Table 1.

Studies included in a meta-analysis to evaluate the relationship between probiotic and synbiotic supplementation and insulin resistance in patients with polycystic ovary syndrome.^{12,14,16–20}

Author, year	Country	Diagnostic criteria	Sample size, n	Duration	Intervention arm	Control arm	Outcomes
Esmaeilinezhad et al., 2019 16	Iran	Rotterdam	46	8 weeks	Lactobacillus rhamnosus GG, Bacillus coagulans, Bacillus indicus	Unknown	HOMA-IR, weight, BMI, waist, hip, FBS, insulin, QUICKI, testosterone, LH, FSH, LH/FSH
Karimi et al., 2018 12	Iran	Rotterdam	99	12 weeks	Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus bulgaricus, Lactobacillus rhamnosus, Bifidobacterium longus, Bifidobacterium breve, Streptococcus thermophilus	Placebo capsules containing starch and maltodextrin, but no bacteria	FBS, FPG, glycohemoglobin, insulin, CRP/HOMA-IR, QUICKI, apelin36
Samimi et al., 2019 14	Iran	Rotterdam	60	12 weeks	Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum	Placebo	FPG, insulin, HOMA-IR, QUICKI, TC, TG, LDL-C, HDL-C
Shoaei et al., 2015 17	Iran	Rotterdam	65	8 weeks	Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus rhamnosus Lactobacillus, Bulgaricus, Bifidobacterium breve, Bifidobacterium longum, Streptococcus thermophiles	Placebo containing starch and maltodextrins but no bacteria	FBS, insulin, HOMA-IR, QUICKI, CRP
Gholizadeh Shamasbi et al., 2019 18	Iran	Rotterdam	62	3 months	20 g of prebiotic	Placebo (maltodextrin)	BMI, weight, hip, waist
Karimi et al., 2020 19	Iran	Rotterdam	99	12 weeks	Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus bulgaricus, Lactobacillus rhamnosus, Bifidobacterium longum, Bifidobacterium breve, Streptococcus thermophilus	Placebo capsules containing starch and maltodextrin but no bacteria	Weight, BMI, waist, hip, blood pressure systolic, blood pressure diastolic, TC, TG, LDL-C, HDL-C
Chen et al., 2018 20	China	Rotterdam	55	12 weeks	Bifid triple viable combined with metformin	Metformin	Weight, BMI, FBS, FSI, HOMA-IR, TC, TG, HDL-C, LDL-C

HOMA-IR, homeostatic model assessment of insulin resistance; BMI, body mass index; CRP, C-reactive protein; FBS, fasting blood sugar; QUICKI, quantitative insulin sensitivity check index; LH, luteinizing hormone; FSH, follicle-stimulating hormone; FPG, fasting plasma glucose; CRP, C-reactive protein; TC, total cholesterol; TG, triglycerides; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol.