scholarly journals The optimal diet for women with polycystic ovary syndrome?

2005 ◽  
Vol 94 (2) ◽  
pp. 154-165 ◽  
Author(s):  
Kate Marsh ◽  
Jennie Brand-Miller
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Saturated Fat ◽  
Human Growth ◽  
Glycaemic Index ◽  
Energy Restriction ◽  
Nutrient Deficiencies ◽  
Optimal Diet ◽  
Ovary Syndrome ◽  
Insulin Levels

An optimal diet is one that not only prevents nutrient deficiencies by providing sufficient nutrients and energy for human growth and reproduction, but that also promotes health and longevity and reduces the risk of diet-related chronic diseases. The composition of the optimal diet for women with polycystic ovary syndrome (PCOS) is not yet known, but such a diet must not only assist short term with weight management, symptoms and fertility, but also specifically target the long-term risks of type 2 diabetes, CVD and certain cancers. With insulin resistance and compensatory hyperinsulinaemia now recognised as a key factor in the pathogenesis of PCOS, it has become clear that reducing insulin levels and improving insulin sensitivity are an essential part of management. Diet plays a significant role in the regulation of blood glucose and insulin levels, yet research into the dietary management of PCOS is lacking and most studies have focused on energy restriction rather than dietary composition per se. On the balance of evidence to date, a diet low in saturated fat and high in fibre from predominantly low-glycaemic-index-carbohydrate foods is recommended. Because PCOS carries significant metabolic risks, more research is clearly needed.

Metformin treatment with or without life style changes in patients with polycystic ovary syndrome

2011 ◽  
Vol 152 (16) ◽  
pp. 628-632 ◽  
Author(s):  
Gyula Petrányi ◽  
Mária Zaoura-Petrányi
Keyword(s):  
Body Mass Index ◽  
Polycystic Ovary Syndrome ◽  
Treatment Period ◽  
Body Mass ◽  
Life Style ◽  
Polycystic Ovary ◽  
Glycaemic Index ◽  
Ovary Syndrome ◽  
Waist To Hip Ratio ◽  
Life Style Changes

Treatment with metformin three times 500 mg daily had been advised since 2002, to patients suffering from the polycystic ovary syndrome diagnosed by the Rotterdam criteria and who did not want to take contraceptive pills. More recently, life style changes have also been introduced to treatment recommendation: increased physical activity, low glycaemic index diet; also with calorie restriction for the obese patients. Aim: To assess the efficacy of the two treatment forms on clinical symptoms of the disease. Method: The metformin only historical control group (metformin monotherapy) consisted of 27 patients between the ages from 18 to 39 years (mean 29 years); to which was the age-matched metformin and life style changes group (triple basal therapy) of 29 patients compared. The following parameters were registered at the beginning and the end of a six-month treatment period: global acne score, Ferriman-Gallwey hirsutism score, body mass index, waist-to-hip circumference ratio, and menstrual cycles. Results: By the end of the treatment period, both acne and hirsutism scores improved significantly in both treatment groups (P<0.001); the improvements did not differ between them: acne 8.6±5.7 vs. 9.2±5.9 (P = 0.70); hirsutism 2.5±2.0 vs. 2.6±1.6 (P = 0.83). Body mass index and waist-to-hip ratio remained practically unchanged in the metformin only group: 0.26±1.0 kg/m2 (P = 0.21) and 0.001±0.02 (P = 0.71). Body mass index decreased in the triple therapy group by 0.91±1.1 kg/m2 (P<0.001); and waist-to-hip ratio by 0.019±0.03 (P<0.001). The decrease of the body mass index was more remarkable in overweight patients: 1.10±1.26 kg/m2 (P = 0.002) vs. 0.64±0.88 kg/m2 (P = 0.03) in lean patients. Recommendation on life style changes with metformin did not show further improvement of hyperandrogenic symptoms in comparison to metformin alone but the combined therapy diminished body size indexes. Conclusion: Authors recommend the triple basal treatment consisting of metformin, physical exercise and low glycaemic index diet to their patients with polycystic ovary syndrome for assessment of its long-term efficacy. Orv. Hetil., 2011, 152, 628–632.

scholarly journals Phenotypic clustering reveals distinct subtypes of polycystic ovary syndrome with novel genetic associations

2019 ◽  
Author(s):  
Matthew Dapas ◽  
Frederick T. J. Lin ◽  
Girish N. Nadkarni ◽  
Ryan Sisk ◽  
Richard S. Legro ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
European Ancestry ◽  
Sequencing Analysis ◽  
Ovary Syndrome ◽  
Biologically Relevant ◽  
Insulin Levels ◽  
Family Based

