Effect of weight loss interventions on the symptomatic burden and biomarkers of polycystic ovary syndrome: a systematic review of randomised controlled trials

Conference: 
SAPC ASM 2024 - Bristol
Talk Code: 
8A.7
Presenter: 
Jadine Scragg
Co-authors: 
Alice Hobson, Lia Willis, Kathryn Taylor, Sharon Dixon, Susan Jebb
Author institutions: 
Nuffield Department of Primary Care Health Sciences, University of Oxford

Problem

Polycystic ovary syndrome (PCOS) affects up to 45% of women of a reproductive age and is associated with obesity. Clinical guidelines recommend weight loss, but the impact of weight loss is unclear. This meta-analysis aims to quantify the effect of weight loss interventions on symptom burden and clinical markers of PCOS.

Approach

MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Web of Science and trial registry databases were searched from inception through November 2023. Randomised clinical trials of women with PCOS were included if they compared any intervention aiming to reduce weight against no or lower-intensity weight loss interventions. Conversations with people with PCOS informed the outcomes. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Pairs of independent reviewers screened the studies, extracted the data, and assessed risk of bias. Pooled mean differences or odds ratios were obtained from random effects meta-analyses.

Findings

44 comparisons from thirty-six studies with 2335 adult participants were included. Four, 20 and 12 studies were judged at high, unclear or low risk of bias, respectively. Compared with no or lower-intensity weight loss interventions, higher-intensity weight loss interventions were associated with greater weight loss (-3.2kg, 95% CI,-3.9 to -2.5; I2=82%) and improvements in symptoms and biomarkers, including menstrual frequency (mean difference 1.9; 95% CI,0.85 to 2.9, I2=61%), free androgen index (mean difference -1.2, 95% CI,-2.2 to -0.1; I2=57%) and HOMA-IR (-0.59, 95% CI,-0.77 to -0.42; I2=0%), but not hirsutism, total testosterone, sex-hormone binding globulin, follicular stimulating hormone or luteinising hormone.

Consequences

Weight loss programmes may lead to improvements in some of the markers of PCOS and should be considered more routinely as a treatment option for PCOS.

Submitted by: 
Jadine Scragg
Funding acknowledgement: