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Introduction and aim <p>Although exercise training is beneficial to patients with polycystic ovary syndrome (PCOS), its impact on cardiometabolic health remains uncertain. Therefore, the objective of the current systematic review with pairwise and network meta-analyses was to investigate the efficacy of different modes of exercise in improving glucose homeostasis, lipid profiles, and systemic inflammation.</p> Methods <p>Three electronic databases, including PubMed, Web of Science, and Scopus were searched in the English language for publications from inception to July 2025. Randomized control trials comparing the effects of exercise training, including aerobic (AT), resistance (RT), combined (CT), or high-intensity interval training (HIIT), Yoga/Tai Chi with non-exercise controls (CON) or another exercise modality on markers of glucose homeostasis, lipid profiles, and C-reactive protein (CRP) were included in the meta-analyses. Weighted mean differences (WMD) or standardized mean differences (SMD) along with 95% confidence intervals (95% CIs), were determined using random-effects models.</p> Results <p>Twenty-five studies involving 1, 107 participants with mean ages from 18 to 34 years, were included. Exercise training reduced fasting insulin [SMD: -0.28, <i>p</i> = 0.01], Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) [SMD: -0.50, <i>p</i> = 0.008], triglycerides (TG) [WMD: -2.70&#xa0;mg/dl, <i>p</i> = 0.01], total cholesterol (TC) [WMD: -3.74&#xa0;mg/dl, <i>p</i> = 0.04], and CRP [SMD: -0.61, <i>p</i> = 0.001], significantly more than CON, but no significant differences were observed for fasting glucose, low-density lipoprotein (LDL), or high-density lipoprotein (HDL). Based on network meta-analysis, Yoga/Tai Chi reduced fasting glucose [WMD: -5.54&#xa0;mg/dL, <i>p</i> = 0.001], AT reduced HOMA-IR [SMD: -0.57, <i>p</i> = 0.03], and CRP [SMD: -0.82, <i>p</i> = 0.001], HIIT reduced fasting insulin [SMD: -0.38, <i>p</i> = 0.03], HOMA-IR [SMD: -0.56, <i>p</i> = 0.05] and LDL [WMD: -6.45&#xa0;mg/dl, <i>p</i> = 0.01], and CT reduced TG [WMD: -3.61&#xa0;mg/dl, <i>p</i> = 0.004] and LDL [WMD: -8.40&#xa0;mg/dl, <i>p</i> = 0.01] significantly more than CON.</p> Conclusion <p>Exercise training may be effective for improving glycemic control, lipid profiles, and systemic inflammation among women with PCOS. Among exercise modes examined, AT and HIIT appeared to be the most effective for improving glucose homeostasis, AT for reducing systemic inflammation, and CT for improving lipid profiles (PROSPERO ID: CRD420251127315).</p>

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Comparative efficacy of exercise modes on cardiometabolic health in women with polycystic ovary syndrome: a systematic review with pairwise and network meta-analyses

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  • 发表日期：

    2026年1月3日

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  • Mousa Khalafi,
  • Saeid Fatolahi,
  • Ghodsieh Rahmatpanah,
  • Michael E. Symonds,
  • Sara K. Rosenkranz,
  • Farnaz Dinizadeh,
  • Alexios Batrakoulis

摘要

Introduction and aim

Although exercise training is beneficial to patients with polycystic ovary syndrome (PCOS), its impact on cardiometabolic health remains uncertain. Therefore, the objective of the current systematic review with pairwise and network meta-analyses was to investigate the efficacy of different modes of exercise in improving glucose homeostasis, lipid profiles, and systemic inflammation.

Methods

Three electronic databases, including PubMed, Web of Science, and Scopus were searched in the English language for publications from inception to July 2025. Randomized control trials comparing the effects of exercise training, including aerobic (AT), resistance (RT), combined (CT), or high-intensity interval training (HIIT), Yoga/Tai Chi with non-exercise controls (CON) or another exercise modality on markers of glucose homeostasis, lipid profiles, and C-reactive protein (CRP) were included in the meta-analyses. Weighted mean differences (WMD) or standardized mean differences (SMD) along with 95% confidence intervals (95% CIs), were determined using random-effects models.

Results

Twenty-five studies involving 1, 107 participants with mean ages from 18 to 34 years, were included. Exercise training reduced fasting insulin [SMD: -0.28, p = 0.01], Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) [SMD: -0.50, p = 0.008], triglycerides (TG) [WMD: -2.70 mg/dl, p = 0.01], total cholesterol (TC) [WMD: -3.74 mg/dl, p = 0.04], and CRP [SMD: -0.61, p = 0.001], significantly more than CON, but no significant differences were observed for fasting glucose, low-density lipoprotein (LDL), or high-density lipoprotein (HDL). Based on network meta-analysis, 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 TG [WMD: -3.61 mg/dl, p = 0.004] and LDL [WMD: -8.40 mg/dl, p = 0.01] significantly more than CON.

Conclusion

Exercise training may be effective for improving glycemic control, lipid profiles, and systemic inflammation among women with PCOS. Among exercise modes examined, AT and HIIT appeared to be the most effective for improving glucose homeostasis, AT for reducing systemic inflammation, and CT for improving lipid profiles (PROSPERO ID: CRD420251127315).