Dissecting the Role of Micro-RNAs As a Diagnostic Marker for Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis

Objective: To investigate the clinical diagnostic value and role of micro-RNAs (miRNAs) in the pathogenesis of polycystic ovary syndrome (PCOS).

Design: Systematic review and meta-analysis.

Setting: Not applicable.

Patient(s): Patients were women of reproductive age with PCOS and controls.

Intervention(s): Summary odds ratio was calculated using a random effects model.

Main Outcome Measure(s): Association of micro-RNAs with PCOS.

Method(s): An electronic literature search was conducted using PubMed, Scopus, and Google Scholar databases to identify all relevant studies up to May 2019. A random effects model was used to conduct a meta-analysis. Fold change and P values were used to pool effect size. A funnel plot was used to assess publication bias. Quality score was calculated using the QUADAS scale. Subgroup analysis was based on tissue type. Odds ratios, 95% confidence intervals, and P values were estimated using meta-analysis. Metaregression was performed for correlating covariates with effect size. Area under the curve and receiver operating characteristic analysis was done to assess diagnostic performance accuracy of miRNAs in PCOS.

Result(s): Twenty-one studies with a total of 79 miRNAs were included initially. Only three miRNAs (miR-29a-5p, miR-320, miR-93) are reported in more than three studies as of December 2018, so 12 studies were finally included in the quantitative analysis of meta-analysis and 21 studies were involved in the systematic review. The micro-RNAs miR-29a-5p and miR-320 were found to be significantly associated with PCOS. Funnel plot revealed an absence of publication bias for miR-29a-5p and miR-320. Receiver operating characteristic analysis with an area under the curve value of 0.95 proved miR-29a-5p to be the better diagnostic marker of PCOS.

Conclusion(s): Aberrant expression of various miRNAs plays an important role in PCOS pathogenesis. Micro-RNAs hold potential diagnostic value for PCOS. These findings may offer new insights for PCOS pathogenesis research.

Prospero Registration Number: CRD42018106198.