Abstract
AIM: Obesity is common in women with polycystic ovary syndrome (PCOS) and can exacerbate PCOS symptoms. Although Acupoint catgut embedding (ACE) is frequently used to treat the clinical symptoms of simple obesity, it is unclear how it will affect obesity associated with PCOS. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) to evaluate the effectiveness of ACE in treating obesity in women with PCOS. METHODS: We searched databases from inception to January 8, 2025. Two independent reviewers extracted data and assessed the risk of bias. All meta-analyses used random effects models, and the GRADE approach was used to assess the certainty of the evidence. RESULTS: We included 25 RCTs (1,663 participants). Based on usual care, compared to blank treatment, ACE probably reduces body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC), and may enable a greater proportion of patients to achieve a weight loss no less than 5% (relative risk [RR] 1.33, 95% CI 1.15 to 1.55) and may reduce triglycerides (TG). Furthermore, when compared to active comparators, ACE probably enables a greater proportion of patients to achieve a weight loss no less than 5% (RR 1.40, 95% CI 1.11 to 1.76) and reduces WC and may also reduce BMI and TG. All effects were supported by low to moderate certainty evidence. CONCLUSION: When compared to blank treatment, on the basis of usual care, ACE for obesity associated with PCOS may improve obesity-related outcomes. When compared to active comparators, it may have comparable or greater therapeutic efficacy and fewer adverse events. Such improvements in obesity-related indicators may help alleviate metabolic and reproductive symptoms in women with PCOS. As all included trials were conducted in China, further high-quality studies in diverse populations are needed to confirm the generalizability of these findings.