Clinical evidence of the effects of carnitine supplementation on body weight, glycemic control and serum lipids in women with polycystic ovary syndrome: a systematic review and meta-analysis

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Several clinical trials have investigated the influence of carnitine on metabolic variables in PCOS, but have yielded conflicting results. This study aimed to summarize the clinical evidence of the effects of carnitine on weight management, glycemic and serum lipids controls in women with PCOS by conducting a meta-analysis of randomized control trials (RCTs). PubMed, Embase, Web of Sciences, Scopus, and the CENTRAL database were searched from inception to March 2021 for eligible articles. Study selection and assessment of quality were conducted independently by two investigators. Effect sizes for each outcome were reported with the weighted mean differences (WMDs) and 95% confidence intervals (CIs). The statistical heterogeneity of the included clinical trials was tested using the I² statistic. Six studies with 672 PCOS participants were included for meta-analysis. Our results revealed that carnitine supplements significantly decreased total cholesterol, low-density lipoprotein-cholesterol, triglycerides, body weight, body mass index, hip circumference, and waist circumference (All p < .05). In addition, carnitine intervention also improved the levels of high-density lipoprotein cholesterol. However, no significant changes were seen in glucose homeostasis parameters. These results were stable after sensitivity analysis, and no significant publication biases were detected. Based on current evidence, carnitine supplementation in women with PCOS had beneficial effects on weight loss and lipid profiles. Further large-scale, well-designed RCTs are required to confirm these results.

肉毒碱影响多囊卵巢综合征女性体重、血糖及血脂方面的临床证据：一项系统综述和荟萃分析 摘要

多囊卵巢综合征（PCOS）是育龄女性最常见的内分泌疾病之一。已有一些临床试验研究了肉毒碱对PCOS代谢的影响, 但结果不一致。本研究旨在通过对随机对照试验（RCTs）的荟萃分析, 总结肉毒碱影响PCOS女性体重管理、血糖和血脂控制的临床证据。在PubMed、Embase、Web of Sciences、Scopus和CENTRAL数据库中检索截止至2021年3月以前所有符合条件的文献。文献选择和质量评估是由两名研究人员独立进行的。采用加权平均差异（WMDs）和95%置信区间（CIs）报告每个结果的效应量。采用统计量I²检验所纳入的临床试验的异质性。对6项研究的672名PCOS患者进行了荟萃分析。结果显示, 肉毒碱能显著降低总胆固醇、低密度脂蛋白胆固醇、甘油三酯、体重、体重指数、臀围和腰围（p均<0.05）。肉毒碱同时还提升高密度脂蛋白胆固醇的水平。但葡萄糖稳态参数未见显著改变。敏感性分析显示结果稳健, 没有明显的发表偏倚。基于目前证据, 肉毒碱可使PCOS女性在减重和脂代谢方面获益。仍需大规模设计良好的RCTs来进一步证实这些结果。

Keywords:

• Body weight
• blood glucose
• carnitine
• lipid
• polycystic ovary syndrome

Disclosure statement

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Medicine Research Program of Guangdong Province (2020491).