AbstractBackgroundPolycystic ovary syndrome (PCOS) is a common, complex genetic disorder affecting up to 15% of reproductive age women worldwide, depending on the diagnostic criteria applied. These diagnostic criteria are based on expert opinion and have been the subject of considerable controversy. The phenotypic variation observed in PCOS is suggestive of an underlying genetic heterogeneity, but a recent meta-analysis of European ancestry PCOS cases found that the genetic architecture of PCOS defined by different diagnostic criteria was generally similar, suggesting that the criteria do not identify biologically distinct disease subtypes. We performed this study to test the hypothesis that there are biologically relevant subtypes of PCOS.Methods and FindingsUnsupervised hierarchical cluster analysis was performed on quantitative anthropometric, reproductive, and metabolic traits in a genotyped discovery cohort of 893 PCOS cases and an ungenotyped validation cohort of 263 PCOS cases. We identified two PCOS subtypes: a “reproductive” group (21-23%) characterized by higher luteinizing hormone (LH) and sex hormone binding globulin (SHBG) levels with relatively low body mass index (BMI) and insulin levels; and a “metabolic” group (37-39%), characterized by higher BMI, glucose, and insulin levels with lower SHBG and LH levels. We performed a GWAS on the genotyped cohort, limiting the cases to either the reproductive or metabolic subtypes. We identified alleles in four novel loci that were associated with the reproductive subtype at genome-wide significance (PRDM2/KAZN1, P=2.2×10-10; IQCA1, P=2.8×10-9; BMPR1B/UNC5C, P=9.7×10-9; CDH10, P=1.2×10-8) and one locus that was significantly associated with the metabolic subtype (KCNH7/FIGN, P=1.0×10-8). We have previously reported that rare variants in DENND1A, a gene regulating androgen biosynthesis, were associated with PCOS quantitative traits in a family-based whole genome sequencing analysis. We classified the reproductive and metabolic subtypes in this family-based PCOS cohort and found that the subtypes tended to cluster in families and that carriers of rare DENND1A variants were significantly more likely to have the reproductive subtype of PCOS. Limitations of our study were that only PCOS cases of European ancestry diagnosed by NIH criteria were included, the sample sizes for the subtype GWAS were small, and the GWAS findings were not replicated.ConclusionsIn conclusion, we have found stable reproductive and metabolic subtypes of PCOS. Further, these subtypes were associated with novel susceptibility loci. Our results suggest that these subtypes are biologically relevant since they have distinct genetic architectures. This study demonstrates how precise phenotypic delineation can be more powerful than increases in sample size for genetic association studies.

Relationship Between Anti-Müllerian Hormone (AMH) and Insulin Levels During Different Tanner Stages in Daughters of Women With Polycystic Ovary Syndrome

2012 ◽  
Vol 19 (4) ◽  
pp. 383-390 ◽  
Author(s):  
Teresa Sir-Petermann ◽  
Amanda Ladrón de Guevara ◽  
Ethel Codner ◽  
Jessica Preisler ◽  
Nicolás Crisosto ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Insulin Levels

scholarly journals Leptin levels in women with polycystic ovary syndrome before and after treatment with diazoxide

1998 ◽  
pp. 184-189 ◽  
Author(s):  
GE Krassas ◽  
TT Kaltsas ◽  
N Pontikides ◽  
H Jacobs ◽  
W Blum ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Free Testosterone ◽  
Common Finding ◽  
Oral Glucose ◽  
Ovary Syndrome ◽  
Insulin Levels ◽  
Igf I ◽  
Before And After ◽  
Igfbp 3

