A systematic review and meta-analysis of the correlation between polycystic ovary syndrome and irritable bowel syndrome

Figures & data

Figure 1. Flowchart of included studies.

Table 1. Clinical characteristics of studies included in the meta-analysis of patients with polycystic ovary syndrome and irritable bowel syndrome.

Study	Country	Type of studies	PCOS criteria	IBS criteria	Age (y, mean ± SE)	BMI (kg/m^2, mean ± SE)	Sample size		Prevalence of IBS		Odds Ratio(95 % CI)
Fatemeh B et al. 2020 [11]	Iran	case-control study	Rotterdam	Rome III	PCOS: 28 ± 4.92* Control: 29.68 ± 5.36	PCOS: 25.52 ± 4.70Control: 24.53 ± 3.88	PCOS:IBS:30 Total:101	Control:IBS:11 Total:100	PCOS:IBS:30(29.7%)IBS-C:21(20.8%)IBS-D:4(3.9%)IBS-M:5(5%)	Control:IBS:11(11%)IBS-C:5(5%)IBS-D:2(2%)IBS-M:4(4%)	3.42(1.60,7.30)
Dursun H et al. 2018 [12]	Turkey	case-control study	Rotterdam	Rome III	PCOS: 24.92 ± 6.22 Control: 26.91 ± 8.27	PCOS: 25.51 ± 4.33Control: 24.01 ± 4.82	PCOS:IBS:21Total:54	Control:IBS:10 Total:53	PCOS:IBS:21(39%)IBS-C:14(26%)IBS-D:4(7%)IBS-A:3(6%)	Control:IBS:10(19%)IBS-C:7(13%)IBS-D:1(2%)IBS-A:2(4%)	2.74(1.14,6.59)
Kałużna M et al. 2022 [16]	Poland	case-control study	Rotterdam	Rome IV	PCOS: IBS:26.96 (median);Non-IBS:24.42(median)Control: IBS:28.25 (median);Non-IBS:24.83 (median)	PCOS: IBS:23.57 (median);Non-IBS:24.21(median)Control: IBS:22.04 (median);Non-IBS:24.20 (median)	PCOS:IBS:32 Total:133	Control:IBS:15 Total:72	PCOS:IBS:32(24%)IBS-C:12(9%)IBS-D:3(2.2%)IBS-M:15(11.3%)IBS-U:2(1.5%)	Control:IBS:15(24%)IBS-C:2(3%)IBS-D:2(3%)IBS-M:8(11%)IBS-U:0(0%)	1.20(0.60,2.41)
Mathur R, et al. 2010 [13]	America	case-control study	NIH 1990	Rome I	PCOS:28.3 ± 1.0*Control: 33.2 ± 1.3	PCOS: 31.4 ± 1.2* Control: 27.5 ± 1.1	PCOS:IBS:15 Total:36	Control:IBS:3 Total:29	PCOS:IBS:15(41.6%)	Control:IBS:3(10.3%)	6.19(1.58,24.28)
Ping-Huei T et al. 2021 [14]	China	case-control studycross-sectional study	Rotterdam	Rome III	PCOS: 25.3 ± 4.9*Control: 48.4 ± 10.5	PCOS: 26.4 ± 6.5*Control: 23.0 ± 12.6	PCOS:IBS:46 Total:431	Control:IBS:15 Total:259	IBS:46(10.7%)IBS-C:2(0.5%)IBS-D:9(2.1%)IBS-M:34(7.8%)IBS-U:1(0.3%)	IBS:15(5.8%)IBS-C:1(0.4%)IBS-D:1(0.4%)IBS-M:13(5%)IBS-U:0(0%)	1.94(1.06,3.56)
Sulaiman A Al Shammari, et al. 2022 [15]	Saudi Arabia	cross-sectional study	Patients’ medical record	Rome IV Diagnostic Questionnaire	NA	PCOS: 26.3 + 6.9Control: NA	PCOS:IBS:49 Total:291	Control:IBS:NA Total:NA	PCOS:IBS:49(16.8%)IBS-C:12(4.1%)IBS-D:6(2%)IBS-M:31(10.7%)	Control: NA	/

CI = confidence interval, IBS = Irritable bowel syndrome, IBS-A = alternating IBS, IBS-C = Constipation-predominant IBS, IBS-D = Diarrhea-predominant IBS, IBS-M = Mixed IBS, IBS-U = Unspecified IBS, NIH = National Institutes of Health criteria, NA = Not available, PCOS = Polycystic ovary syndrome, *Statistically different between cases and controls, p < 0.05.

Table 2. Evaluating the quality of case-control studies, and included studies methodology quality based on the Newcastle-Ottawa Scale.

Study	Selection				Comparability			Exposure		Quality scores
Fatemeh B et al. 2020 [11]	*	*		*		*		*	*	Total:6Section:3/4Comparability:1/2Exposure:2/2
Dursun H et al. 2018 [12]	*			*		*		*	*	Total:5Section:2/4Comparability:1/2Exposure:2/2
Kałużna M et al. 2022 [16]	*	*	*	*		**		*	*	Total:8Section:4/4Comparability:2/2Exposure:2/2
Mathur R et al. 2010 [13]	*	*	*	*				*	*	Total:6Section:4/4Comparability:0/2Exposure:2/2
Ping-Huei T et al. 2021 [14]	*	*	*	*				*	*	Total:6Section:4/4Comparability:0/2Exposure:2/2

“*” = One score.

Figure 2. Meta-analysis of the five articles included and Forest plots of sensitivity analyses. (a) Forest plot of odds of IBS in PCOS patients; (b) Forest plot after the fixed effects pattern is substituted with a random effects pattern; (c)Forest plot of odds of IBS in PCOS patients after excluding one study with NIH criteria for PCOS diagnosis; (d)Forest plot of odds of IBS in PCOS patients after excluding two trials by Rome I and IV criteria for IBS diagnosis; CI = confidence interval; IBS = Irritable bowel syndrome; NIH = National Institutes of Health criteria; PCOS = Polycystic ovary syndrome.

Figure 3. Sensitivity analysis plot for OR of IBS in PCOS women. IBS = Irritable bowel syndrome; PCOS = Polycystic ovary syndrome. OR = odd ratios.

Figure 4. Funnel plot of included articles. OR = odd ratios.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.