Insulin sensitizing drugs for weight loss in women of reproductive age who are overweight or obese: systematic review and meta-analysis
Abstract
BACKGROUND: Women of reproductive age, who are overweight or obese, are prone to infertility. Weight loss in these women leads to increased fecundity, higher chances of conception after infertility treatment and improved pregnancy outcome. In spite of the advantages, most patients have difficulty in losing weight and often regain lost weight over time. This review assesses whether treatment with insulin sensitizing drugs contributes to weight loss, compared with diet or a lifestyle modification programme. METHODS: After a systematic search of the literature, only randomized controlled trials (RCTs), investigating the effect of insulin sensitizing drugs on weight loss compared with placebo and diet and/or a lifestyle modification programme, were included. Subjects were restricted to women of reproductive age. The main outcome measure was change in body mass index (BMI). RESULTS: Only 14 trials, unintentionally all but two on women with polycystic ovary syndrome (PCOS) only, were included in the analysis. Treatment with metformin showed a statistically significant decrease in BMI compared with placebo (weighted mean difference, -0.68; 95% CI -1.13 to -0.24). There was some indication of greater effect with high-dose metformin (>1500 mg/day) and longer duration of therapy (>8 weeks). Limitations were power, low use of intention-to-treat analysis and heterogeneity of the studies. CONCLUSION: A structured lifestyle modification programme to achieve weight loss should still be the first line treatment in obese women with or without PCOS. Adequately powered RCTs are required to confirm the findings of this review and to assess whether the addition of high-dose metformin therapy to a structured lifestyle modification programme might contribute to more weight loss.
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Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011 · see citing works
Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy
Kahn, S. E., Haffner, S. M., Heise, M. A., Herman, W. H., Holman, R. R., Jones, N. P., Kravitz, B. G., Lachin, J. M., O'Neill, M. C., Zinman, B., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa066224 · Cited by 2,962 · see citing works
Clark, A. M., Ledger, W., Galletly, C., Tomlinson, L., Blaney, F., Wang, X., & Norman, R. J. (1995) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a135772 · Cited by 642 · see citing works
Self-citationPasquali, R., Gambineri, A., Biscotti, D., Vicennati, V., Gagliardi, L., Colitta, D., Fiorini, S., Cognigni, G. E., Filicori, M., & Morselli-Labate, A. M. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.8.6738 · Cited by 635 · see citing works
Ovulatory and Metabolic Effects of d-<i>Chiro</i>-Inositol in the Polycystic Ovary Syndrome
Nestler, J. E., Jakubowicz, D. J., Reamer, P., Gunn, R. D., & Allan, G. (1999) · New England Journal of Medicine · doi:10.1056/nejm199904293401703 · Cited by 518 · see citing works
Pregnancy outcome after first-trimester exposure to metformin: a meta-analysis
Gilbert, C., Valois, M., & Koren, G. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.02.098 · Cited by 274 · see citing works
Huber-Buchholz, M.-M. (1999) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.84.4.1470 · Cited by 269 · see citing works
Endocrine consequences of weight loss in obese, hyperandrogenic, anovulatory women
Guzick, D. S., Wing, R., Smith, D., Berga, S. L., & Winters, S. J. (1994) · Fertility and Sterility · doi:10.1016/s0015-0282(16)56632-1 · Cited by 246 · see citing works
Gambineri, A., Pelusi, C., Genghini, S., Morselli‐Labate, A. M., Cacciari, M., Pagotto, U., & Pasquali, R. (2004) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2004.01973.x · Cited by 216 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2350 · Cited by 1,919 · see citing works
“A systematic review and meta-analysis demonstrated that there was significant weight loss in trials using metformin compared with placebo in women with PCOS (255).”
BackgroundWild, R. A., Carmina, E., Diamanti-Kandarakis, E., Dokras, A., Escobar-Morreale, H. F., Futterweit, W., Lobo, R., Norman, R. J., Talbott, E., & Dumesic, D. A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2724 · Cited by 1,010 · see citing works
“A 2-h post 75-g oral glucose challenge be performed in PCOS women with a BMI greater than 30 kg/m2, or alternatively in lean PCOS women with advanced age ( 40 yr), personal history of gestational diabetes, or family history of T2DM (44, 93).”
