Table 2.
Summary table of randomized controlled trials assessed for the International Evidence-based Guidelines Clinical Consensus Statement (Table 3) [58, 59]
| Study | Design | Exercise N (total N) | Participant characteristics | PCOS diagnostic criteria | Intervention characteristics | Comparison | Cardiorespiratory and body composition outcomes | Cardio-metabolic outcomes |
Hormonal reproductive outcomes |
|---|---|---|---|---|---|---|---|---|---|
| Almenning et al. [64] | RCT | HIIT = 8 RT = 8 (25) |
Age = 27.2 HIIT BMI = 26.1 ±6.5 RT BMI = 27.4±6.9 |
Rotterdam | Type: HIIT or RT Frequency: 3/week Intensity: Vigorous Duration: 10 weeks Supervision: Partial |
Usual care - standard exercise recommendations | HIIT: ↑ V02peakNo change in RT: V02peak HIIT:↓ BF %, ↓ FM No change in weight, BMI, WC FFM RT: ↓ BF % ↑ FFM No change in weight, BMI, WC FM |
HIIT: ↓ HOMA-IR, ↓ Fasting Insulin, ↑ HDL, ↑ endothelial function No change in fasting glucose, TC, LDL. RT: No change in fasting glucose, fasting insulin, HOMA-IR, TC, HDL, LDL |
HIIT: ↓ DHEAS No change in T, FAI, AMH, SHBG. RT: ↓ AMH ↑ SHBG, ↓ FAI No change in T, DHEAS |
| Brown et al. [68] | RCT | 8 (20) | Age = 36.5 (IQR-5) BMI = 37.9 (IQR-9.4) |
NIH | Type: Aerobic Frequency: 3–5/week Intensity: Moderate (50% VO2max) Duration: 20–24 weeks Supervision: Full |
Control group | ↑ VO2peak No change in weight, BMI, WC |
No change in HOMA-IR, fasting glucose, fasting insulin, AUCglucose, AUCinsulin. | Not measured |
| Bruner et al. [65] | RCT (pilot) | 7(12) | Age = 32.3 ±1 BMI = 36.2±2 |
Rotterdam | Type: Aerobic and RT (1/week nutrition sessions) Frequency: 3/week Intensity: Vigorous (70–85% HRmax) Duration: 12 weeks Supervision: Full |
Nutritional counselling only | ↑ VO2peak ↓ WC. No change in weight, BMI |
↓ Fasting Insulin. No change in LDL, HDL, TC |
No change in T, SHBG, FAI |
| Hoegar et al. [69] | RCT | 11 (23) | Age = 29.4±5.7 BMI = 39.7±7.1 |
NIH | Type: N/R Frequency: N/R Intensity: N/R Duration: 48 weeks Supervision: None |
Metformin, lifestyle modification plus metformin, or placebo alone | VO2peak not measured ↓ Weight | No change in AUCglucose or AUCinsulin | No change in T, SHBG, FAI. |
| Ladson et al. [70] | RCT | 59(114) | Age = 28.8 ±4.6 BMI = 38.3±8 |
NIH | Type: Aerobic Frequency: ≥ 2/week Intensity: N/R Duration: 26 weeks Supervision: Partial |
Metformin plus caloric restriction and exercise | No Change in VO2peak ↓ WC |
↑ AUCglucose, ↑ HDL No change in Fasting glucose, Fasting insulin, AUCinsulin, cholesterol, LDL |
No Change in T, SHBG, FAI, E, LH, FSH |
| Nybacka et al. [47–49] | RCT (and secondary analysis of RCT) | Exercise = 17, Diet and exercise =12 (43) | (2011) Age = 31.8±4.9 BMI = 34.9±5.3 (2013) Age = 31.3±4.8 BMI = 34.8±5.2 |
Rotterdam | Type: Aerobic (bike or treadmill) Frequency: 2–3/week Intensity: Moderate Duration: 16 weeks Supervision: Full |
Diet only | VO2peak not measured ↓ BMI ↓ Upper body fat ↓ WC |
