João Vitor Martins Bernal, Juan Carlos Sánchez-Delgado, Noemi Marchini de Souza Couto, Adriana Marcela Jácome-Hortúa, Victor Barbosa Ribeiro, Kelly Yoshida de Melo, Lucas Dalvit Ferreira, Annick Beatriz Oliveira Dias de Macedo, Hugo Celso Dutra de Souza
{"title":"体育锻炼对多囊卵巢综合征女性心血管自主调节的影响：系统回顾和荟萃分析","authors":"João Vitor Martins Bernal, Juan Carlos Sánchez-Delgado, Noemi Marchini de Souza Couto, Adriana Marcela Jácome-Hortúa, Victor Barbosa Ribeiro, Kelly Yoshida de Melo, Lucas Dalvit Ferreira, Annick Beatriz Oliveira Dias de Macedo, Hugo Celso Dutra de Souza","doi":"10.1111/cen.70042","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Women with polycystic ovary syndrome (PCOS) exhibit cardiovascular autonomic imbalance, an important predictor of mortality. Physical exercise is an intervention known to enhance cardiovascular autonomic modulation in various populations. However, it remains unclear whether these benefits extend to women with PCOS, given that specific pathophysiological characteristics may influence autonomic adaptations. Therefore, this review aimed to synthesize the available evidence to improve understanding of this topic.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic search of CENTRAL, Embase, PubMed, Scopus, and Web of Science was conducted, followed by a snowball search to ensure comprehensive coverage of relevant randomized and non-randomized clinical trials. Random-effects meta-analyses were performed to quantitatively summarize the effects of exercise interventions on autonomic cardiovascular regulation in this population. The certainty of evidence was assessed using the GRADEpro tool.</p><p><strong>Results: </strong>Five studies were selected, including 316 women with PCOS (214 in the exercise group and 102 in the control group). The meta-analysis indicated that aerobic exercise reduces the percentage of sequences with three consecutive cardiac cycles without significant variations (mean difference [MD = -6.13; 95% CI = -8.56 to -3.71, p < 0.001; I<sup>2</sup> = 0%; moderate-certainty evidence) and increase the percentage of sequences with three consecutive cardiac cycles with two different variations (MD = 7.16; 95% CI = 4.61 to 9.72; p < 0.001; I<sup>2</sup> = 8%; moderate-certainty evidence) and the root mean square of successive differences (MD = 12.84; 95% CI = 2.66 to 23.03; p = 0.01; I<sup>2</sup> = 52%; low-certainty evidence).</p><p><strong>Conclusion: </strong>The benefits of aerobic exercise on cardiovascular autonomic modulation appear to extend to women with PCOS, increasing vagal modulation and reducing sympathetic modulation. However, further studies are needed to strengthen the evidence and clarify the effects of other exercise modalities.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Physical Exercise on Cardiovascular Autonomic Modulation in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.\",\"authors\":\"João Vitor Martins Bernal, Juan Carlos Sánchez-Delgado, Noemi Marchini de Souza Couto, Adriana Marcela Jácome-Hortúa, Victor Barbosa Ribeiro, Kelly Yoshida de Melo, Lucas Dalvit Ferreira, Annick Beatriz Oliveira Dias de Macedo, Hugo Celso Dutra de Souza\",\"doi\":\"10.1111/cen.70042\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Women with polycystic ovary syndrome (PCOS) exhibit cardiovascular autonomic imbalance, an important predictor of mortality. Physical exercise is an intervention known to enhance cardiovascular autonomic modulation in various populations. However, it remains unclear whether these benefits extend to women with PCOS, given that specific pathophysiological characteristics may influence autonomic adaptations. Therefore, this review aimed to synthesize the available evidence to improve understanding of this topic.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic search of CENTRAL, Embase, PubMed, Scopus, and Web of Science was conducted, followed by a snowball search to ensure comprehensive coverage of relevant randomized and non-randomized clinical trials. Random-effects meta-analyses were performed to quantitatively summarize the effects of exercise interventions on autonomic cardiovascular regulation in this population. The certainty of evidence was assessed using the GRADEpro tool.</p><p><strong>Results: </strong>Five studies were selected, including 316 women with PCOS (214 in the exercise group and 102 in the control group). The meta-analysis indicated that aerobic exercise reduces the percentage of sequences with three consecutive cardiac cycles without significant variations (mean difference [MD = -6.13; 95% CI = -8.56 to -3.71, p < 0.001; I<sup>2</sup> = 0%; moderate-certainty evidence) and increase the percentage of sequences with three consecutive cardiac cycles with two different variations (MD = 7.16; 95% CI = 4.61 to 9.72; p < 0.001; I<sup>2</sup> = 8%; moderate-certainty evidence) and the root mean square of successive differences (MD = 12.84; 95% CI = 2.66 to 23.03; p = 0.01; I<sup>2</sup> = 52%; low-certainty evidence).</p><p><strong>Conclusion: </strong>The benefits of aerobic exercise on cardiovascular autonomic modulation appear to extend to women with PCOS, increasing vagal modulation and reducing sympathetic modulation. However, further studies are needed to strengthen the evidence and clarify the effects of other exercise modalities.</p>\",\"PeriodicalId\":10346,\"journal\":{\"name\":\"Clinical Endocrinology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Endocrinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/cen.70042\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/cen.70042","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Effects of Physical Exercise on Cardiovascular Autonomic Modulation in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.
Objective: Women with polycystic ovary syndrome (PCOS) exhibit cardiovascular autonomic imbalance, an important predictor of mortality. Physical exercise is an intervention known to enhance cardiovascular autonomic modulation in various populations. However, it remains unclear whether these benefits extend to women with PCOS, given that specific pathophysiological characteristics may influence autonomic adaptations. Therefore, this review aimed to synthesize the available evidence to improve understanding of this topic.
Design: Systematic review and meta-analysis.
Methods: A systematic search of CENTRAL, Embase, PubMed, Scopus, and Web of Science was conducted, followed by a snowball search to ensure comprehensive coverage of relevant randomized and non-randomized clinical trials. Random-effects meta-analyses were performed to quantitatively summarize the effects of exercise interventions on autonomic cardiovascular regulation in this population. The certainty of evidence was assessed using the GRADEpro tool.
Results: Five studies were selected, including 316 women with PCOS (214 in the exercise group and 102 in the control group). The meta-analysis indicated that aerobic exercise reduces the percentage of sequences with three consecutive cardiac cycles without significant variations (mean difference [MD = -6.13; 95% CI = -8.56 to -3.71, p < 0.001; I2 = 0%; moderate-certainty evidence) and increase the percentage of sequences with three consecutive cardiac cycles with two different variations (MD = 7.16; 95% CI = 4.61 to 9.72; p < 0.001; I2 = 8%; moderate-certainty evidence) and the root mean square of successive differences (MD = 12.84; 95% CI = 2.66 to 23.03; p = 0.01; I2 = 52%; low-certainty evidence).
Conclusion: The benefits of aerobic exercise on cardiovascular autonomic modulation appear to extend to women with PCOS, increasing vagal modulation and reducing sympathetic modulation. However, further studies are needed to strengthen the evidence and clarify the effects of other exercise modalities.
期刊介绍：
Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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