The Effects of Time-Restricted Eating on Glycemic Control, Lipid Profiles, Androgen Levels, and Blood Pressure in PMOS: A Systematic Review and Meta-Analysis

Background/Objectives: Polyendocrine metabolic ovarian syndrome (PMOS) is a common endocrine–metabolic disorder. Time-restricted eating (TRE) has emerged as a potential dietary intervention, but its efficacy in PMOS remains unclear. This systematic review and meta-analysis aimed to evaluate the effects of TRE on metabolic, hormonal, and anthropometric parameters in women with PMOS. Methods: A literature search was conducted using PubMed, Scopus, Web of Science databases, Embase, Cochrane Library, and the WHO International Clinical Trials Registry Platform for studies published from inception to 1 July 2026. Eight studies involving 363 women with PMOS were included in the systematic review. Among these, five controlled studies (four randomised controlled trials and one randomised crossover trial), involving 264 participants, were eligible for quantitative synthesis. Results: Quantitative synthesis was conducted using five controlled studies involving 264 participants. Meta-analysis showed that TRE significantly reduced fasting plasma glucose (MD = −0.17 mmol/L, 95% CI: −0.31 to −0.03), fasting insulin (MD = −28.86 pmol/L, 95% CI: −51.98 to −5.74), and HOMA-IR (MD = −0.66, 95% CI: −0.86 to −0.45). TRE also significantly improved QUICKI (SMD = 0.48, 95% CI: 0.05 to 0.92) and reduced HbA1c levels (MD = −1.70%, 95% CI: −3.18 to −0.22). No statistically significant differences were observed for body weight, BMI, waist circumference, lipid profiles (LDL-C, HDL-C, TC, and TG), total testosterone, SHBG, free androgen index, or blood pressure outcomes (SBP P = 0.05; DBP P = 0.11). Subgroup analyses based on comparator type revealed no significant subgroup differences for the key outcomes. Conclusions: TRE may improve insulin sensitivity-related outcomes—including fasting plasma glucose, fasting insulin, HOMA-IR, and QUICKI—as well as HbA1c in women with PCOS. However, current evidence does not demonstrate significant effects on anthropometric measures, lipid metabolism, androgen-related outcomes, or blood pressure. Long-term, larger trials are warranted to confirm these benefits.