Effects of acupuncture and exercise on insulin sensitivity, adipose tissue characteristics, and markers of coagulation and fibrinolysis in women with polycystic ovary syndrome: secondary analyses of a randomized controlled trial

Fertil Steril. 2012 Feb;97(2):501-8. doi: 10.1016/j.fertnstert.2011.11.010. Epub 2011 Dec 9.


Objective: To investigate the possible effects of low-frequency electroacupuncture (EA) and physical exercise on markers of coagulation and fibrinolysis, insulin sensitivity, and adipose tissue characteristics in women with polycystic ovary syndrome (PCOS).

Design: Secondary analyses of a prospective, randomized controlled clinical trial.

Setting: Department of Physiology and Department of Obstetrics and Gynecology, University of Gothenburg.

Patient(s): Eighty-four women with PCOS were randomized.

Intervention(s): Women with PCOS were randomized to 16 weeks of low-frequency EA (14 treatments), physical exercise (at least 3 times/wk), or no intervention.

Main outcome measure(s): Anthropometrics, circulating coagulation and fibrinolytic markers, insulin sensitivity (euglycemic hyperinsulinemic clamp), hemodynamics, and adipose tissue morphology/function recorded at baseline, after 16 weeks of intervention, and after a 16-week follow-up.

Result(s): In the low-frequency EA group, circulating plasminogen activator inhibitor 1 activity decreased by 21.8% after 16 weeks of intervention and by 31.1% at the 16-week follow-up and differed from the physical exercise and the no intervention groups. The EA group had decreases in circulating fibrinogen and tissue plasminogen activator (t-PA), sagittal diameter, and diastolic blood pressure after treatment, and fibrinogen remained lower at the 16-week follow-up. In the physical exercise group, lipoprotein lipase activity increased and diastolic blood pressure decreased after treatment, and both diastolic and systolic blood pressure were lower at follow-up. No other variables were affected.

Conclusion(s): Low-frequency EA counteracted a possible prothrombotic state in women with PCOS, as reflected by a decrease in plasminogen activator inhibitor 1 activity. Despite within-group improvements, there were no between-group differences in anthropometric, metabolic, or hemodynamic variables after 16 weeks of EA or physical exercise at the dose/intensity studied.

Trial registration: ClinicalTrials.gov NCT00484705.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipocytes / pathology
  • Adult
  • Biomarkers / blood
  • Blood Coagulation*
  • Blood Pressure
  • Electroacupuncture*
  • Exercise Therapy*
  • Female
  • Fibrinogen / metabolism
  • Fibrinolysis*
  • Heart Rate
  • Humans
  • Insulin Resistance*
  • Lipoprotein Lipase / metabolism
  • Oxygen Consumption
  • Plasminogen Activator Inhibitor 1 / blood
  • Polycystic Ovary Syndrome / blood
  • Polycystic Ovary Syndrome / pathology
  • Polycystic Ovary Syndrome / physiopathology
  • Polycystic Ovary Syndrome / therapy*
  • Prospective Studies
  • Subcutaneous Fat, Abdominal / metabolism
  • Subcutaneous Fat, Abdominal / pathology
  • Subcutaneous Fat, Abdominal / physiopathology*
  • Sweden
  • Time Factors
  • Tissue Plasminogen Activator / blood
  • Treatment Outcome
  • Young Adult


  • Biomarkers
  • Plasminogen Activator Inhibitor 1
  • SERPINE1 protein, human
  • Fibrinogen
  • LPL protein, human
  • Lipoprotein Lipase
  • Tissue Plasminogen Activator

Associated data

  • ClinicalTrials.gov/NCT00484705