Comparative efficacy of exercise modes on cardiometabolic health in women with polycystic ovary syndrome: a systematic review with pairwise and network meta-analyses.
Level 1 - systematic review of randomized trials
Systematic review with pairwise and network meta-analyses of randomized controlled trials
PubMed 41484603 · doi:10.1186/s12905-025-04240-x
What was done
A systematic review and pairwise/network meta-analysis searched PubMed, Web of Science, and Scopus through July 2025 for randomized controlled trials in women with polycystic ovary syndrome (PCOS). Interventions included aerobic training (AT), resistance training (RT), combined training (CT), high-intensity interval training (HIIT), and Yoga/Tai Chi compared against non-exercise controls or another exercise modality. Primary outcomes were markers of glucose homeostasis, lipid profiles, and C-reactive protein (CRP), analyzed using random-effects models.
What was found
Across 25 RCTs involving 1,107 participants (mean ages 18 to 34 years), exercise overall significantly reduced fasting insulin (SMD: -0.28, p = 0.01), HOMA-IR (SMD: -0.50, p = 0.008), triglycerides (WMD: -2.70 mg/dL, p = 0.01), total cholesterol (WMD: -3.74 mg/dL, p = 0.04), and CRP (SMD: -0.61, p = 0.001) compared to controls, with no significant differences for fasting glucose, LDL, or HDL. In network meta-analyses versus control, Yoga/Tai Chi reduced fasting glucose (WMD: -5.54 mg/dL, p = 0.001); AT reduced HOMA-IR (SMD: -0.57, p = 0.03) and CRP (SMD: -0.82, p = 0.001); HIIT reduced fasting insulin (SMD: -0.38, p = 0.03), HOMA-IR (SMD: -0.56, p = 0.05), and LDL (WMD: -6.45 mg/dL, p = 0.01); and CT reduced triglycerides (WMD: -3.61 mg/dL, p = 0.004) and LDL (WMD: -8.40 mg/dL, p = 0.01).
Why it matters
This review helps guide exercise prescription in PCOS by demonstrating that AT and HIIT are most effective for glycemic control and inflammation, whereas combined training is superior for lipid improvements.
Limits
The abstract omits confidence intervals, intervention durations, exercise volume/intensity parameters, and adherence rates. Individual trials were relatively small (average ~44 participants per study), literature searches were limited to English-language publications, and the population was restricted to young women (mean ages 18–34).
Cited by
- supports Sprint interval training and high-intensity interval training improve glucose disposal and insulin management in individuals with PCOS.