Another study indicated that chronic inflammatory state in patients could be considered as a potential link between PCOS and type 2 diabetes mellitus (T2DM) and cardiovascular complications ( 7). Studies have demonstrated that OS-induced pro-inflammatory states might contribute to insulin resistance and subsequent atherosclerosis ( 5). A previous systematic review had assessed the markers of circulating OS markers in patients with PCOS and control subjects, and reported an increase in the levels of malondialdehyde (MDA) (1.9, CI 95% 1.2 to 2.6) and a reduction in the levels of glutathione (GSH) (-3.7, CI 95%-6.2 to -1.2) ( 6) in PCOS patients, which suggested that OS might be the pathophysiological process associated with PCOS ( 5). Large number of studies have suggested that OS, insulin resistance and dyslipidemia were closely associated with PCOS ( 4, 5). A previously published meta-analysis showed that the pooled prevalence estimate was 5%-15% when PCOS was diagnosed with the Rotterdam criteria ( 2, 3). The long-term complications of PCOS mainly include diabetes, cardiovascular disease and metabolic syndrome ( 1, 2). The main clinical risk associated with PCOS is infertility due to ovulation disorders.
PCOS is one of the most common endocrine diseases in women of reproductive age ( 1). The effect of magnesium and melatonin supplementation on the markers of metabolism needs to be further verified. However, magnesium combined with other supplements (vitamin E, zinc, zinc-calcium-vitamin D) significantly improved serum hs-CRP, insulin, HOMA-IR, TG, TC levels, and the improvement in OS markers was inconclusive. Magnesium intake alone did not lead to a significant improvement in the markers of OS, blood glucose, or serum lipids in PCOS. Magnesium combined with vitamin E or zinc-calcium-vitamin D significantly improved glucose and lipid metabolism in PCOS patients. Whilemagnesium supplementation alone did not show any significant improvement in the markers of inflammation, OS or metabolism in PCOS, seven of the nine articles reported the effect of magnesium co-supplementation on OS or metabolic markers in PCOS patients. Four of the nine studies reported the effects of magnesium supplementation alone on OS or metabolic markers in women with PCOS. The primary outcomes were the markers of blood glucose and OS.363 patients from nine RCTs were included in the current systematic review.
Randomized controlled trials (RCTs) for PCOS undergoing therapy with magnesium supplementation alone or in combination with other agents. Electronic databases (PubMed, Cochrane Library databases, Embase, Web of science, CMB, CNKI, VIP, Wan Fang and ) were searched from their inception until January 2022. The objective of this systematic review is to synthesize the available evidence on the effectiveness of magnesium supplements on the markers of inflammation, oxidative stress (OS), and metabolism in PCOS patients and to provide a basis for its clinical treatment.
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