Metabolic Phenotype Predicts Biochemical Response to Inositol Supplementation in Polycystic Ovary Syndrome: A Systematic Review and Meta‐Analysis
Pooled result · TT, cFT, FAI and SHBGResult — go to the resultSMD −1.30 95% CI −2.17 to −0.42Authors' conclusion
Inositol supplementation is associated with improvements in biochemical hyperandrogenism in women with PCOS, with evidence of phenotype-dependent variability. The most consistent biochemical response was observed in normal-weight individuals.
Study context
- Population
- Women with polycystic ovary syndrome (PCOS) diagnosed by NIH, Rotterdam or AE-PCOS criteria
- Participants
- 440 women9 RCTs
- Comparison
- Inositol supplementation vs control
- Outcome
- Serum total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI) and SHBG
Methodological detailsPRISMA, prespecified subgroup analyses by body mass index (BMI) and HOMA-IR
- PRISMA
- Prespecified subgroup analyses by BMI and HOMA-IR
Pooled result
TT, cFT, FAI and SHBG
SMD
−1.30
95% CI −2.17 to −0.42
Inositol supplementationvs control
SMD −1.30 (95% CI −2.17 to −0.42)
As reported in the abstract
Further pooled results
Total testosterone (TT), subgroup by BMI: normal-weight women (BMI < 25 kg/m²)
- Largest and most consistent reduction in TT among normal-weight women (BMI < 25 kg/m²), SMD
- −2.97 (95% CI −3.78 to −2.16)
- Prespecified subgroup analysis
- Minimal heterogeneity (I² = 9%)
- Exploratory
Subgroups: overweight or obese women; women with insulin resistance independent of BMI
- No significant improvements in overweight or obese women, nor in women with insulin resistance considered independently of BMI
- Exploratory
Original publication
Metabolic Phenotype Predicts Biochemical Response to Inositol Supplementation in Polycystic Ovary Syndrome: A Systematic Review and Meta‐Analysis. Clin Endocrinol (Oxf). Published 7 April 2026. doi:10.
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