Weight loss and vascular inflammatory markers in overweight women with and without polycystic ovary syndrome

2012 ◽  
Vol 25 (5) ◽  
pp. 500-503 ◽  
Author(s):  
Lisa J. Moran ◽  
Manny Noakes ◽  
Gary A. Wittert ◽  
Peter M. Clifton ◽  
Robert J. Norman
Keyword(s):  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Inflammatory Markers ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Overweight Women

scholarly journals Comparison of Single and Combined Treatment with Exenatide and Metformin on Menstrual Cyclicity in Overweight Women with Polycystic Ovary Syndrome

2008 ◽  
Vol 93 (7) ◽  
pp. 2670-2678 ◽  
Author(s):  
Karen Elkind-Hirsch ◽  
Ory Marrioneaux ◽  
Madhu Bhushan ◽  
Denise Vernor ◽  
Rajat Bhushan
Keyword(s):  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Inflammatory Markers ◽  
Polycystic Ovary ◽  
Combined Treatment ◽  
Ovulation Rate ◽  
Secondary Outcome ◽  
Ovary Syndrome ◽  
Anthropometric Measures ◽  
Overweight Women

Abstract Context: Insulin resistance and obesity are common features of the polycystic ovary syndrome (PCOS). Weight loss and use of insulin-lowering drugs have been shown to improve both reproductive and metabolic aspects of PCOS. Objective: We evaluated exenatide (EX) and metformin (MET), alone and in combination (COM), on menstrual cyclicity, hormonal parameters, metabolic profiles, and inflammatory markers in overweight, insulin-resistant women with PCOS. Design, Setting, and Participants: Sixty overweight oligoovulatory women with PCOS (body mass index > 27; 18–40 yr) were randomized to one of three treatment groups: MET [1000 mg twice daily (BID)], EX (10 μg BID), or COM (MET 1000 mg BID, EX 10 μg BID) for 24 wk. The primary outcome was menstrual frequency; secondary outcome measures included changes in ovulation rate, insulin action, anthropometric measures, androgen levels, and inflammatory markers. Results: Forty-two (70%) patients completed the study. COM therapy was superior to EX or MET monotherapy in improving menstrual cyclicity, ovulation rate, free androgen index, and insulin sensitivity measures and reducing weight and abdominal fat. Both EX arms were more effective in promoting weight loss than MET (P = 0.003). Conclusions: COM appears better than either EX or MET alone on menstrual cycle frequency and hormonal and metabolic derangements. A marked decrease in central adiposity could partly explain the improvements in reproductive function, insulin-glucose parameters, and adiponectin observed in these overweight women with PCOS treated with COM therapy. Larger trials of longer duration are warranted to assess the long-term efficacy and safety of combined EX-MET therapy in overweight women with PCOS.

scholarly journals C-Reactive Protein before and after Weight Loss in Overweight Women with and without Polycystic Ovary Syndrome

2007 ◽  
Vol 92 (8) ◽  
pp. 2944-2951 ◽  
Author(s):  
Lisa J. Moran ◽  
Manny Noakes ◽  
Peter M. Clifton ◽  
Gary A. Wittert ◽  
Damien P. Belobrajdic ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Fat Mass ◽  
Polycystic Ovary ◽  
C Reactive Protein ◽  
Ovary Syndrome ◽  
Overweight Women ◽  
Reactive Protein ◽  
Postprandial Insulin

Abstract Background: Polycystic ovary syndrome (PCOS) is associated with reproductive and metabolic abnormalities. It is unknown whether overweight women with and without PCOS achieve similar benefits from weight loss for cardiovascular risk factors. Method: Overweight body mass index-matched women with (n = 15) and without (n = 17) PCOS (weight, 95.3 ± 17.6 kg; body mass index, 35.6 ± 5.3 kg/m2, mean ± sd) followed an 8-wk weight loss regime. Results: All subjects had similar reductions in weight (3.9 ± 3.6 kg, 3.8%, vs. 4.5 ± 4.1 kg, 4.7%, respectively, for PCOS and non-PCOS), waist circumference, fat mass, triglycerides, free testosterone, and fasting and postprandial insulin. At baseline, C-reactive protein (CRP) between groups was not significantly different (5.5 ± 3.1 mg/liter for PCOS vs. 4.9 ± 3.0 mg/liter for non-PCOS). There was a significant interaction between PCOS status and CRP (P = 0.016) such that CRP decreased with weight loss for non-PCOS women (−1.2 ± 1.8 mg/liter; P = 0.025) but not for PCOS women. For all women, the change in CRP correlated with the change in weight (r = 0.560; P = 0.003), fat mass (r = 0.477; P = 0.016), and postprandial insulin (r = 0.402; P = 0.046). Adiponectin, IL-6, and TNF-α were not significantly different between groups before or after weight loss. Only subjects with baseline CRP levels below the median (4.52 mg/liter) showed increases in adiponectin (0.98 ± 1.3 μg/liter) (P = 0.015) and greater reductions in triglycerides (P = 0.001) with weight loss. Conclusion: A 4–5% weight loss improved lipid, glucose, and insulin profiles in women with and without PCOS. This degree of weight loss was not effective in lowering CRP concentrations in PCOS women, suggesting that greater weight loss is required in this group to achieve equivalent cardiovascular benefit to non-PCOS women.

scholarly journals Dietary Composition in Restoring Reproductive and Metabolic Physiology in Overweight Women with Polycystic Ovary Syndrome

2003 ◽  
Vol 88 (2) ◽  
pp. 812-819 ◽  
Author(s):  
L. J. Moran ◽  
M. Noakes ◽  
P. M. Clifton ◽  
L. Tomlinson ◽  
R. J. Norman
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Weight Maintenance ◽  
Density Lipoprotein ◽  
Energy Restriction ◽  
Ovary Syndrome ◽  
Overweight Women ◽  
Free Androgen Index

Overweight women with polycystic ovary syndrome (PCOS) were randomized to a high protein (HP; 40% carbohydrate and 30% protein; n = 14) or a low protein (LP; 55% carbohydrate and 15% protein) diet (n = 14). The intervention consisted of 12 wk of energy restriction (∼6000 kJ/d), followed by 4 wk of weight maintenance. Pregnancies (two HP and one LP); improvements in menstrual cyclicity, lipid profile, and insulin resistance (as measured by the homeostasis model); and decreases in weight (7.5%) and abdominal fat (12.5%) occurred independently of diet composition. Improvements in menstrual cyclicity were associated with greater decreases in insulin resistance and fasting insulin (P = 0.011). On the LP diet, high density lipoprotein cholesterol decreased 10% during energy restriction (P = 0.008), and the free androgen index increased 44% in weight maintenance stages (P = 0.027). Weight loss leads to improvements in cardiovascular and reproductive parameters potentially mediated by improvements in surrogate measures of insulin resistance. An HP weight loss diet may result in minor differential endocrine and metabolic improvements.

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