SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1553684
Comparative effects of acupuncture and metformin on insulin sensitivity in women with polycystic ovary syndrome : A systematic review and meta-analysis
Provisionally accepted
- Reproductive Medicine Center, Yantai Yuhuangding Hospital, Yantai, China
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Objective: To systematically evaluate the clinical efficacy of acupuncture and metformin on insulin resistance (IR) in women with Polycystic Ovary Syndrome (PCOS).Methods: A computer search was conducted up to September 30, 2024, in databases including PubMed, EMBASE, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and VIP, to collect randomized controlled trials (RCTs) on acupuncture treatment for PCOS. The effect of acupuncture and metformin on insulin sensitivity in PCOS patients was assessed. Two researchers independently screened the literature, extracted data, and evaluated the quality of included studies using the bias assessment tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Meta-analysis and network analysis were conducted using Stata 17.Our primary outcome measure was the the homeostasis model assessment of insulin resistance(HOMA-IR).The secondary outcomes were fasting blood glucose (FBG), fasting insulin (FINS), body mass index (BMI), and waist-to-hip ratio (WHR).Results: A total of 11 RCTs involving 1,248 patients were included. The meta-analysis results showed that the reduction in HOMA-IR [SMD = 0.17, 95% CI (-0.18, 0.52)] and FINS [SMD = 0.17, 95% CI (-0.38, 0.71)] values in the acupuncture group were smaller than those in the metformin group. However, reductions in BMI [SMD = -0.15, 95% CI (-0.88, 0.58)], WHR [SMD = -0.15, 95% CI (-0.88, 0.58)], and FPG [SMD = -0.19, 95% CI (-0.40, 0.02)] were greater in the acupuncture group than in the metformin group, but the differences were not statistically significant. Subgroup analysis with placebo interventions added to each group showed that metformin plus sham acupuncture was more effective than acupuncture plus placebo in reducing HOMA-IR values [SMD = 0.49, 95% CI (0.02, 0.96)] with a statistically significant difference; acupuncture plus placebo treatment had a greater advantage in reducing FPG [SMD = -0.38, 95% CI (-0.57, -0.19)] with a statistically significant difference.The network meta-analysis results indicated that only Electroacupuncture (SMD = -0.27, 95% CI [-1.37, 0.83]) and Abdominal acupuncture (SMD = -0.13, 95% CI [-1.19, 0.94]) demonstrated significant effects on reducing HOMA-IR values in women with
Keywords: Acupuncture, Polycystic Ovary Syndrome, Metformin, Insulin Resistance, Systematic review, Meta-analysis
Received: 07 Jan 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Wang, Qu, Bao and Cong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: qinglan Qu, Reproductive Medicine Center, Yantai Yuhuangding Hospital, Yantai, China
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