The Effect of Acupuncture on Glucose Metabolism and Lipid Profiles in Patients with PCOS: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective. To evaluate the effectiveness of acupuncture on glucose metabolism and lipid profiles in patients with polycystic ovary syndrome (PCOS). Methods. Databases, including the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal Database (VIP), Wanfang, PubMed, and the Cochrane Library were searched for the relevant literature, with the retrieval deadline being February 2020. Two reviewers independently screened, selected, and extracted the data and validated the results. The methodological quality of the included studies was evaluated with the risk of bias tool, and the meta-analysis was performed using the RevMan 5.3.5 software. Results. A total of 737 patients with PCOS from 10 randomized controlled trials were included in the meta-analysis. A pooled analysis showed significant decreases in body mass index (mean difference (MD) = –1.47, 95% CI –2.35 to –0.58, $P$ < 0.001) and waist-to-hip ratio (MD = –0.04, 95% CI [–0.06, –0.02], $P$ < 0.001) in the acupuncture group along with significant improvements in fasting plasma glucose (MD = –0.38, 95% CI [–0.70, –0.07], P = 0.02), homeostasis model assessment of insulin resistance (MD = –0.22, 95% CI [–0.41, –0.02], $P$ = 0.03), and triglycerides (MD = –0.26, 95% CI [–0.48, –0.04], $P$ = 0.02). No significant differences were observed in the Ferriman–Gallwey score, 2 h fasting plasma glucose, fasting insulin, 2 h fasting insulin, serum total cholesterol, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol. Conclusion. Acupuncture is relatively effective and safe in improving glucose metabolism and insulin sensitivity in patients with PCOS. The included studies were generally of not bad methodological quality, but further large-scale, long-term randomized controlled trials with rigorous methodological standards are still warranted.