数据日期 2026-10-29 · 生成时间 2026-10-29 06:03
研究问题
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age, with a prevalence ranging from 6% to 20%, depending on the diagnostic criteria applied.
方法
The analysis included women who initiated one of the studied therapeutic regimens and completed an uninterrupted six-month course, with clinical and laboratory data available both at baseline and after six months.；The exclusion criteria were: (1) ongoing treatment with combined oral contraceptives, progestins, or other hormonal therapy that could influence metabolic or androgen parameters; (2) treatment with spironolactone; (3) concurrent fertility treatment; (4) discontinuation or change of the initially prescribed therapeutic regimen during the six-month follow-up; and (5) insufficient baseline or six-month clinical or laboratory data for the planned analyses.；These criteria were applied to minimize the potential influence of concomitant therapies on the metabolic and androgen parameters evaluated during follow-up.；The assignment of treatment was not randomized and was based on standard clinical judgment by the treating physician instead of a predetermined trial procedure.
核心结论
Significant differences between treatment groups were observed for BMI (p < 0.001), fasting plasma glucose (p < 0.001), IRI (p < 0.001), HOMA-IR (p < 0.001), total cholesterol (p = 0.04), HDL-C (p = 0.02), and triglycerides (p = 0.02).；In the metformin cohort, decreases in BMI, FPG, IRI, HOMA-IR, total cholesterol, LDL-C, triglycerides, testosterone, androstenedione, DHEAS, and 17-OH-progesterone, and an elevation in HDL-C, persisted statistically significant post-Holm adjustment (all adjusted p < 0.001).；In the myo-inositol cohort, statistically significant decreases were observed in IRI (adjusted p = 0.002), HOMA-IR (adjusted p = 0.009), total cholesterol (adjusted p = 0.042), LDL-C (adjusted p = 0.011), triglycerides (adjusted p = 0.042), androstenedione (adjusted p < 0.001), and DHEAS (adjusted p < 0.001). ‖ 结论：These findings should not be interpreted as evidence of comparative treatment efficacy or superiority because of the observational design, non-randomized treatment allocation, and potential residual confounding.
局限
Notable overall effects of the treatment groups were detected for DHEAS and 17-OH-progesterone; nevertheless, these general results do not pinpoint specific differences between treatment pairs and should be interpreted with caution due to the non-randomized treatment assignment and possible residual confounding.；Nevertheless, direct comparison of the magnitude of these changes with those observed in the other treatment groups is limited by the non-randomized treatment allocation and baseline differences between groups.；Therefore, the observed within-group changes with combination therapy should be considered hypothesis-generating and require confirmation in prospective controlled studies.
对本项目的价值
★★★☆☆ 代谢轴既干预敏感性最高，也是老药新用供给最充足的来源。最大样本量约 52；设计 回顾性、观察性。
全文来源
PMC JATS 全文（正文 46,648 字符，已过标题/DOI 逐字归属校验）
原文题录
- 英文标题：Comparative Effects of Myo-Inositol, Metformin, Berberine, and Combination Therapy on Metabolic, Anthropometric and Hormonal Parameters in Women with Polycystic Ovary Syndrome: A 6-Month Observational Cohort Study.
- 期刊与标识：J Clin Med · PMID 42941281 · DOI 10.3390/jcm15207765**
A 级证据分级：A 级（同行评议人体研究）
本文属人体研究证据，但需注意：观察性或小样本干预的结论不等于已证实临床获益；效应量与长期安全性仍需更大规模、更长随访的试验验证。
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