Effects of inositol in women with polycystic ovary syndrome: an umbrella review of meta-analyses from randomized controlled trials
Abstract
OBJECTIVES: This umbrella review aimed to synthesize and appraise the evidence regarding the efficacy of inositol for Polycystic Ovary Syndrome (PCOS) by integrating meta-analyses of randomized controlled trials(RCTs), thereby assessing the robustness of the existing body of evidence.
METHODS: We searched four databases from inception to August 2025 for relevant RCT meta-analyses. Primary outcomes included hormonal profiles, glycolipid metabolism, anthropometrics, and reproductive outcomes. Quality was assessed using AMSTAR-2 and GRADE.
RESULTS: Thirteen meta-analyses were included. AMSTAR-2 ratings were 23.1% high, 53.8% low, and 23.1% very low quality. GRADE assessment of 85 evidence items revealed no high-quality evidence; 18.9% were moderate, 40% low, and 41.1% very low quality. Pooled analyses demonstrated that inositol significantly improved multiple outcomes compared to placebo/FA: it reduced serum luteinizing hormone (LH: MD -3.43 IU/L, 95% CI [-4.29, -2.56], P < 0.00001), total testosterone (TT), free testosterone (FT: MD -0.02 nmol/L, 95% CI [-0.02, -0.01], P < 0.00001), improved sex hormone-binding globulin (SHBG: MD 36.72 nmol/L, 95% CI [28.52, 44.91], P < 0.00001), and androstenedione. Benefits were also observed for homeostatic model assessment of insulin resistance (HOMA-IR: MD -1.14, 95% CI [-1.35, -0.94], P < 0.00001), fasting insulin (FI: MD -23.40 pmol/L, 95% CI [-32.80, -14.01], P < 0.00001), triglycerides, and reproductive outcomes (live births: Risk…
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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.
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