BackgroundInfluentialSelf-citationCharacteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics
Glueck, C. J., & Goldenberg, N. (2019) · Metabolism · doi:10.1016/j.metabol.2018.11.002 · Cited by 442 · see citing works
Naderpoor, N., Shorakae, S., de Courten, B., Misso, M. L., Moran, L. J., & Teede, H. J. (2015) · Human Reproduction Update · doi:10.1093/humupd/dmv025 · Cited by 334 · see citing works
Spritzer, P. M., Lecke, S. B., Satler, F., & Morsch, D. M. (2015) · Reproduction · doi:10.1530/rep-14-0435 · Cited by 330 · see citing works
“These effects of metformin are more potent when it is combined with lifestyle interventions (Nieuwenhuis-Ruifrok et al. 2009).”
BackgroundComplications and challenges associated with polycystic ovary syndrome: current perspectives
Palomba, S., Santagni, S., Falbo, A., & La Sala, G. B. (2015) · International Journal of Women's Health · doi:10.2147/ijwh.s70314 · Cited by 287 · see citing works
Salamun, V., Jensterle, M., Janez, A., & Vrtacnik Bokal, E. (2018) · European Journal of Endocrinology · doi:10.1530/eje-18-0175 · Cited by 204 · see citing works
Agarwal, N., Rice, S. P. L., Bolusani, H., Luzio, S., Dunseath, G., Ludgate, M., & Rees, D. (2009) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jc.2009-1985 · Cited by 170 · see citing works
“68 in BMI was found compared with placebo (51).”
BackgroundFacchinetti, F., Bizzarri, M., Benvenga, S., D’Anna, R., Lanzone, A., Soulage, C. O., Renzo, G. C. D., Hod, M., Cavalli, P., Chiu, T. T. Y., et al. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.09.024 · Cited by 144 · see citing works
“the metabolic syndrome [5].”
BackgroundMyo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials
Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. E. (2017) · Endocrine Connections · doi:10.1530/ec-17-0243 · Cited by 190 · see citing works
“Nonetheless, these drugs have been reported to be associated with adverse effects (81).”
Review: Role of metformin in the management of polycystic ovary syndrome
Lashen, H. (2010) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018810380215 · Cited by 176 · see citing works
“They also reported an effect related to both the dose and duration of treatment [Nieuwenhuis-Ruifrok et al. 2009].”
BackgroundJensterle, M., Kravos, N. A., Pfeifer, M., Kocjan, T., & Janez, A. (2015) · Hormones · doi:10.1007/bf03401383 · Cited by 117 · see citing works
Obesity and Polycystic Ovary Syndrome
Vrbíková, J., & Hainer, V. (2009) · Obesity Facts · doi:10.1159/000194971 · Cited by 237 · see citing works
Jensterle, M., Salamun, V., Kocjan, T., Vrtacnik Bokal, E., & Janez, A. (2015) · Journal of Ovarian Research · doi:10.1186/s13048-015-0161-3 · Cited by 103 · see citing works
“In accordance with our study, most studies and meta-analysis concluded that as a mono-therapy, metformin does not significantly reduce body weight, although some studies have reported some marginal benefit in longer observation period [14, 15].”
ResultPolycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances
Spritzer, P. M. (2014) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/0004-2730000003051 · Cited by 118 · see citing works
“These effects of metformin are more potent when it is combined with lifestyle intervention (41).”
Panidis, D., Tziomalos, K., Papadakis, E., Vosnakis, C., Chatzis, P., & Katsikis, I. (2013) · Endocrine · doi:10.1007/s12020-013-9971-5 · Cited by 93 · see citing works
Metformin in obesity, cancer and aging: addressing controversies
Berstein, L. M. (2012) · Aging · doi:10.18632/aging.100455 · Cited by 85 · see citing works
“It is not clear whether this can be explained by metformin underdosage [22], although a recent meta-analysis indicates that both drug dose and duration of treatment are highly relevant [23].”
BackgroundNaderpoor, N., Shorakae, S., de Courten, B. V., Misso, M. L., Moran, L., & Teede, H. J. (2016) · Human Reproduction Update · doi:10.1093/humupd/dmv063 · Cited by 256 · see citing works
“One review reported a trend for improved weight loss with lifestyle + metformin compared with metformin alone (Nieuwenhuis-Ruifrok et al., 2009), although not all studies were in PCOS or included lifestyle modification.”
