Effect of Metformin Monotherapy on Circulating Leptin Levels in Polycystic Ovary Syndrome: A Systematic Review and Bayesian Meta-analysis of Randomized Placebo Controlled Trials
Abstract
Abstract: Polycystic ovary syndrome (PCOS) is a common endocrine condition that presents with reproductive, metabolic, and cardiometabolic disturbances. Altered adipokine activity, including changes in circulating leptin, a macromolecule, may contribute to its clinical features. Metformin is widely used to improve insulin resistance and reproductive outcomes in this population, yet its effect on leptin has remained uncertain. This systematic review and meta-analysis evaluated randomized controlled trials comparing metformin with placebo for changes in circulating leptin levels in women with PCOS. Six trials with seven effect size estimates met the inclusion criteria. Classical random effects modeling showed that metformin produced a significant reduction in leptin compared with placebo, with a pooled standardized mean difference of - 1.60 and a confidence interval from - 2.49 to - 0.72. Baseline leptin levels were similar between the groups. Bayesian analysis supported these findings, yielding a posterior mean effect of - 1.38 with a credible interval from - 2.30 to - 0.25. Heterogeneity was substantial and metaregression identified baseline body mass index and fasting insulin as significant moderators. The direction of benefit remained stable in sensitivity analyses and no evidence of publication bias was detected. The certainty of evidence was rated as moderate, reflecting consistent findings across analytical approaches and acceptable methodological quality of the trials.…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Increased expression of circulating miRNA-93 in women with polycystic ovary syndrome may represent a novel, non-invasive biomarker for diagnosis
- Identification of key genes associated with polycystic ovary syndrome (PCOS) and ovarian cancer using an integrated bioinformatics analysis
- Identification of key pathways and genes in polycystic ovary syndrome via integrated bioinformatics analysis and prediction of small therapeutic molecules
- Regulation of Androgen Receptor Expression Alters AMPK Phosphorylation in the Endometrium: In Vivo and In Vitro Studies in Women with Polycystic Ovary Syndrome
- Effect of oral administration of low-dose follicle stimulating hormone on hyperandrogenized mice as a model of polycystic ovary syndrome
- Systems pharmacology to investigate the interaction of berberine and other drugs in treating polycystic ovary syndrome
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.