{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:55:16Z","timestamp":1791363316693,"version":"4.3.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of inositol supplementation on biochemical hyperandrogenism in women with polycystic ovary syndrome (PCOS) and to explore whether metabolic phenotype modifies the endocrine response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analysis of randomized controlled trials conducted in accordance with PRISMA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>Women diagnosed with PCOS according to established criteria (NIH, Rotterdam, or AE\u2010PCOS). Nine eligible trials comprising a total of 440 participants were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Primary outcomes were serum total testosterone (TT), calculated free testosterone (cFT), free androgen index (FAI), and sex hormone\u2013binding globulin (SHBG). Prespecified subgroup analyses explored differences according to body mass index (BMI) and insulin resistance (HOMA\u2010IR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Inositol supplementation was associated with significant reductions in TT (SMD \u20131.30; 95% CI \u20132.17 to \u20130.42), cFT, and FAI, together with an increase in SHBG. Substantial heterogeneity was observed for several outcomes. In subgroup analyses, the largest and most consistent reduction in TT was observed among normal\u2010weight women (BMI\u2009&lt;\u200925\u2009kg\/m\u00b2) (SMD \u20132.97; 95% CI \u20133.78 to \u20132.16), with minimal heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      \u00b2 = 9%). No significant improvements were detected in overweight or obese women, nor in women with insulin resistance when considered independently of BMI. These subgroup findings should be interpreted as exploratory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inositol supplementation is associated with improvements in biochemical hyperandrogenism in women with PCOS, with evidence of phenotype\u2010dependent variability. The most consistent biochemical response was observed in normal\u2010weight individuals. These findings support a metabolically informed, hypothesis\u2010generating framework and highlight the need for adequately powered, phenotype\u2010stratified trials incorporating clinically meaningful outcomes, including standardized measures of hirsutism, ovulatory function, and patient\u2010reported endpoints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70140","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:02:40Z","timestamp":1775624560000},"page":"237-244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic Phenotype Predicts Biochemical Response to Inositol Supplementation in Polycystic Ovary Syndrome: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-7955","authenticated-orcid":false,"given":"Daniele","family":"Tienforti","sequence":"first","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Puocci","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Venditti","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Gizzi","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Pisan\u00f2","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Cocci","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Perfetto","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"D'Alessandro","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Spagnolo","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Giorgio","family":"Baroni","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arcangelo","family":"Barbonetti","sequence":"additional","affiliation":[{"name":"Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(15)30642-6"},{"key":"e_1_2_10_3_1","volume-title":"Polycystic Ovary Syndrome, Blackwell Scientific","author":"Zawadski J. 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