BackgroundPolycystic ovaries and obesity
Messinis, I. E., Messini, C. I., Anifandis, G., & Dafopoulos, K. C. (2014) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2014.11.001 · Cited by 93 · see citing works
Fiedorowicz, J. G., Miller, D. D., Bishop, J. R., Calarge, C. A., Ellingrod, V. L., & Haynes, W. G. (2012) · Current Psychiatry Reviews · doi:10.2174/157340012798994867 · Cited by 79 · see citing works
Tian, F., Zheng, Z., Zhang, D., He, S., & Shen, J. (2018) · Bioscience Reports · doi:10.1042/bsr20181304 · Cited by 80 · see citing works
Ganie, M., Marwaha, R., Aggarwal, R., & Singh, S. (2010) · European Journal of Endocrinology · doi:10.1530/eje-09-1012 · Cited by 78 · see citing works
Ganie, M., Laway, B., Wani, T. A., Zargar, M. A., Nisar, S., Ahamed, F., Khurana, M. L., & Ahmed, S. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.01.149 · Cited by 75 · see citing works
The Saudi clinical practice guideline for the management of overweight and obesity in adults
Alfadda, A. A., Aldhwayan, M., Alharbi, A. A., Alkhudhair, B. K., Nozha, O. M. A., Al-Qahtani, N. M., ALZAHRANI, S. H., Bardisi, W. M., Sallam, R. M., Riva, J. J., et al. (2016) · Saudi Medical Journal · doi:10.15537/smj.2016.10.14353 · Cited by 64 · see citing works
Impact of Obesity on Gynecology
Pandey, S., & Bhattacharya, S. (2010) · Women s Health · doi:10.2217/whe.09.77 · Cited by 69 · see citing works
“The magnitude of the effect was greater with highdose metformin (>1500 mg/day) and longer duration of therapy (>8 weeks) [111].”
BackgroundGLP-1 receptor agonists in the treatment of polycystic ovary syndrome
Lamos, E. M., Malek, R., & Davis, S. N. (2017) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2017.1292125 · Cited by 71 · see citing works
“Women with PCOS in general describe difficulty losing weight [55], and this class of medications can provide meaningful weight loss that when combined with metformin appears superior to metformin or orlistat alone [47,48].”
BackgroundResultÇınar, N., Harmanci, A., Demir, B., & Yıldız, B. O. (2012) · Human Reproduction · doi:10.1093/humrep/des113 · Cited by 79 · see citing works
“Also, metformin does not seem to result in weight loss in all patients with PCOS (Nieuwenhuis-Ruifrok et al., 2009).”
BackgroundLadson, G., Dodson, W. C., Sweet, S. D., Archibong, A. E., Kunselman, A. R., Demers, L. M., Lee, P. A., Williams, N. I., Coney, P., & Legro, R. S. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.05.048 · Cited by 56 · see citing works
“In addition, the addition of metformin has been associated with increased weight loss when combined with lifestyle interventions (6).”
BackgroundJENSTERLE, M., GORICAR, K., & JANEZ, A. (2016) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2016.3081 · Cited by 56 · see citing works
Use of metformin in the treatment of polycystic ovary syndrome
Genazzani, A. D., Ricchieri, F., & Lanzoni, C. (2010) · Women's Health · doi:10.2217/whe.10.43 · Cited by 51 · see citing works
Shorakae, S., Boyle, J. A., & Teede, H. J. (2014) · Internal Medicine Journal · doi:10.1111/imj.12495 · Cited by 48 · see citing works
Patel, R., & Shah, G. (2017) · Current Medical Research and Opinion · doi:10.1080/03007995.2017.1279597 · Cited by 47 · see citing works
Tabrizi, R., Ostadmohammadi, V., Lankarani, K. B., Peymani, P., Akbari, M., Kolahdooz, F., & Asemi, Z. (2018) · Lipids in Health and Disease · doi:10.1186/s12944-018-0779-4 · Cited by 51 · see citing works
“There are numerous primary and secondary causes of hypertriglyceridemia and hypercholesterolemia, such as genetics, lifestyle and diet, especially obesity and physical inactivity, diseases, including metabolic syndrome (MetS), hyperinsuliemia, diabetes mellitus, and renal disease [1, 2].”
BackgroundInfluentialA guide to understanding polycystic ovary syndrome (PCOS)
Duncan, W. C. (2014) · Journal of Family Planning and Reproductive Health Care · doi:10.1136/jfprhc-2012-100505 · Cited by 40 · see citing works
“45 The degree of weight loss may relate to how engaged the patient is with a concurrent weight-loss programme.”
