Healthcare (Basel, Switzerland) · 2025
The Effects of Different Exercises on Insulin Resistance and Testosterone Changes in Women with Polycystic Ovarian Syndrome: A Network Meta-Analysis Study.
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Tan Yuandan, Liu Yujie, Koga Ami, Yuan Yuling, Yu Haohan, Liu Jingmin
Аннотация
OBJECTIVE: To compare the efficacy of exercise modalities for simultaneously improving homeostasis model assessment for insulin resistance (HOMA-IR) and total testosterone in women with polycystic ovary syndrome (PCOS).
METHODS: We conducted a Bayesian network meta-analysis of 19 randomized controlled trials (n = 808) to evaluate six exercise interventions: yoga, moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), resistance training (RT), combined aerobic-resistance training (CT), and control (CG). Primary outcomes were changes in HOMA-IR and total testosterone, with interventions ranked via surface under the cumulative ranking curve (SUCRA).
RESULTS: For HOMA-IR reduction, yoga (SUCRA = 90.73%; SMD = -0.73, 95% CrI: -1.3 to -0.086) and HIIT (SUCRA = 74.12%; SMD = -0.47, 95% CrI: -0.75 to -0.15) demonstrated superior efficacy versus MICT (SUCRA = 50.56%) and CT (SUCRA = 42.29%), while RT was the least effective (SUCRA = 32.53%). For testosterone lowering, yoga was ranked the highest again (SUCRA = 92.46%; SMD = -0.85, 95% CrI: -1.7 to -0.12), followed by MICT (SUCRA = 75.72%; SMD = -0.56, 95% CrI: -0.97 to -0.25) and HIIT (SUCRA = 61.12%; SMD = -0.42, CrI: -0.88 to -0.12). CT and RT showed non-significant effects for both outcomes (p > 0.05).
CONCLUSIONS: Yoga is the optimal intervention for dual-pathway improvement in PCOS. HIIT and MICT provide outcome-specific benefits (metabolic vs. endocrine), whereas CT and RT necessitate protocol refinement.
SYSTEMATIC REVIEW REGISTRATION: This systematic review and network meta-analysis study was registered in PROSPERO (CRD420251011979).
METHODS: We conducted a Bayesian network meta-analysis of 19 randomized controlled trials (n = 808) to evaluate six exercise interventions: yoga, moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), resistance training (RT), combined aerobic-resistance training (CT), and control (CG). Primary outcomes were changes in HOMA-IR and total testosterone, with interventions ranked via surface under the cumulative ranking curve (SUCRA).
RESULTS: For HOMA-IR reduction, yoga (SUCRA = 90.73%; SMD = -0.73, 95% CrI: -1.3 to -0.086) and HIIT (SUCRA = 74.12%; SMD = -0.47, 95% CrI: -0.75 to -0.15) demonstrated superior efficacy versus MICT (SUCRA = 50.56%) and CT (SUCRA = 42.29%), while RT was the least effective (SUCRA = 32.53%). For testosterone lowering, yoga was ranked the highest again (SUCRA = 92.46%; SMD = -0.85, 95% CrI: -1.7 to -0.12), followed by MICT (SUCRA = 75.72%; SMD = -0.56, 95% CrI: -0.97 to -0.25) and HIIT (SUCRA = 61.12%; SMD = -0.42, CrI: -0.88 to -0.12). CT and RT showed non-significant effects for both outcomes (p > 0.05).
CONCLUSIONS: Yoga is the optimal intervention for dual-pathway improvement in PCOS. HIIT and MICT provide outcome-specific benefits (metabolic vs. endocrine), whereas CT and RT necessitate protocol refinement.
SYSTEMATIC REVIEW REGISTRATION: This systematic review and network meta-analysis study was registered in PROSPERO (CRD420251011979).