Leptin, a product of the ob gene, is a 16 kDa protein which is produced by adipocytes. In humans, obesity is a common finding in women with polycystic ovary syndrome (PCOS). The role, however, of leptin in PCOS is not clear. Some studies have reported increased levels of leptin in PCOS, while others report that they are normal. Also, insulin resistance is a common finding in PCOS. The aim of this study was to investigate further the role of insulin in leptin secretion in patients with PCOS by treating them for 10 days with diazoxide, an insulin-reducing compound. Eight women with PCOS, mean age 22.1 +/- 2.7 years, with mean body mass index (BMI) 28.4 +/- 5.7kg/m2, were studied. An oral glucose tolerance test (OGTT) was performed in all women and blood samples were taken before and at 30, 60, 90, 120 and 150 min after the administration of glucose. Glucose, insulin, leptin, free testosterone, delta4 androstenedione, sex hormone binding globulin (SHBG), LH, FSH, IGF-I and insulin-like growth factor-binding protein-3 (IGFBP-3) were measured in the sera taken before the administration of glucose, while glucose and insulin levels were measured in all samples which were collected after the administration of glucose. Diazoxide 300 mg daily was given to all women starting after the end of the OGTT for 10 days. A second OGTT was performed the day after the discontinuation of the diazoxide treatment. The same hormonal and biochemical parameters were also measured in all patients during the second OGTT. After the administration of diazoxide a reduction in sum insulin (262 +/- 147 vs 679 +/- 341 microU/ml. P<().01), leptin (18.5 +/- 10.6 vs 24.2 +/- 10.2 ng/ml, P<0.01), free testosterone (3.0 +/- 1.9 vs 5.1 +/- 1.9 pg/ml, P<0.01), delta4 androstenedione (3.8 +/- 1.9 vs 5.7 +/- 2.0 ng/ml, P<0.01) and IGF-I (219.5 +/- 69.2 vs 314.5 +/- 82.3 ng/ml, P<0.01) levels was observed. Serum SHBG (38.8 +/- 16.8 vs 27.8 +/- 12.1 nmol/l, P<0.01) and sum glucose levels (994.1 +/- 252.7 vs 711.1 +/- 166.1 mg/dl, P<0.05) were increased while IGFBP-3 (3.96 +/- 2.49 vs 3.75 +/- 2.24mg/l), FSH (6.2 +/- 1.8 vs 6.0 +/- 2.5 mU/l) and LH (18.9 +/- 6.7 vs 21.4 +/- 6.7 mU/l) concentrations did not change significantly. A significant positive correlation was found between serum leptin and BMI values before and after administration of diazoxide as well as between leptin, insulin and IGFBP-3 values. Also, sum insulin values correlated significantly with BMI. However, when multiple regression analysis was used this correlation was eliminated except that between leptin and BMI. This was most probably due to the small number of cases. The mechanism of the reduction of leptin levels is unclear. However, it is suggested that the concomitant decrease of insulin levels may play a role.

scholarly journals Dietary Options in Polycystic Ovary Syndrome (PCOS)

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Hafsa Kamran ◽  
Maria Aslam ◽  
Shaista Jabeen
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Intervention Program ◽  
Polycystic Ovary ◽  
Glycemic Load ◽  
Energy Restriction ◽  
Moderate Physical Activity ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Female Population ◽  
Increased Risk

Abstract Poly Cystic Ovary Syndrome is the hormonal imbalance that is by and large considered to affect more or less 10% of the female population. PCOs is more common in obese and overweight women, which further increases androgen secretion causing impaired metabolism and reproductive functions. Women with PC-OS are at increased risk of developing cardiovascular diseases, dyslipidemias, hypertension and type II diabetes Mellitus. Weight reduction is difficult to achieve in obese women with PCOS than normal individuals. So a comprehensive lifestyle intervention program including individualized diet with moderate energy restriction based on basic healthy eating principles, at least 30 minutes moderate physical activity 3-5 days a week and behavior modification approach is required. Hypocaloric diets along with modification of carbohydrates have found to be effective. Selection of foods among low glycemic load (GL) and high fiber foods and replacing fats with polyunsaturated fats may be a helpful strategy in PCOS patients. Keywords:  Polycystic Ovary Syndrome (PCOS), Obesity, Insulin Resistance, Diet.

scholarly journals Polycystic Ovary Syndrome and Dietary Patterns in Iran: A Review Study

2019 ◽  
Author(s):  
Asieh Panjeshahin ◽  
Maryam Khosravi ◽  
Mahdieh Hosseinzadeh
Keyword(s):  
Food Intake ◽  
Polycystic Ovary Syndrome ◽  
Dietary Patterns ◽  
Polycystic Ovary ◽  
Saturated Fat ◽  
Reproductive Age ◽  
Comprehensive Treatment ◽  
Dietary Habit ◽  
Ovary Syndrome ◽  
Total Calorie

Background: Polycystic Ovary Syndrome (PCOs) is one of the most common metabolic and endocrine abnormalities among women in reproductive age. In the case of not comprehensive treatment, PCOs can lead to hormonal, metabolic, and fertility disorders.  The exact cause of PCOs is still unclear. This disease seems to have a genetic background caused by the interference of several key genes with the environmental factors such as dietary habit and food intake, which play an important role in prevention and treatment of this syndrome. Methods: We searched Scopus, PubMed, SID, and Magiran data bases to find the studies conducted in Iran on dietary patterns, dietary intake, food intake, and PCOs published in English. Results: The findings showed that decrease of weight and fat intake from total calorie (especially saturated fat and cholesterol), increase of physical activity and intake of dietary fibers can improve this syndrome. Furthermore, DASH diet, increase of the protein/carbohydrate ratio in the diet, the low-calorie diets, or iso-caloric diets with a low glycemic index can also be useful in this regard. Discussion: In recent studies, the effects of some healthy diets were studied on PCOs women. A few of these studies were about finding appropriate dietary patterns for PCOs patients, but their number was limited. So, further studies are needed in this regard.

