Efeitos da atividade física em mulheres com síndrome dos ovários policísticos: revisão sistemática e metanálise

Abstract

Polycystic Ovary Syndrome (PCOS) affects 5% to 20% of women of reproductive age, leading to metabolic, hormonal, and reproductive complications. Although physical exercise is beneficial for PCOS management, the specific impact of exercise on clinical outcomes remains uncertain. This systematic review and meta-analysis assessed the effects of aerobic and resistance exercise on BMI, insulin levels, lipid profiles, and hormonal parameters in women with PCOS. The objective of the study was to synthesize available evidence on the effects of aerobic and resistance exercise on BMI, insulin levels, lipid profiles, and hormonal parameters in women with PCOS. Data sources included PubMed, Web of Science, and Embase. A systematic review with meta-analysis was conducted, including studies that evaluated women with PCOS of reproductive age and improvements in quality of life associated with aerobic or resistance exercise. PCOS diagnosis was based on the Rotterdam consensus or NIH criteria. Only reproductive-aged women diagnosed with PCOS were included in the study. All studies implemented supervised aerobic or resistance exercise interventions, followed by a control group of women with PCOS who did not undergo any intervention. The included studies provided primary and post-intervention data. The main outcomes analyzed were hyperandrogenism, measured by serum testosterone levels, insulin resistance, HDL, LDL, total cholesterol, triglycerides, and BMI. A total of 10 randomized controlled trials (RCTs) involving 382 women were included from an initial pool of 2,288 articles. Aerobic interventions lasting 12 to 24 weeks demonstrated significant reductions in BMI, waist circumference, and insulin levels, although effects on fasting glucose were inconsistent. Total cholesterol and LDL levels improved, while HDL and triglycerides showed variable responses. Hormonal assessments indicated reductions in testosterone and increases in SHBG in some studies. Resistance exercise was associated with increases in lean body mass and reductions in body fat percentage, with minimal hormonal changes observed. The combined effect size based on the random-effects model was statistically significant, indicating that aerobic exercise interventions significantly reduced total cholesterol and triglyceride levels compared to control groups. However, the combined effect size was not statistically significant for HDL, LDL, BMI, insulin, or testosterone levels compared to control groups. These findings underscore the beneficial effects of structured exercise programs on a range of PCOS-related outcomes, including significant improvements in anthropometric measures, metabolic profiles, hormonal balance, and reproductive health. The results highlight the importance of incorporating structured exercise interventions as a viable therapeutic strategy to manage PCOS and enhance the overall well-being of affected women.