The effect of lifestyle interventions in women with polyendocrine metabolic ovarian syndrome: A systematic review and meta-analysis

The systematic review and meta-analysis study explores the effectiveness of lifestyle interventions in women with polyendocrine metabolic ovarian syndrome (PMOS). Lifestyle interventions are generally recommended as the first-line treatment for PMOS, but their impact on various outcomes remains uncertain. The study aimed to evaluate the effectiveness of lifestyle interventions on reproductive, anthropometric, and metabolic outcomes.

The research team conducted a search across several databases, including Medline, EMBASE, All EBM, PsycInfo, and CINAHL, to identify studies that compared lifestyle interventions with minimal or no treatment (usual care) in women with PMOS. A total of 34 studies, involving 1,871 participants, met the inclusion criteria. The pooled analyses revealed that women who participated in lifestyle interventions were more likely to achieve regular menstrual cycles, with an odds ratio (OR) of 4.03 (95% CI [1.16, 14.05]; I² = 73%, 5 studies, 237 women) compared to those who had minimal or no treatment.

Furthermore, lifestyle interventions were associated with reduced waist circumference (mean difference (MD) −2.38; 95% CI [−4.68, −0.08]; I² = 90%, 18 studies, 915 women) and fasting glucose levels (MD −0.13; 95% CI [−0.25, −0.02]; I² = 86%, 22 studies, 1,045 women) compared to usual care. Additionally, fasting insulin levels were also lower in women who followed lifestyle interventions (MD −6.08; 95% CI [−9.86, −2.30]; I² = 71%, 18 studies, 824 women).

Subgroup analyses indicated that diet interventions had a more significant impact on reducing fasting glucose levels, while exercise was the most effective method for reducing waist circumference and fasting insulin levels. Women with PMOS who were overweight or obese experienced greater reductions in weight, waist-to-hip ratio, fasting glucose, fasting insulin, total testosterone, total cholesterol, and low-density lipoprotein levels as a result of lifestyle interventions.

Despite the promising findings, the study highlighted the high between-study heterogeneity in pooled estimates across many outcomes, which may limit the generalizability of the results. Nevertheless, the study supports the international recommendation that lifestyle interventions should be considered as first-line treatment for PMOS, tailored to individual needs.