No change in HOMA, fasting glucose, fasting insulin, ↓ CRP |
No change in FAI, T, SHBG, AMH, LH, FSH |
| Orio et al. [71] | RCT | 39 (150) | Age = 25.9±2.7 BMI = 26.7±2.8 |
NIH | Type: Aerobic (cycling) Frequency: 3/week Intensity: Vigorous (60–70% VO2max) Duration: 26 weeks Supervision: Full |
Oral contraceptives | ↑ VO2peak ↓ BMI, ↓ W/H ratio |
↓ Fasting Insulin, ↓ HOMA, ↓ AUCinsulin, ↓ TC, ↑ HDL, ↓ LDL No change in AUCglucose, Facing glucose |
No change in FAI, SHBG, T, E, P, LH, FSH, A, DHEAS |
| Stener-Victorin et al. [72] | RCT | 5 (20) | Age = 30.4 ±5.5 BMI = 26.8±4.8 |
Rotterdam | Type: Aerobic (walking) Frequency: 3/week Intensity: Light Duration: 16 weeks Supervision: None |
Low frequency electroacupuncture or control group | VO2peak not measured ↓ Weight, ↓ BMI |
↓ HOMA-IR, ↓ Fasting Insulin No change in Fasting glucose |
↑ SHBG, ↑ FAI No change in T |
| Jedel et al. [73] Stener-Victorin et al. [74] |
RCT and Prospective RCT | 15 (30) | Age = 30.2 ±4.9 BMI = 27.7±6.4 |
Rotterdam | Type: Aerobic Frequency: 3/week Intensity: Moderate Duration: 16 weeks Supervision: None |
Low frequency electroacupuncture or control group | ↑ VO2peak ↓ Weight, ↓ WC, No change in BMI |
Not measured | ↓ T, ↑ SHBG, ↑ LH, ↑ FSH No change in DHEA |
| Thomson et al. [43,75] | RCT Secondary analysis of RCT |
Diet and aerobic exercise = 18, Diet, and combined exercise =20 (52) | (2008) Age = 29.3 ±6.8 BMI = 36.1 ±4.8 (2016) Age = 30.3 ±6.2 BMI = 36.4±5.6 |
Rotterdam | Type: Aerobic, or combined aerobic and RT Frequency: 5/week Intensity: Moderate (50–75% of 1RM) Duration: 20 weeks Supervision: N/R |
Diet only group | ↑ VO2peak ↓ Weight, ↓ WC, ↓ FM, ↓ BF % |
↓ Fasting glucose, ↓ Fasting insulin, ↓ HOMA-IR, ↓ BP, ↓ Lipids | ↓ T, ↓ FAI, ↑ SHBG |
| Vigorito et al. [76] | RCT | 45 (90) | Age = 21.7±2.3 BMI = 29.3±2.9 |
Rotterdam | Type: Aerobic Frequency: 3/week Intensity: Vigorous (60–70% VO2max) Duration: 12 weeks Supervision: Full |
Usual care with given standard exercise recommendations | ↑ VO2peak ↓ WC, ↓ BMI, ↓ W/H ratio |
↓ Fasting Insulin, ↓ AUCinsulin, ↓ AUCglucose/AUCinsulin ratio, ↓ CRP No change in Fasting glucose, AUCglucose |
No change in FSH, LH, E, P, T, SHBG, FAI |
HIIT high intensity interval training, RT resistance training, HRmax maximal heart rate, PCOS polycystic ovary syndrome, N/R not reported, ↑ increase, ↓ decrease, VO2peak peak oxygen consumption, BMI body mass index, WC waist circumference, W/H waist to hip ratio, FM fat mass, FFM fat free mass, BF % body fat percentage, AUC area under the curve, HOMA-IR Homeostatic Model Assessment of Insulin Resistance, TC total cholesterol, HDL high density lipoproteins, LDL low density lipoproteins, hsCRP high sensitivity C-reactive protein, FSH follicle stimulating hormone, LH luteinizing hormone, SHBG sex hormone binding globulin, T testosterone, FAI free androgen index, P progesterone, E estradiol, A androstenedione, AMH anti Mullerian hormone, DHEA dehydropiandrosterone