Author(s): LI, Z., KIM, S., Institution: KOREA UNIVERSITY, Country: KOREA, SOUTH, Abstract-ID: 679

INTRODUCTION:
Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic dysregulation and insulin resistance. Although exercise is a cornerstone of lifestyle management in PCOS, the comparative effectiveness of different exercise modalities and the dose–response relationship remain unclear. We compared the efficacy of aerobic, resistance, combined, mind–body, and high-intensity interval training (HIIT) on key clinical indicators in women with PCOS and identified the optimal weekly exercise dose for each outcome.
METHODS:
Randomised controlled trials were systematically searched from inception to December 2025, and risk of bias was assessed using the Cochrane Risk of Bias Tool. A Bayesian random-effects network meta-analysis was conducted in R and Stata; interventions were ranked using the surface under the cumulative ranking curve (SUCRA), and dose–response relationships were examined across exercise volumes expressed as MET-min/week.
RESULTS:
A total of 1,889 records were identified, and 64 studies met the inclusion criteria and were included in the network meta-analysis. HIIT was most effective for reducing fasting glucose, with an optimal dose of approximately 710 MET-min/week (MD = −4.5, 95% CrI −6.67 to −2.42). Aerobic exercise produced the greatest reduction in systolic blood pressure at approximately 920 MET-min/week (MD = −7.12, 95% CrI −10.1 to −4.14) and the largest increase in HDL-C at approximately 600 MET-min/week (MD = 3.94, 95% CrI 1.85 to 6.15). Combined exercise showed superior effects on waist circumference (optimal dose ~800 MET-min/week) and diastolic blood pressure (~650 MET-min/week; MD = −2.85, 95% CrI −4.28 to −1.36) and ranked highly for lowering LDL-C.
CONCLUSION:
These findings suggest that exercise modality should be selected based on the targeted clinical outcome in women with PCOS—HIIT for glycaemic control, aerobic exercise for blood pressure and HDL-C improvement, and combined exercise for reductions in waist circumference and LDL-C—supporting personalised exercise prescriptions aligned with individual clinical goals; future research should evaluate long-term adherence and sustainability.