scholarly journals Effect of a low-starch/low-dairy diet on fat oxidation in overweight and obese women with polycystic ovary syndrome

2014 ◽  
Vol 39 (11) ◽  
pp. 1237-1244 ◽  
Author(s):  
Ali M. Pohlmeier ◽  
Jennifer L. Phy ◽  
Phillip Watkins ◽  
Mallory Boylan ◽  
Julian Spallholz ◽  
...  
Keyword(s):  
Body Weight ◽  
Polycystic Ovary Syndrome ◽  
Dietary Intervention ◽  
Polycystic Ovary ◽  
Fat Oxidation ◽  
Carbohydrate Oxidation ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Increased Risk ◽  
Significant Difference

Polycystic ovary syndrome (PCOS) affects between 4%–18% of reproductive-aged women and is associated with increased risk of obesity and obesity-related disease. PCOS is associated with hyperinsulinemia, which is known to impair fat oxidation. Research shows that carbohydrates from dairy and starch-based foods cause greater postprandial insulin secretion than carbohydrates from nonstarchy vegetables and fruits. The purpose of this study was to determine whether an ad libitum 8-week low-starch/low-dairy diet would improve fasting and postprandial fat oxidation after a high saturated fat liquid meal (HSFLM) in overweight and obese women with PCOS. Prospective 8-week dietary intervention using a low-starch/low-dairy diet in 10 women (body mass index ≥25 kg/m2 and ≤45 kg/m2) with PCOS. Indirect calorimetry was used at fasting and for 5 h following consumption of the HSFLM to determine respiratory exchange ratio (RER), macronutrient oxidation, and energy expenditure (EE) at week 0 and week 8. Participants had a reduction in body weight (–8.1 ± 1.8 kg, p < 0.05) and fasting insulin (–19.5 ± 8.9 μg/mL, p < 0.05) after dietary intervention; however, these were not significantly correlated with improved fat oxidation. There was a reduction in fasting RER, and fasting and postprandial carbohydrate oxidation, and an increase in fasting and postprandial fat oxidation after adjusting for body weight. There was also significant difference in incremental area under the curve from pre- to post-diet for fat (0.06 ± 0.00 g/kg per 5 h; p < 0.001) and carbohydrate oxidation (–0.29 ± 0.06 g/kg per 5 h; p < 0.001), but not for RER or EE. In conclusion, an 8-week low-starch/low-dairy diet increased fat oxidation in overweight and obese women with PCOS.

scholarly journals Responses of Serum Androgen and Insulin Resistance to Metformin and Pioglitazone in Obese, Insulin-Resistant Women with Polycystic Ovary Syndrome

2005 ◽  
Vol 90 (3) ◽  
pp. 1360-1365 ◽  
Author(s):  
C. Ortega-González ◽  
S. Luna ◽  
L. Hernández ◽  
G. Crespo ◽  
P. Aguayo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Weight ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Waist To Hip Ratio

Severe insulin resistance is a key abnormality in obese women with polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate whether pioglitazone decreases insulin resistance (IR) and hyperandrogenism to the same extent as metformin in obese women with PCOS who have not received any previous treatment. Fifty-two women with PCOS were randomly allocated to receive either pioglitazone (30 mg/d, n = 25) or metformin (850 mg three times daily, n = 27) and were assessed before and after 6 months. Body weight, body mass index, and waist to hip ratio increased significantly (P ≤ 0.05) after pioglitazone treatment but not after metformin treatment. Fasting serum insulin concentration (P &lt; 0.001 for both drugs) and the area under the insulin curve during a 2-h oral glucose tolerance test decreased after pioglitazone (P &lt; 0.002) or metformin (P &lt; 0.05) treatment. IR (homeostasis model of assessment-IR index) decreased and insulin sensitivity (elevation of the quantitative insulin sensitivity check index and the fasting glucose to insulin ratio) increased (P ≤ 0.008) after treatment with either drug. Hirsutism (P &lt; 0.05) and serum concentrations of free testosterone (P &lt; 0.02) and androstenedione (P &lt; 0.01) declined to a similar extent after treatment with the drugs. Treatment with pioglitazone or metformin was associated with the occurrence of pregnancy (n = 5 and n = 3, respectively). These results suggest that pioglitazone is as effective as metformin in improving insulin sensitivity and hyperandrogenism, despite an increase in body weight, body mass index, and the waist to hip ratio associated with pioglitazone.

scholarly journals Assessment of Psycho-emotional Distress Due to Age, Body Mass Index, and Marital Status in Polycystic Ovary Syndrome in North Indian Population