scholarly journals Oxidative Stress in Response to Saturated Fat Ingestion Is Linked to Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome

2019 ◽  
Vol 104 (11) ◽  
pp. 5360-5371 ◽  
Author(s):  
Frank González ◽  
Robert V Considine ◽  
Ola A Abdelhadi ◽  
Anthony J Acton
Keyword(s):  
Oxidative Stress ◽  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Protein Content ◽  
Polycystic Ovary ◽  
Saturated Fat ◽  
Ros Generation ◽  
Ovary Syndrome ◽  
Control Subjects ◽  
Androgen Secretion

Abstract Context Oxidative stress and insulin resistance are often present in polycystic ovary syndrome (PCOS). Objective We determined the effect of saturated fat ingestion on leukocytic reactive oxygen species (ROS) generation, p47phox expression, and circulating thiobarbituric acid–reactive substances (TBARS) in women with PCOS. Design Cross-sectional study. Setting Academic medical center. Patients Twenty women of reproductive age with PCOS (10 lean, 10 with obesity) and 19 ovulatory control subjects (10 lean, 9 with obesity). Main Outcome Measures ROS generation and p47phox mRNA and protein content were quantified in leukocytes, and TBARS was measured in plasma from blood drawn while the subjects were fasting and 2, 3, and 5 hours after saturated fat ingestion. Insulin sensitivity was derived from an oral glucose tolerance test (ISOGTT). Androgen secretion was assessed from blood drawn while the subjects were fasting and 24, 48, and 72 hours after human chorionic gonadotropin (HCG) administration. Results Regardless of weight class, women with PCOS exhibited lipid-induced increases in leukocytic ROS generation and p47phox mRNA and protein content as well as plasma TBARS compared with lean control subjects. Both PCOS groups exhibited lower ISOGTT and greater HCG-stimulated androgen secretion compared with control subjects. The ROS generation, p47phox, and TBARS responses were negatively correlated with ISOGTT and positively correlated with HCG-stimulated androgen secretion. Conclusion In PCOS, increases in ROS generation, p47phox gene expression, and circulating TBARS in response to saturated fat ingestion are independent of obesity. Circulating mononuclear cells and excess adipose tissue are separate and distinct contributors to oxidative stress in this disorder.

scholarly journals The treatment of insulin resistance does not improve adrenal cytochrome P450c17alpha enzyme dysregulation in polycystic ovary syndrome

1999 ◽  
pp. 56-61 ◽  
Author(s):  
K Unluhizarci ◽  
F Kelestimur ◽  
Y Sahin ◽  
F Bayram
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Glucose Disposal ◽  
Ovary Syndrome ◽  
Metformin Therapy ◽  
Insulin Levels ◽  
Healthy Women

OBJECTIVE: To determine whether metformin. when given to non-diabetic women with polycystic ovary syndrome (PCOS), results in a reduction of insulin resistance and hyperinsulinemia while body weight is maintained. Also we aimed to see whether the reduction in insulin levels attenuates the activity of adrenal P450c17alpha enzyme in patients with PCOS. DESIGN: We investigated the 17-hydroxyprogesterone (17-OHP) and androstenedione responses to ACTH, insulin responses to an oral glucose tolerance test (OGTT) and glucose disposal rate in an insulin tolerance test before and after metformin therapy (500 mg, orally, twice daily, for 12 weeks). METHODS: The presence of hyperinsulinemia in 15 women with PCOS was demonstrated by an OGTT and results were compared with those of 10 healthy women. Insulin sensitivity was measured by the rate of endogenous glucose disposal after i.v. bolus injection of insulin. 17-OHP and androstenedione responses to ACTH were measured in all the women with PCOS and the normal women. RESULTS: Women with PCOS were hyperinsulinemic (102.0+/-13.0 (S.E.M.) VS 46.2+/-4.4 pmol/l) and hyperandrogenemic (free testosterone 15.3+/-1.7 vs 7.9+/-0.6 nmol/l; androstenedione 11.8+/-0.8 vs 8.2+/-0.6 nmol/l) and more hirsute (modified Ferriman-Gallwey score, 17.7+/-1.6 vs 3.0+/-0.3) than healthy women. In addition, women with PCOS had higher 17-OHP and androstenedione responses to ACTH when compared with healthy women. Metformin therapy resulted in some improvement in insulin sensitivity and reduced the basal and post-glucose load insulin levels. But 17-OHP and androstenedione responses to ACTH were unaltered in response to metformin. CONCLUSIONS: PCOS is characterized by hyperactivity of the adrenal P450c17alpha enzyme and insulin resistance. It seems that there is no direct relationship between insulin resistance and adrenal P450c17alpha enzyme dysregulation.

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