BackgroundWhy does Polycystic Ovary Syndrome (PCOS) Need Long-term Management?
Ruan, X., Li, M., & Mueck, A. O. (2019) · Current Pharmaceutical Design · doi:10.2174/1381612825666190130104922 · Cited by 43 · see citing works
el Sharkwy, I. A. E., & El-Din, M. S. (2019) · Gynecological Endocrinology · doi:10.1080/09513590.2019.1576622 · Cited by 38 · see citing works
“On the contrary, there was a significant BMI reduction with metformin [18,25,26].”
RetractedAMPK activation—protean potential for boosting healthspan
McCarty, M. F. (2013) · AGE · doi:10.1007/s11357-013-9595-y · Cited by 30 · see citing works
Lazaridou, S., Dinas, K., & Tziomalos, K. (2017) · HORMONES · doi:10.14310/horm.2002.1757 · Cited by 27 · see citing works
Management of anovulatory infertility
Li, R., & Ng, E. H. Y. (2012) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2012.05.004 · Cited by 33 · see citing works
Fábregues, F., Castelo-Branco, C., Carmona, F., Guimera, M., Casamitjana, R., & Balasch, J. (2011) · Gynecological Endocrinology · doi:10.3109/09513590.2010.487595 · Cited by 26 · see citing works
“Metformin is not considered an anti-obesity drug eventhough the role of insulin-sensitising drugs in achieving weight loss in women of reproductive age who are overweight or obese remains controversial [29].”
BackgroundGarzia, E., Galiano, V., Marfia, G., Navone, S., Grossi, E., & Marconi, A. (2022) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-021-00876-0 · Cited by 25 · see citing works
“Our results show that metformin is effective in reducing body fat and support the relationships between treatment success and duration [45].”
ResultArora, S., Sinha, K., Kolte, S., & Mandal, A. (2016) · Journal of Human Reproductive Sciences · doi:10.4103/0974-1208.178636 · Cited by 23 · see citing works
“IR/hyperinsulinemia in PCOS being the main pathogenic defect is also supported by clinical, biochemical, and hormonal response to insulin sensitizers.[10,11] With adipose tissue being one of the important sources of pro-inflammatory cytokines, IR in obese women has been attributed to elevation of adipocytokines and ot…”
BackgroundKujawska-Łuczak, M., Musialik, K., Szulińska, M., Swora-Cwynar, E., Kargulewicz, A., Grzymisławska, M., Pupek-Musialik, D., & Bogdański, P. (2017) · Archives of Medical Science · doi:10.5114/aoms.2016.62014 · Cited by 21 · see citing works
“This hypothesis is supported by a meta-analysis of 14 studies of treatment with metformin, which showed that reduction in body mass depends on the daily dosage, and increases when it is higher than 1500 mg/day [11].”
BackgroundResultPalliyaguru, D. L., Minor, R. K., Mitchell, S. J., Palacios, H. H., Licata, J. J., Ward, T. M., Abulwerdi, G. A., Elliott, P. J., Westphal, C. H., Ellis, J. L., et al. (2020) · The Journals of Gerontology Series A · doi:10.1093/gerona/glaa148 · Cited by 23 · see citing works
“SRT1720 also improves glucose homeostasis and insulin sensitivity in mouse and rat models of type 2 diabetes (T2D) (3).”
BackgroundInfluentialNemati, M., Nemati, S., Taheri, A.-M., & Heidari, B. (2017) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2017.07.004 · Cited by 21 · see citing works
Oliveira, F. R., Mamede, M., Bizzi, M., Rocha, A. L., Ferreira, C. N., Gomes, K. B., Cândido, A. L., & Reis, F. (2020) · Hormone and Metabolic Research · doi:10.1055/a-1157-0615 · Cited by 18 · see citing works
Efficacy and safety of metformin or oral contraceptives, or both in polycystic ovary syndrome
Yang, Y.-M., & Choi, E. (2015) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s89737 · Cited by 18 · see citing works
“28 However, in cases where only the OCPs were administered, their effects on the BMI levels were not clear.”
