SynthesisOncotarget2017

Impact of metformin on C-reactive protein levels in women with polycystic ovary syndrome: a meta-analysis.

Yong Chen, Meng Li, Hongli Deng, Sheying Wang, Lihua Chen, Ningsha Li, Dan Xu, Qiguang Wang

Full text readMeta-AnalysisReview
In one paragraph

Synthesis in Oncotarget, 2017. The graph read 2 numbers from its abstract, feeding 1 cell of the map: it supports the treatment in 1. Cited by 6 papers, 2 of them syntheses that pooled it.

2numbers the graph read from it
1cell of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-1.650 · no effect
Serum CRP levelsmetformin vs control (placebo or no treatment)favours the treatment · obesity, gdmfeeds one cell of the map
Δ -1.23-1.65 to -0.81< 0.001
CRP levels significantly decreased after metformin treatment (WMD = -1.23mg/L, 95%CI: -1.65 to -0.81, I2 = 93% and P < 0.001 for heterogeneity).

Read, but not usablea number the graph found but could not read as for or against

Serum CRP levelsmetformin treatment beyond 6 months vs metformin treatment less than 6 monthscomparator not stated · obesity, gdmfeeds one cell of the map
Δ -1.47
Interestingly, the degree of decreased CRP levels was not depended on metformin dosage, but more significantly in patients treated beyond 6 months (WMD≥6months = -1.47mg/L vs.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Metformin×inflammation & biomarkers

SupportsOpen on the map →What to test next →

3 readable studies in this cell: 1 favour the treatment, 2 find no difference, 0 favour the comparator.

Belief with this paper
0.50one trial · 1 family supports, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
0 · no effect
NCT00386100688 enrolled · 2006
Δ 1.47-14.8 to 20.8
NCT00727857600 enrolled · 2007
Δ 4.88-4.71 to 14.0

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

8 authors.

Yong ChenDepartment of Clinical Laboratory, The First Hospital of Changsha City, Hunan, People's Republic of China.
Meng LiDepartment of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Guangxi, People's Republic of China.
Hongli DengDepartment of Clinical Laboratory, People's Hospital of Liuyang City, Hunan, People's Republic of China.
Sheying WangDepartment of Clinical Laboratory, The First Hospital of Changsha City, Hunan, People's Republic of China.
Lihua ChenDepartment of Clinical Laboratory, The First Hospital of Changsha City, Hunan, People's Republic of China.
Ningsha LiDepartment of Clinical Laboratory, The First Hospital of Changsha City, Hunan, People's Republic of China.
Dan XuDepartment of Clinical Laboratory, The First Hospital of Changsha City, Hunan, People's Republic of China.
Qiguang WangDepartment of Clinical Laboratory, The First Affiliated Hospital of Hunan Normal University, People's Hospital of Hunan, Hunan, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

The impact of the recommended first-line treatment with metformin on C-reactive protein (CRP) levels in patients with polycystic ovary syndrome (PCOS) is still controversial. We conducted a meta-analysis of studies reporting the impact of metformin on serum CRP levels in women with PCOS. The weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs) were used to assesse the effects. GRADE approach was used to assesse the quality of the evidence. A total of 20 studies that included 433 women with PCOS were analyzed. CRP levels significantly decreased after metformin treatment (WMD = -1.23mg/L, 95%CI: -1.65 to -0.81, I2 = 93% and P < 0.001 for heterogeneity). The decreased levels of CRP were observed both in lean (BMI<25 kg/m2) and obese (BMI>25 kg/m2) patients. Interestingly, the degree of decreased CRP levels was not depended on metformin dosage, but more significantly in patients treated beyond 6 months (WMD≥6months = -1.47mg/L vs. WMD<6months = -0.94 mg/L). Decreased CRP levels are not associated with the status of IR and androgen in patients with PCOS. However, the quality of evidence was very low because of the limitations and inconsistency of the included studies. Therefore, metformin shows the potential effects on CRP levels in women with PCOS. However, considering the very low quality of evidence for the analysis, the effect of metformin on CRP levels are still very uncertain, and large-scale randomized-controlled study is needed to ascertain the long-term effects of metformin in PCOS.

Indexed as

AdultAndrogensC-Reactive ProteinFemaleHumansMetforminObesityPolycystic Ovary SyndromeTreatment OutcomeYoung AdultAndrogensC-Reactive ProteinMetforminCRPmeta-analysismetforminpolycystic ovary syndrome

Identifiers

PMID28404960
PMCPMC5471066

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.