ 71 ]. PCOS treatment usually means lifelong follow-up and multiple treatments, including various treatment methods, depending on the patient’s performance, complications, wishes, and goals [ 15 , 16 , 17 , 26 , 72 , 73 ].…”