Baldani, D. P., Skrgatic, L., Ougouag, R., & Kasum, M. (2018) · Gynecological Endocrinology · doi:10.1080/09513590.2017.1381681 · Cited by 17 · see citing works
Refuerzo, J. S., Viteri, O. A., Hutchinson, M., Pedroza, C., Blackwell, S., Tyson, J., & Ramin, S. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.12.019 · Cited by 17 · see citing works
Kim, S. Y., Park, E.-S., & Kim, H. W. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17207438 · Cited by 19 · see citing works
The Local Effects of Ovarian Diathermy in an Ovine Model of Polycystic Ovary Syndrome
Connolly, F., Rae, M. T., Butler, M. B., Klibanov, A. L., Sboros, V., McNeilly, A. S., & Duncan, W. C. (2014) · PLoS ONE · doi:10.1371/journal.pone.0111280 · Cited by 14 · see citing works
“Indeed insulin sensitisers improve outcomes in these women with PCOS [65–67], and in an ovine PCOS model rosiglitazone prevented the cycle deteriation that is characteristic of these sheep as the breeding season progresses [68].”
BackgroundThe effect of vertical sleeve gastrectomy on a rat model of polycystic ovarian syndrome.
Wilson-Pérez, H. E., & Seeley, R. (2011) · Endocrinology · doi:10.1210/en.2011-1241 · Cited by 13
“ilar effects, although it does not substantially improve hirsutism (26) and is itself associated with slight weight loss (31, 32).”
BackgroundMidlife women’s health consequences associated with polycystic ovary syndrome
Ali, A. T., & Guidozzi, F. (2019) · Climacteric · doi:10.1080/13697137.2019.1679111 · Cited by 16 · see citing works
Pharmacologic Treatment of Polycystic Ovary Syndrome: Alternate and Future Paths
Legro, R. S., & Martel‐Duguech, L. (2017) · Seminars in Reproductive Medicine · doi:10.1055/s-0037-1603729 · Cited by 11 · see citing works
Morgante, G., Massaro, M. G., Scolaro, V., Cappelli, V., Luddi, A., Troìa, L., & de Leo, V. (2020) · European Review for Medical and Pharmacological Sciences · doi:10.26355/eurrev_202008_22500 · Cited by 10 · see citing works
Wang, X.-J., Cai, S., Tang, S., Yang, L., Tan, J., Sun, X., & Gong, F. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01388-x · Cited by 9 · see citing works
“Metformin, an insulin sensitisation agent, has also been reported to have a modest effect on weight loss [17] and is used in women with polycystic ovary syndrome (PCOS).”
BackgroundResultVaes, B., Ruelens, C., Saikali, S., Smets, A., Henrard, S., Renard, F., van den Akker, M., Pottelbergh, G. V., Goderis, G., & der Heyden, J. V. (2017) · European Journal of Public Health · doi:10.1093/eurpub/ckx106 · Cited by 17 · see citing works
Orbetzova, M., Pehlivanov, B., Mitkov, M., Atanassova, I., Kamenov, Z., Kolarov, G., & Genchev, G. (2011) · Folia Medica · doi:10.2478/v10153-011-0052-3 · Cited by 9 · see citing works
Whitaker, K. (2011) · Journal of pharmacy and practice · doi:10.1177/0897190010384632 · Cited by 9 · see citing works
“This medication has been shown to improve glucose tolerance and metabolic status as well as in having been shown to restore ovulation and menstrual regularity both as a singular therapy and in combination with other therapies.(36-45)”
BackgroundMetformina: más allá del control glucémico
de Colombia, U. N., Morantes-Caballero, J. A., Londoño-Zapata, G. A., de Colombia, U. N., Rivera, M. R., de Colombia, U. N., Pinilla-Roa, A. E., & de Colombia, U. N. (2017) · Revista Médicas UIS · doi:10.18273/revmed.v30n1-2017005 · Cited by 9 · see citing works
Metformin for women who are obese during pregnancy for improving maternal and infant outcomes
Eames, A. J., Grivell, R., Deussen, A., Hague, W., & Dodd, J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010564 · Cited by 6 · see citing works
Obesity in Polycystic Ovary Syndrome: Insulin Sensitizing Therapy
Hoeger, K. M. (2012) · Current Obesity Reports · doi:10.1007/s13679-012-0030-y · Cited by 6 · see citing works
“Studies of short duration (< 8 weeks) also did not demonstrate a benefit [63].”
