Biomarkers to inform the management of polycystic ovary syndrome: A review of systematic reviews

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Clinical Endocrinology Pub Date : 2024-08-18 DOI:10.1111/cen.15101

Hugo Walford, Bede Tyler, Ali Abbara, Sophie Clarke, Vikram Talaulikar, Bassel Al Wattar

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Abstract

Introduction

Polycystic ovarian syndrome (PCOS) is the commonest endocrine condition affecting reproductive age women. Many biomarkers may aid assessment and management, however evidence is limited on their utility in clinical practice. We conducted a review of systematic reviews to identify the most useful biomarkers in the clinical management of PCOS.

Methods

We searched MEDLINE, EMBASE, CENTRAL and HTA until August 2023 for reviews evaluating biomarkers in PCOS women compared to healthy controls. Methodological quality was assessed using the AMSTAR2 tool. We reported pooled evidence for each biomarker with 95% confidence intervals from the most recent, up-to-date, and best quality review.

Results

From 3360 citations, we included 75 systematic reviews (88 biomarkers, 191,792 women). Most reviews (50/75, 67%) were moderate quality, but reported high heterogeneity (66/75, 88%). We identified 63 abnormal biomarkers in women with PCOS versus healthy controls. Of these, 22 core biomarkers could help evaluate the multisystemic impact of PCOS and inform patient management and surveillance: dehydroepiandrosterone, prolactin, sex hormone-binding globulin, total and free testosterone, anti-Mullerian hormone, systolic and diastolic blood pressure, c-reactive protein, fibrinogen, oral glucose tolerance test, homoeostatic model assessment-insulin resistance index, fasting insulin, total cholesterol, triglycerides, lipoprotein(a), HDL, LDL, non-HDL-cholesterol, ferritin, iron, and 25-hydroxy-vitamin D.

Conclusion

We identified 22 core biomarkers assessing the multisystemic impact of PCOS and inform its clinical management. Future research is required to establish validated healthcare pathways.

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为多囊卵巢综合征管理提供依据的生物标志物：系统回顾综述。

导言多囊卵巢综合征（PCOS）是影响育龄妇女最常见的内分泌疾病。许多生物标志物可帮助评估和管理，但有关其在临床实践中的效用的证据却很有限。我们对系统综述进行了回顾，以确定在多囊卵巢综合症临床管理中最有用的生物标志物：方法：我们检索了 MEDLINE、EMBASE、CENTRAL 和 HTA（截至 2023 年 8 月）中有关评估 PCOS 妇女与健康对照组生物标志物的综述。使用 AMSTAR2 工具对方法学质量进行了评估。我们报告了每种生物标志物的汇集证据，以及来自最近、最新和质量最好的综述的 95% 置信区间：从 3360 条引文中，我们纳入了 75 篇系统综述（88 种生物标志物，191792 名女性）。大多数综述（50/75，67%）质量中等，但报告的异质性较高（66/75，88%）。我们在患有多囊卵巢综合症的女性与健康对照组中发现了 63 种异常生物标志物。其中，22 个核心生物标志物有助于评估多囊卵巢综合症的多系统影响，并为患者管理和监测提供信息：脱氢表雄酮、催乳素、性激素结合球蛋白、总睾酮和游离睾酮、抗穆勒氏管激素、收缩压和舒张压、c 反应蛋白、纤维蛋白原、口服葡萄糖耐量试验、胰岛素抵抗指数、空腹胰岛素、总胆固醇、甘油三酯、脂蛋白（a）、高密度脂蛋白、低密度脂蛋白、非高密度脂蛋白胆固醇、铁蛋白、铁和 25-羟维生素 D。结论我们确定了 22 个核心生物标志物，用于评估多囊卵巢综合征的多系统影响，并为临床管理提供依据。未来的研究需要建立有效的医疗路径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.