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Health-related physical fitness in women with polycystic ovary syndrome versus controls: a systematic review and meta-analysis

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Abstract

Introduction

Polycystic ovary syndrome (PCOS) is a common endocrinopathy associated with cardiometabolic dysfunction.

Purpose

(1) To compare HRPF indices, including cardiorespiratory fitness (CRF), muscle strength, and muscle endurance, between women with and without PCOS (i.e., controls). (2) To explore the impact of moderating factors, i.e., insulin sensitivity, androgen levels, physical activity levels, and body mass index, on these indices.

Methods

Articles comparing HRPF between PCOS and control groups were identified until February 27th, 2022. Random-effects meta-analyses were conducted and moderating factors were explored with subgroup and meta-regression analyses.

Results

Twenty studies were included. Compared to controls, CRF was lower in women with PCOS (n = 15, − 0.70 [− 1.35, − 0.05], P = 0.03, I2 = 95%). Meta-regression analyses demonstrated that fasting insulin (P = 0.004) and homeostatic model assessment of insulin resistance (P = 0.006) were negatively associated with CRF, while sex-hormone binding globulin levels (P = 0.003) were positively associated. Absolute muscle strength was not different between PCOS and controls (n = 7, 0.17 [− 0.10, 0.45], P = 0.22, I2 = 37%). One study evaluated muscle endurance and reported lower core endurance in PCOS subjects compared to controls.

Conclusion

These data suggest that PCOS may be associated with impaired CRF. It remains unclear whether muscle strength and endurance differ between women with PCOS and controls. As this data set was limited by a small sample size, potential for bias, and inconsistent findings, additional studies accounting for the heterogeneous presentation of PCOS as well as improved matching between PCOS and controls for characteristics known to affect HRPF would help elucidate the impact of PCOS on indices of HRPF.

PROSPERO registration number

CRD42020196380.

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Availability of data and materials

All data analyzed during this study are included in this published article and supplementary information file. Please direct further data inquiries to the corresponding author.

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Acknowledgements

The authors would like to acknowledge M.M. Leyne for her contributions to the development of this publication by assisting with the screening process.

Funding

The authors would like to acknowledge the following funding sources: The Fonds de recherche Santé (FRQS), the Fondation des maladies du cœur et de l’AVC du Québec (FMCQ), and the Canadian Institutes of Health Research (CIHR). C.W.U. holds the FRQS Établissement de jeunes chercheurs (Junior 1) from the FRQS in partnership with the FMCQ. D.C. was funded by the CIHR through the Frederick Banting and Charles Best Canada Graduate Scholarship-Master’s award. J.C.G. holds the FRQS Établissement de jeunes chercheurs (Junior 1) from the FRQS.

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Author notes

  1. Joint senior authorship: Jenna C. Gibbs and Charlotte W. Usselman.

Authors and Affiliations

  1. Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Canada

    Domenica Cirone, Danielle E. Berbrier & Charlotte W. Usselman

  2. Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada

    Jenna C. Gibbs

  3. McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Canada

    Charlotte W. Usselman

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  1. Domenica Cirone
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Contributions

This study constitutes the master’s thesis of D.C. The conception and design of the study was primarily performed by D.C. with assistance from D.E.B. as well as J.C.G. and C.W.U. The literature search was performed by D.C., the screening and quality assessment process was performed by D.C. and D.E.B. with assistance from M.M.L.; D.C. performed all data analyses. The original draft of the manuscript was written by D.C. and all authors contributed to the subsequent editing and reviewing of the manuscript. D.C. was formally supervised by C.W.U. and informally supervised by J.C.G.

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Correspondence to Charlotte W. Usselman.

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Cirone, D., Berbrier, D.E., Gibbs, J.C. et al. Health-related physical fitness in women with polycystic ovary syndrome versus controls: a systematic review and meta-analysis. Arch Gynecol Obstet 309, 17–36 (2024). https://doi.org/10.1007/s00404-023-07004-w

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