BackgroundSmith, J. W., & Taylor, J. S. (2011) · Nursing for Women s Health · doi:10.1111/j.1751-486x.2011.01664.x · Cited by 2 · see citing works
Obesity and ovarian insufficiency
Misharina, E. V., Abashova, E., & Potin, V. (2016) · Journal of obstetrics and women s diseases · doi:10.17816/jowd65564-74 · Cited by 5 · see citing works
Reaves, P., Weaver, R., Gaines, F., Carson, E., Williams, R., Mccray, R., Osiyemi, O., Weaver, C. R., Kirksey, O. W., & Holder, M. S. (2008) · The Internet Journal of Health · doi:10.5580/1d6a · Cited by 5 · see citing works
Obesity in PCOS and Infertility
Messinis, I. E., Messini, C. I., & Dafopoulos, K. C. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-416045-3.00008-x · Cited by 3 · see citing works
Current procedures for managing polycystic ovary syndrome
Massicotte, M.-H., Langlois, F., & Baillargeon, J. (2009) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.09.74 · Cited by 5 · see citing works
Diet and exercise in the management of PCOS: Starting from the basics
Markantes, G. Κ., Tsichlia, G., & Georgopoulos, N. A. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823045-9.00010-9 · Cited by 4 · see citing works
Spritzer, P. (2015) · Revista Brasileira de Ginecologia e Obstetrícia · doi:10.1590/so100-720320140005212 · Cited by 4 · see citing works
PCOS from Lifestyle to the Use of Inositol and Insulin Sensitizers
Genazzani, A. D., Prati, A., Despini, G., Marini, G. M. F., & Ricchieri, F. (2014) · ISGE series · doi:10.1007/978-3-319-03494-2_7 · Cited by 7 · see citing works
Uso de metformina em mulheres obesas com Síndrome do Ovário Policístico
de Freitas, L., Santos, J. G., Guimarães, M. A., & de Souza, J. D. (2017) · Revista de Ciências Médicas · doi:10.24220/2318-0897v25n2a3613 · Cited by 3 · see citing works
“[28] realizaram uma revisão que estudou mulheres com sobrepeso ou obesidade, não necessariamente com SOP.”
BackgroundInfluentialNemati, M., & Nemati, S. (2016) · Reproductive System & Sexual Disorders · doi:10.4172/2161-038x.1000191
“In accordance with our results, many researchers investigated the biochemical and clinical aspects of metformin in PCOS patients and confirmed our results about the effect of this drug on weight loss and BMI reduction [11,15,28,31,33-35].”
BackgroundResultMetformin and pregnancy outcomes in obese women
Refuerzo, J. (2015) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(15)00234-x · Cited by 3 · see citing works
Motta, E., Domingues, T., & Soares, J. M. (2012) · Revista Brasileira de Ginecologia e Obstetrícia · doi:10.1590/s0100-72032012000300001 · Cited by 3 · see citing works
Savastano, S., Valentino, R., Pizza, G., Rosa, A. D., Orio, F., Passaretti, F., Formisano, P., Lombardi, G., Beguinot, F., & Colao, A. (2010) · Journal of Endocrinological Investigation · doi:10.1007/bf03346622 · Cited by 2 · see citing works
Obesity in polycystic ovary syndrome and infertility
Messinis, I. E., Messini, C. I., & Dafopoulos, K. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817919-2.00003-6 · Cited by 4 · see citing works
PCOS and Insulin Resistance (IR): From Lifestyle to Insulin Sensitizers
Genazzani, A. D., Santagni, S., Rattighieri, E., Chierchia, E., Despini, G., Prati, A., & Ricchieri, F. (2014) · ISGE series · doi:10.1007/978-3-319-09662-9_2 · Cited by 2 · see citing works
Anti-Obesity Drugs for Obese Women Planning Pregnancy
Li, R., Lee, C. P., Lam, K. S. L., & Ho, P. C. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-416045-3.00031-5 · Cited by 3 · see citing works
Godoy-Gijon, E., Meseguer-Yebra, C., Palacio-Aller, L., Godoy-Rocati, D., & Lahoz-Rallo, C. (2016) · Clínica e Investigación en Arteriosclerosis · doi:10.1016/j.arteri.2015.08.001 · Cited by 1 · see citing works
Insulin resistance and hyperinsulinemia
Misharina, E. V., Borodina, V. L., Glavnova, O., Nicolaencov, I. P., Potin, V., & Tarasova, M. (2016) · Journal of obstetrics and women s diseases · doi:10.17816/jowd65175-86 · Cited by 1 · see citing works
Metformin for obesity or overweight
Li, W.-X., Gou, J.-F., Yan, X., & Yang, L. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008835.pub2 · Cited by 1 · see citing works
Obesity – should we revise indications for treatment with metformin?
