title: Reproductive and metabolic abnormalities in women taking valproate for bipolar disorder: a meta-analysis.
abstract: OBJECTIVE
  We aimed to evaluate the relationship between valproate (VPA) and reproductive endocrine abnormalities in women with bipolar disorder.
  
  
  METHODS
  We searched studies in electronic databases of China Biology Medicine disc, PubMed, and Embase. Two authors collected articles and extracted data independently. Meta-analysis was performed for polycystic ovary syndrome (PCOS) and its components. The mean difference (MD) and 95% confidence interval (CI) were used to compare continuous variables. The Mantel-Haenszel formula was used to calculate the odds ratio (OR).
  
  
  RESULTS
  There were statistically significant differences between the VPA treated and non-VPA treated groups in PCOS (OR 6.74; 95% CI 1.66-27.32; P=0.00), menstrual disorder (OR 1.81; 95% CI 1.02-3.23; P=0.04), and hyperandrogenism (HA) (OR 2.02; 95% CI 1.11-3.65; P=0.02). There was no statistically significant difference between the VPA treated and non-VPA treated groups in PCO (OR 1.37; 95% CI 0.71-2.66; P=0.35). The overall risk of menstrual disorders, PCO, and HA in the VPA treated group was higher than in the non-VPA treated group (OR 1.75; 95% CI 1.23-2.47; P=0.00). The levels of total and free testosterone in the VPA treated group were higher than in the non-VPA treated group (MD 0.12; 95% CI 0.05-0.19; P=0.00; MD 0.14, 95% CI 0.07-0.21; P=0.00, respectively).
  
  
  CONCLUSIONS
  VPA was associated with the elevated levels of testosterone and HA in women with BD.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Sichuan, China.
authors.forename: Shaoping
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Sichuan, China. Electronic address: xiaoyizou@163.com.
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Zou
mesh_terms: D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000139:chemically induced*; D008599:Menstruation Disturbances / Q000097:blood / Q000139:chemically induced*; D008659:Metabolic Diseases / Q000139:chemically induced*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000139:chemically induced*; D013739:Testosterone / Q000097:blood; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D013739:Testosterone; D014635:Valproic Acid
keywords: Bipolar disorder; Meta-analysis; Polycystic ovary syndrome; Valproate