多囊卵巢综合征伴代谢综合征与糖尿病：一项系统综述与荟萃分析。
完整摘要 · 中文译文
目的：多囊卵巢综合征（PCOS）是一种与代谢并发症相关的常见内分泌疾病。本研究系统综述并荟萃分析了PCOS与代谢综合征及糖尿病风险之间的关联。 方法：按照PRISMA指南，在PubMed、Scopus、Web of Science、Embase和Cochrane CENTRAL中全面检索1990年至2025年间发表的研究。纳入以鹿特丹、NIH或AES标准诊断PCOS的观察性研究（横断面、病例对照、队列研究）。采用标准化检查表提取数据，并使用纽卡斯尔-渥太华量表评估研究质量。采用DerSimonian-Laird随机效应模型计算合并相对危险度（RR）。采用Cochrane Q和I²评估异质性，并通过亚组分析探讨差异来源。 结果：从3，747篇文章中，纳入44项关于糖尿病的研究（54个效应量）和6项关于代谢综合征的研究。PCOS女性的糖尿病风险高72%（RR：1.72，95% CI：1.43-2.06），以鹿特丹标准最强（RR：1.86）。妊娠期糖尿病风险最高（RR：2.05），>40岁女性风险亦较高（RR：1.88）。对于代谢综合征，PCOS使风险增加48%（RR：1.48，95% CI：1.15-1.90），以NIH标准最强（RR：3.41）。地域差异显示欧洲糖尿病风险较高（RR：1.97），亚洲代谢综合征风险较高（RR：1.99）。异质性较大，但未检测到发表偏倚。 结论：PCOS显著升高糖尿病和代谢综合征风险，受诊断标准、年龄、BMI和地域影响。标准化诊断方法和长期 纵向研究对于完善风险评估和指导针对性干预至关重要。
完整摘要 · 英文原文
PURPOSE: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder linked to metabolic complications. This study systematically reviewed and meta-analyzed the association between PCOS and the risk of Metabolic Syndrome and Diabetes Mellitus. METHODS: A comprehensive search was conducted in PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL for studies published between 1990 and 2025, following PRISMA guidelines. Observational studies (cross-sectional, case-control, cohort) diagnosing PCOS by Rotterdam, NIH, or AES criteria were included. Data extraction used a standardized checklist, and study quality was assessed with the Newcastle-Ottawa Scale. Pooled relative risks (RR) were calculated using the DerSimonian-Laird random-effects model. Heterogeneity was evaluated with Cochrane Q and I², and subgroup analyses explored variations. RESULTS: From 3,747 articles, 44 studies (54 effect sizes) on DM and six on MetS were included. Women with PCOS had a 72% higher risk of DM (RR: 1.72, 95% CI: 1.43-2.06), strongest with Rotterdam criteria (RR: 1.86). Risk was highest for gestational DM (RR: 2.05) and in women > 40 years (RR: 1.88). For MetS, PCOS increased risk by 48% (RR: 1.48, 95% CI: 1.15-1.90), strongest with NIH criteria (RR: 3.41). Geographic differences showed higher DM risk in Europe (RR: 1.97) and MetS in Asia (RR: 1.99). Heterogeneity was substantial, but no publication bias was detected. CONCLUSION: PCOS significantly elevates risks of DM and MetS, influenced by diagnostic criteria, age, BMI, and geography. Standardized diagnostic approaches and longitudinal studies are essential to refine risk assessment and guide targeted interventions.