Kujawska-Luczak, M., Stankowiak-Kulpa, H., Swora-Cwynar, E., Musialik, K., Bogdański, P., Suliburska, J., & Grzymislawski, M. (2014) · Przeglad menopauzalny = Menopause review · doi:10.5114/pm.2014.42713 · Cited by 1
“The authors emphasize the greater effect of high-dose metformin and longer duration of therapy [30].”
BackgroundAntiobesity drugs for obese women planning pregnancy
Li, R., Lam, K. S. L., & Ho, P. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817921-5.00030-8 · Cited by 2 · see citing works
Incretin System: New Pharmacological Target in Obese Women with Polycystic Ovary Syndrome
Sever, M. J., Ferjan, S., & Janež, A. (2018) · InTech eBooks · doi:10.5772/intechopen.70648 · Cited by 1 · see citing works
Maternal Obesity, Gestational Weight Gain, and Childhood Growth in the First Year of Life
Ehrenthal, D., Minkovitz, C., & Strobino, D. (2014) · Springer eBooks · doi:10.1007/978-1-4471-2831-1_10 · Cited by 1 · see citing works
Evaluating Genetic Obesity Interventions: A Survival Analysis Approach
Zaidan, S. (2025) · Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ) · doi:10.54133/ajms.v8i2.1926
“Beyond its glycemic control benefits, metformin has been associated with modest weight loss, particularly in individuals with insulin resistance or polycystic ovary syndrome (PCOS) [11,12].”
The potential of metformin in weight loss
Григорьева, И. Н., & Nepomnyashchikh, D. L. (2025) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2024-530
Effect of obesity therapy in women of reproductive age on leptin level and hormonal ovarian function
Riazantceva, E. М., Tarasova, M., Tkachenko, N., & Gzgzyan, A. (2020) · doi:10.17816/jowd69317-26
[Evidence-based therapy of polycystic ovarian syndrome].
Gődény, S., & Csenteri, O. K. (2015) · Orvosi Hetilap · doi:10.1556/650.2015.30253
“mértékben, de szignifi kánsan csökkent (WMD: –0,68 [95% CI: (–1,13) – (–0,24)]) [25].”
Polycystic Ovary Syndrome and Cardiovascular Disease
nder, B., Taner, D., Ylmaz, H., & Muzaffer, M. (2012) · InTech eBooks · doi:10.5772/25519
Efficacy and safety of metformin in over weight and obese patients with polycystic ovary syndrome
Siddiqui, A., Khan, M., Zehra, T., & Ali, S. M. (2011) · Pakistan Journal of Medical Sciences · doi:10.12669/pjms.272.440
“15 Aruna et al 16 has demonstrated that six months of metformin therapy showed significant improvement in BMI, WHR and menstrual irregularity and ultrasonographic features but no change in serum fasting insulin was seen.”
Anti-Obesity Surgery for Women Planning Pregnancy?
Deonarine, K., Dan, D., & Teelucksingh, S. (2013) · Elsevier eBooks · doi:10.1016/b978-0-12-416045-3.00032-7 · Cited by 2 · see citing works
- Authors
- Nieuwenhuis-Ruifrok, A. E., Kuchenbecker, W. K. H., Hoek, A., Middleton, P., & Norman, R. J.
- Affiliations
- University Medical Center Groningen (NL)
- Women's and Children's Hospital (AU)
- The University of Adelaide (AU)
- Corresponding author
- Kuchenbecker, W.K.H.
- Venue
- Human Reproduction Update
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-10-22
- Volume
- 15
- Issue
- 1
- Pages
- 57-68
- ISSN
- 1355-4786 (ISSN-L)
- 1460-2369
- OpenAlex
- W2103297384
- Cited by
- 110
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 1 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 11 · 2016: 9 · 2015: 15 · 2014: 13 · 2013: 9 · 2012: 10
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction Update (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- insulin-sensitizing drugs, metformin, weight loss, obesity, overweight, women of reproductive age, polycystic ovary syndrome, infertility, body mass index, lifestyle modification, diet, pregnancy outcomes
- MeSH terms
- Adult, Diet Therapy, Female, Humans, Hypoglycemic Agents, Metformin, Obesity, Body Mass Index, Randomized Controlled Trials as Topic, Anti-Obesity Agents, Overweight
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