Abstract

INTRODUCTION: Polycystic Ovarian Syndrome (PCOS) affects 18-22% women of reproductive age. We conducted a systematic review and meta-analysis to quantify expected benefits of lifestyle (exercise and dietary) interventions on various clinical outcomes in PCOS.

METHODS: Potential studies were identified by conducting systematic search of Pub Med, CINAHL and Cochrane controlled trials registry (1966 to April 2013) using key concepts of PCOS, exercise, dietary and lifestyle interventions.

RESULTS: Significant improvements were seen in women who received lifestyle intervention versus usual care, in body composition parameters of body mass index (BMI), mean difference (MD) -1.12 kg.m-2 (95%CI -0.22 to -0.03, P=0.009), body weight MD -3.42 kg (95%CI -4.86 to -1.99, P<0.00001), waist circumference MD -1.64 cm (95%CI -2.09 to -1.19, P<0.00001), waist hip ratio MD -0.03 (95%CI -0.05 to -0.01, P=0.0002) and body fat % MD -1.71% (95%CI -3.10 to -0.32, P=0.02). Insulin improved significantly, MD -1.10 pmol/L (95%CI -2.05 to -0.16, P=0.02). Lipid profile improved, total cholesterol MD -0.09 mmol/L (95%CI -0.14 to -0.04, P=0.0007) and low density lipoprotein (LDL) MD -0.15 mmol/L (95%CI -0.23 to -0.07, P=0.0003). C-reactive protein (CRP) was significantly lower, MD -0.47 mmol/L (95%CI -0.80 to -0.15, P=0.004). Significant improvements were also observed in cardio-respiratory fitness with resting heart rate MD -1.89 beats.min-1 (95%CI -2.90 to -0.88, p=0.0002) and peak VO2 MD 5.09 ml.kg-1 .min-1 (95% CI 3.13 to 7.05, P<0.00001).

CONCLUSIONS: Our analyses suggest lifestyle intervention is optimal for improving body composition parameters, insulin, total and LDL-cholesterol, CRP and cardio-respiratory fitness in women with PCOS.