Journal of School of Public Health and Institute of Public Health Research
مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
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2023
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مقایسه همزمان مداخلات دارویی در زنان چاق مبتلا به سندرم پلی کیستیک تخمدان: یک مطالعه سیستماتیک و متاآنالیز شبکهای
Simultaneous Comparison of Pharmacological Interventions in Obese Women with Polycystic Ovary Syndrome: A Systematic Review and Network Meta-Analysis
بهداشت عمومی
Public Health
پژوهشي
Research
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">زمینه و هدف</span></span></b><b><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">: </span></span></b><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">تاکنون درمان</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus""></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">های دارویی مختلفی برای درمان چاقی معرفی شده است. در این مطالعه به مقایسه داروهای موجود برای درمان چاقی</span></span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">زنان مبتلا به سندرم پلیکیستیک تخمدان(</span></span><span dir="LTR" style="font-size:11.0pt"> (PCOS</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> به صورت همزمان پردا</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">خته شده است</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">روشکار: </span></span></b><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">این مطالعه به روش مرور سیستماتیک و متاآنالیز شبکه ای (</span></span><span dir="LTR" style="font-size:11.0pt">NMA</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">)انجام شد. پایگاههای اطلاعاتی عمده بینالمللی از جمله</span></span> <span dir="LTR" style="font-size:11.0pt">PubMed</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">، </span></span><span dir="LTR" style="font-size:11.0pt">Web of Science</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">، </span></span><span dir="LTR" style="font-size:11.0pt">Scopus</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">، </span></span><span dir="LTR" style="font-size:11.0pt">Cochrane Library</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> و </span></span><span dir="LTR" style="font-size:11.0pt">Embase</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> تا مارس 2022 جستجو شدند. در این مطالعه فقط کارآزماییهای تصادفیسازی و کنترلشده (</span></span><span dir="LTR" style="font-size:11.0pt">RCT</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">) که مداخلات دارویی زنان مبتلا به </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">سندرم پلیکیستیک تخمدان</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> را با هم مقایسه میکردند، وارد مطالعه شدند. دو محقق مسئول غربالگری منابع بازیابی شده بودند. برای ارزیابی خطر سوگیری از ابزار کاکرین استفاده شد. فرض سازگاری توسط حلقه خاص و طراحی با رویکردهای تعامل درمان ارزیابی شد. تفاوت میانگین، بر اساس تجزیه و تحلیل </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">از</span></span> <span dir="LTR" style="font-size:11.0pt">P-score</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">برای خلاصه کردن اثرات درمان در </span></span><span dir="LTR" style="font-size:11.0pt">NMA</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> استفاده شد. برای گزارش نتایج از مدل اثرات تصادفی استفاده شد. نتایج با فاصله اطمینان 95% (</span></span><span dir="LTR" style="font-size:11.0pt">CI</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">) گزارش شد. برای بررسی ناهمگنی مطالعات از آماره </span></span><span dir="LTR" style="font-size:11.0pt">I<sup>2</sup></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> استفاده شد.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">از 9335 مرجع بازیابی شده، 9 مطالعه </span></span><span dir="LTR" style="font-size:11.0pt">RCT</span><span style="font-size:11.0pt"><span style="font-family:"B Lotus""> معیارهای واجد شرایط برای این مطالعه را داشتند. دو شبکه برای درمان چاقی در زنان مبتلا به سندرم پلی کیستیک تخمدان وجود داشت. </span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">(</span></span><span dir="LTR" style="font-size:11.0pt">1.2</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">)</span></span><b> </b><span dir="LTR" style="font-size:11.0pt">Liraglutide</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> با </span></span><span dir="LTR" style="font-size:11.0pt">[P-score=</span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"B Nazanin""><span style="color:black">0/86</span></span></span><span dir="LTR" style="font-size:11.0pt">,MD=-</span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"B Nazanin""><span style="color:black">8/02(-20/99,4/94)</span></span></span><span dir="LTR" style="font-size:11.0pt">]</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> به عنوان بهترین درمان در شبکه اول </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">و<b> </b></span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">(</span></span><span dir="LTR" style="font-size:11.0pt">120</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">) </span></span><span dir="LTR" style="font-size:11.0pt"> Orlistat</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""><span style="color:black">با</span></span></span> <span dir="LTR" style="font-size:11.0pt">[P-score=</span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"B Nazanin""><span style="color:black">0/88</span></span></span><span dir="LTR" style="font-size:11.0pt">,MD=-</span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"B Nazanin""><span style="color:black">3/49 (-5/17,-1/81)</span></span></span><span dir="LTR" style="font-size:11.0pt">]</span><span style="font-size:11.0pt"><span style="font-family:"B Lotus""> به عنوان بهترین درمان در شبکه دوم بود.</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus""></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">نتیجهگیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">بر اساس نتایج این </span></span><span dir="LTR" style="font-size:11.0pt">NMA</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> به نظر میرسد </span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">(</span></span><span dir="LTR" style="font-size:11.0pt">1.2</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">)</span></span><b> </b> <span dir="LTR" style="font-size:11.0pt">Liraglutide</span><span style="font-size:11.0pt"><span style="font-family:"B Lotus""> و</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">(</span></span><span dir="LTR" style="font-size:11.0pt">120</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">) </span></span><span dir="LTR" style="font-size:11.0pt"> Orlistat</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus"">به</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Lotus""> عنوان بهترین درمان چاقی در زنان مبتلا به سندرم پلی کیستیک باشد.</span></span><span dir="LTR" style="font-size:11.0pt"></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:11.0pt">Background and Aim:</span></b> So far various medicinal treatments have been introduced to treat obesity. In this study we compared the available drugs for the treatment of obesity in women with polycystic ovary syndrome (PCOS).</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:11.0pt">Materials and Methods:</span></b> This study was conducted using systematic review and network meta-analysis (NMA) methods. The major international databases including PubMed, Web of Science, Scopus, Cochrane Library and Embase were searched, the search ending in March 2022. Only randomized controlled trials (RCTs) comparing medicinal interventions in women with PCOS were included in the study. Two of the researchers were responsible for screening the retrieved sources. The Cochrane tool was used to assess the risk of bias. The loop-specific and design by treatment interaction approaches were used to assess the consistency assumption. Treatments in each network were ranked using the P-score. The random effects model was used to report the results. The results were reported at %95 confidence interval (CI). I<sup>2 </sup>statistic was used to check the heterogeneity of the studies.</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:11.0pt">Results:</span></b> Out of the 9335 retrieved references, 9 studies met the eligibility criteria. There were two networks for the treatment of obesity in women with polycystic ovary syndrome: Liraglutide (1.2), [P-score=0.86, MD=-8.02(-20.99, 4.94)] as the best treatment in the first network, and Orlistat (120), [P-score=0.88, MD=-3.49 (-5.17, -1.81)] as the best treatment in the second network.</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:11.0pt">Conclusion:</span></b> Based on the results of network meta-analysis, it seems that the best medicinal interventions for obesity in women with polycystic syndrome rare Liraglutide (1.2) and Orlistat (120).</span></span></span></span></span></span><br>
چاقی, متاآنالیز شبکه, مرور سیستماتیک, درمانهای دارویی
Obesity, Network Meta-Analysis, Systematic Review, Medicinal Treatments
447
460
http://sjsph.tums.ac.ir/browse.php?a_code=A-10-1-213&slc_lang=other&sid=1
Mina
Morsali
مینا
مرسلی
morsali.mina97@gmail.com