GLP-1 Receptor Agonists Versus Metformin In Polycystic Ovary Syndrome: A Meta-analysis

Objective: To systematically review the efficacy and safety of GLP-1 receptor agonists for treating polycystic ovary syndrome(PCOS)by comparing its effect with that of metformin.Methods: PubMed,The Cochrane Library,EMbase,WanFang Data and CNKI were searched online to collect randomized controlled trials(RCTs)of GLP-1 receptor agonists for treating PCOS from the data of their establishment to June 2018.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies.Then results of meta-analysis were performed using RevMan 5.3 software.Result: A total of 8 RCTs was included.The meta-analysis showed that: compared with metformin,GLP-1 receptor agonists were more effective in improving insulin sensitivity[MD=-0.40,95%CI(-0.74,-0.06),P=0.02] and reducing BMI[MD=-1.02,95%CI(-1.85,-0.19),P=0.02] and abdominal girth[MD=-0.45,95%CI(-0.89,-0.00),P=0.05].There were no significant differences between GLP-1 and metformin in case of improving menstrual frequency and lowering serum total testosterone and FAI.GLP-1 receptor agonists had a higher incidence of nausea and headache than metformin,but no significant differences in diarrhea,bloating,vomiting and so on.Conclusion: GLP-1 receptor agonists are superior to metformin in improving insulin sensitivity and reducing BMI and abdominal girth in PCOS patients.However,the incidence of adverse events such as nausea and headache is higher.