Endocrinology & Metabolic Syndrome
Open Access
ISSN: 2161-1017
ISSN: 2161-1017
Rutong Wang, Yanhong Wei, Yueze Zhu, Mengyao Wang, Weihua Nong*, Xiaocan Lei
The efficacy of acupuncture in treating Polycystic Ovary Syndrome (PCOS) has been a subject of debate, primarily due to the limitations of previous studies such as small sample sizes, ethnic disparities and an absence of in-depth exploration into the mechanisms at play. This comprehensive meta-analysis aims to synthesize the available evidence and deliver a definitive and unambiguous conclusion. Our search, which extended to July 2024, encompassed international scientific databases including PubMed, Web of Science, Embase and Scopus. We included all meta-analyses that investigated acupuncture as a treatment modality for PCOS. The pooled results were derived using both fixed and random effects models, contingent upon the heterogeneity observed. Heterogeneity was assessed using the I2 statistic and the Cochrane Q test. The quality of the included meta-analyses was meticulously evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool. Our review included a total of 10 studies, encompassing 34,946 patients. The findings suggest that acupuncture is significantly associated with an elevated pregnancy rate (Relative Risk (RR): 1.50, 95% Confidence Interval (CI): 1.40-1.61) and ovulation rate (Mean Difference (MD): 1.62, 95% CI: 1.09-2.16). Furthermore, acupuncture has been shown to substantially decrease insulin resistance, as measured by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (MD: -0.35, 95% CI: -0.43 to -0.26), serum testosterone levels (MD: -0.15, 95% CI: -0.19 to -0.11), Luteinizing Hormone (LH) levels (MD: -1.60, 95% CI: -1.90 to -1.31), fasting insulin levels (MD: -2.29, 95% CI: -2.47 to -2.12), miscarriage rate (RR: 0.76, 95% CI: 0.58 to 0.99) and Body Mass Index (BMI) (MD: -1.28, 95% CI: -1.46 to -1.10). Sensitivity analysis substantiated the robustness of these findings. Acupuncture's impact on metabolic indicators is noteworthy; it significantly reduced insulin resistance (HOMA-IR: MD: -0.35, 95% CI: -0.43 to -0.26), testosterone levels (MD: -0.15, 95% CI: -0.19 to -0.11), LH levels (MD: -1.60, 95% CI: -1.90 to -1.31) and fasting insulin levels (MD: -2.29, 95% CI: -2.47 to -2.12). The treatment also had a pronounced effect on reducing the miscarriage rate (RR: 0.76, 95% CI: 0.58 to 0.99), BMI (MD: -1.28, 95% CI: -1.46 to -1.10) and waist-hip ratio (MD: -0.03, 95% CI: -0.03 to 0.02). The improvements in menstrual frequency (MD: -0.41, 95% CI: -0.63 to -0.19) and menstrual cycle regularity (RR: 1.22, 95% CI: 1.17 to 1.26) further underscore the positive influence of acupuncture on the endocrine milieu of PCOS patients. Although the reduction in adverse events did not achieve statistical significance (RR: 0.95, 95% CI: 0.85 to 1.07), this observation is still of interest. The significant decrease in Fasting Blood Glucose (FBG) (MD: -0.36, 95% CI: -0.55 to -0.17) adds to the evidence base for acupuncture's role in ameliorating metabolic dysregulations in PCOS. This meta-analysis, with its rigorous methodology and broad scope, provides compelling evidence supporting the therapeutic benefits of acupuncture for PCOS, offering a valuable addition to the current treatment options.
Published Date: 2025-01-10; Received Date: 2024-08-16