Patten Rhiannon K, Boyle Russell A, Moholdt Trine, Kiel Ida, Hopkins William G, Harrison Cheryce L, Stepto Nigel K
Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Front Physiol. 2020 Jul 7;11:606. doi: 10.3389/fphys.2020.00606. eCollection 2020.
Polycystic ovary syndrome (PCOS) is a common and complex endocrinopathy with reproductive and metabolic manifestations. Exercise training has consistently been found to result in improved clinical outcomes in women with PCOS, but shortfalls with exercise prescription are evident. The aim of this systematic review and meta-analysis was to identify exercise intervention characteristics that provide favourable outcomes in women with PCOS. A systematic review of published literature was conducted using EBSCOhost and Ovid Medline up to May 2019. The review adheres to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines as per our PROSPERO protocol (CRD42018088367). Randomised controlled trials, non-randomised controlled trials, and uncontrolled trials that evaluated an exercise intervention of at least moderate intensity in women with PCOS were included. Meta-analyses were performed using general linear mixed modelling and Bayesian inferences about effect magnitudes. Thirty-three articles were identified for systematic review of which 19 were meta-analysed. Intervention duration ranged from 6 to 26 weeks. A total number of 777 women were included in the meta-analysis. The meta-analysis found that improvements in health outcomes are more dependent on exercise intensity rather than dose. Fixed effects analysis reported a moderate increase in VO (24.2%; 90% CL, 18.5-30.1), and small reductions in HOMA-IR (-36.2%; 90% CL, -55.3 to -9.0), and waist circumference (-4.2%; 90% CL -6.0 to -2.3) as a result of vigorous intensity exercise. These results are confirmed in the predicted analysis which reported the greatest improvements in VO, BMI, and waist circumference after vigorous intensity exercise alone or when combined with diet, particularly for women with clinically adverse baseline values. Exercise training in the management of PCOS is becoming more common. Results from our analysis support the use of exercise and suggest that vigorous intensity exercise may have the greatest impact on cardiorespiratory fitness, body composition, and insulin resistance. Our results indicate that, a minimum of 120 min of vigorous intensity per week is needed to provide favourable health outcomes for women with PCOS with studies of longer duration required to evaluate outcomes with sustained exercise.
多囊卵巢综合征（PCOS）是一种常见且复杂的内分泌疾病，具有生殖和代谢方面的表现。一直以来，运动训练被发现可改善PCOS女性的临床结局，但运动处方存在明显不足。本系统评价和荟萃分析的目的是确定能为PCOS女性带来良好结局的运动干预特征。使用EBSCOhost和Ovid Medline对截至2019年5月发表的文献进行了系统评价。该评价遵循我们的PROSPERO方案（CRD42018088367）中的系统评价和荟萃分析优先报告项目（PRISMA）指南。纳入了评估PCOS女性至少中等强度运动干预的随机对照试验、非随机对照试验和非对照试验。使用一般线性混合模型和关于效应量的贝叶斯推断进行荟萃分析。共识别出33篇文章进行系统评价，其中19篇进行了荟萃分析。干预持续时间为6至26周。荟萃分析共纳入777名女性。荟萃分析发现，健康结局的改善更多地取决于运动强度而非运动量。固定效应分析报告，剧烈强度运动使VO适度增加（24.2%；90%可信区间，18.5 - 30.1），HOMA-IR小幅降低（-36.2%；90%可信区间，-55.3至-9.0），腰围降低（-4.2%；90%可信区间，-6.0至-2.3）。这些结果在预测分析中得到证实，该分析报告，单独进行剧烈强度运动或与饮食相结合时，VO、BMI和腰围改善最为明显，尤其是对于基线值临床不良的女性。运动训练在PCOS管理中越来越普遍。我们的分析结果支持运动的使用，并表明剧烈强度运动可能对心肺适能、身体成分和胰岛素抵抗产生最大影响。我们的结果表明，每周至少需要120分钟的剧烈强度运动才能为PCOS女性带来良好的健康结局，需要更长时间的研究来评估持续运动的结局。
