{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:02:58Z","timestamp":1794013378022,"version":"4.8.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This umbrella review aimed to synthesize and appraise the evidence regarding the efficacy of inositol for Polycystic Ovary Syndrome (PCOS) by integrating meta-analyses of randomized controlled trials(RCTs), thereby assessing the robustness of the existing body of evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched four databases from inception to August 2025 for relevant RCT meta-analyses. Primary outcomes included hormonal profiles, glycolipid metabolism, anthropometrics, and reproductive outcomes. Quality was assessed using AMSTAR-2 and GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen meta-analyses were included. AMSTAR-2 ratings were 23.1% high, 53.8% low, and 23.1% very low quality. GRADE assessment of 85 evidence items revealed no high-quality evidence; 18.9% were moderate, 40% low, and 41.1% very low quality. Pooled analyses demonstrated that inositol significantly improved multiple outcomes compared to placebo\/FA: it reduced serum luteinizing hormone (LH: MD -3.43 IU\/L, 95% CI [-4.29, -2.56],\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), total testosterone (TT), free testosterone (FT: MD -0.02 nmol\/L, 95% CI [-0.02, -0.01],\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), improved sex hormone-binding globulin (SHBG: MD 36.72 nmol\/L, 95% CI [28.52, 44.91],\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), and androstenedione. Benefits were also observed for homeostatic model assessment of insulin resistance (HOMA-IR: MD -1.14, 95% CI [-1.35, -0.94],\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), fasting insulin (FI: MD -23.40 pmol\/L, 95% CI [-32.80, -14.01],\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.00001), triglycerides, and reproductive outcomes (live births: Risk Ratio [RR] 2.29, 95% CI [1.07, 4.93],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03; ovulation rate: RR 2.75, 95% CI [1.71, 4.41],\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.0001). However, versus metformin(MET), its effects on most parameters were not significant, except for triglycerides and pregnancy rates. Cross-subgroup analysis of inositol subtypes indicated MI\/MI+FA was superior for metabolic and reproductive outcomes, while D-chiro-inositol monotherapy should be used with caution in clinical practice; combination therapy did not consistently outperform monomers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Inositol improves core PCOS manifestations. Supported by moderate-quality evidence for effects on TT, FT, SHBG, HOMA-IR, and pregnancy\/ovulation rates, it is a promising therapy. Differential efficacy of inositol subtypes may inform personalized treatment. However, outcomes based on low-quality evidence require cautious interpretation and should not solely guide clinical decisions, highlighting the need for larger, rigorous trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD420251146691.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1741509","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:26:48Z","timestamp":1770787608000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of inositol in women with polycystic ovary syndrome: an umbrella review of meta-analyses from randomized controlled trials"],"prefix":"10.3389","volume":"17","author":[{"given":"Mengxue","family":"Duan","sequence":"first","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]},{"name":"Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Yang","sequence":"additional","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]},{"name":"Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Li","sequence":"additional","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]},{"name":"Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Wu","sequence":"additional","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]},{"name":"Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Yin","sequence":"additional","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]},{"name":"Department of Gynecology, Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqiu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Chengdu University of Traditional Chinese Medicine","place":["Chengdu, 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