The effect of exercise training on metabolic factors in women with polycystic ovary syndrome: A systematic review and meta-analysis

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, which is associated with insulin resistance. The present systematic review and meta-analysis study was conducted with aim to investigate the effect of exercise training on metabolic factors in women with PCOS.

In this study, a systematic search was conducted in PubMed, Web of Science, SID, Magiran, and Google Scholar databases for English and Persian articles published until September 2022. Meta-analysis was performed to investigate the impact of exercise training on fasting blood glucose, insulin, insulin resistance index (HOMA-IR), fat percentage and body fat mass in women with PCOS. Standardized mean differences (SMD) or weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using random effect model. Also, I2 test was used to determine heterogeneity, and funnel plot and Egger test were used to evaluate publication bias.

Exercise training caused a significant decrease in insulin [SMD=-0.47, -0.79 to -0.15, P=0.004], HOMA-IR [WMD=-0.57, -1.02 to -0.12, P=0.01), and body fat percentage [WMD=-1.89, -3.36 to -0.42, P=0.01] in women with PCOS; but exercise did not change fasting glucose [WMD=0.65, -2.17 to 3.47, P=0.65] and body fat mass [WMD=-1.58, -3.88 to 0.7, P=0.17].

Exercise reduces body fat percentage, fasting insulin, and insulin resistance in PCOS patients. It is noteworthy that both types of aerobic and resistance training reduce fasting insulin in these patients, but the impact of resistance training is greater than aerobic exercise. Therefore, exercise is recommended as a non-drug solution to improve body composition, reduce insulin resistance and prevent diabetes for women with PCOS.