2020 ◽  
Vol 8 (4) ◽  
pp. 368-375
Author(s):  
Fauzia Tabassum ◽  
Hemali Heidi Sinha ◽  
Kavita Dhar ◽  
Chandra Jyoti ◽  
Md Sayeed Akhtar ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Polycystic Ovary Syndrome ◽  
Marital Status ◽  
Body Mass ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Significant Difference ◽  
The Impact

Objectives: Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder in reproductive age having a greater impact on health-related quality of life (HRQOL). The aim of this study was to find out PCOS demographics and its related HRQOL effects for improving psychological understanding in disease management. Materials and Methods: A prospective questionnaire-based study was conducted for a period of twelve months at All India Institute of Medical Sciences, Patna, India. The data of 100 PCOS cases were collected about socio-demographic status, clinical history, and dietary intake. Then, a validated PCOS questionnaire (PCOSQ) was used to observe the impact of PCOS symptoms on patients’ HRQOL. Results: The overall 57% and 48% of PCOS cases belonged to the age range of 20-30 years and had a body mass index (BMI) of >25-30, respectively. Based on the results, a significant difference was observed in the mean score of PCOSQ vs. marital status in PCOS cases with respect to emotion (P=0.039), body weight (P=0.002), and infertility (P=0.001). Furthermore, the result showed a significant difference in the domain of emotion (P=0.008), body hair (P=0.035), body weight (P<0.001), and infertility (P=0.018) among BMI group, and a high score was observed in the BMI group <18 in comparison to the other groups of BMI. Conclusions: In general, our findings indicated that infertility, emotions, and BMI had extremely higher impacts on the HRQOL of women suffering from PCOS although their educational status failed to affect HRQOL.

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 Circulating resistin and follistatin levels in obese and non-obese women with polycystic ovary syndrome: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0246200
Author(s):  
Tahereh Raeisi ◽  
Hossein Rezaie ◽  
Mina Darand ◽  
Akram Taheri ◽  
Nazila Garousi ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Obesity Status ◽  
Significant Difference ◽  
Mean Differences ◽  
Stratified Analysis

This meta-analysis was performed to resolve the inconsistencies regarding resistin and follistatin levels in women with polycystic ovary syndrome (PCOS) by pooling the available evidence. A systematic literature search using PubMed and Scopus was carried out through November 2020 to obtain all pertinent studies. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between the levels of resistin and follistatin with PCOS in the overall and stratified analysis by obesity status. A total of 47 publications, 38 for resistin (2424 cases; 1906 controls) and 9 studies for follistatin (815 cases; 328 controls), were included in the meta-analysis. Resistin levels were significantly higher in PCOS women compared with non-PCOS controls (WMD = 1.96 ng/ml; 95%CI = 1.25–2.67, P≤0.001) as well as in obese PCOS women vs. obese controls, and in non-obese PCOS women compared with non-obese controls, but not in obese PCOS vs. non-obese PCOS patients,. A significantly increased circulating follistatin was found in PCOS patients compared with the controls (WMD = 0.44 ng/ml; 95%CI = 0.30–0.58, P≤0.001) and in non-obese PCOS women compared with non-obese controls and in obese PCOS women vs. obese controls, but, no significant difference in follistatin level was observed in obese PCOS compared with non-obese PCOS women. Significant heterogeneity and publication bias was evident for some analyses. Circulating levels of resistin and follistatin, independent of obesity status, are higher in women with PCOS compared with controls, showing that these adipokines may contribute to the pathology of PCOS.

Increased insulin sensitivity and fibrinolytic capacity after dietary intervention in obese women with polycystic ovary syndrome

Metabolism ◽  
1995 ◽  
Vol 44 (5) ◽  
pp. 611-616 ◽  
Author(s):  
Per Andersen ◽  
Ingebjørg Seljeflot ◽  
Michael Abdelnoor ◽  
Harald Arnesen ◽  
Per Olav Dale ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Dietary Intervention ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Fibrinolytic Capacity

scholarly journals Phosphodiesterase 4 Inhibition as a Potential New Therapeutic Target in Obese Women With Polycystic Ovary Syndrome

2014 ◽  
Vol 99 (8) ◽  
pp. E1476-E1481 ◽  
Author(s):  
Mojca Jensterle ◽  
Tomaz Kocjan ◽  
Andrej Janez
Keyword(s):  
Body Weight ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Combined Treatment ◽  
Pde4 Inhibitor ◽  
Model Assessment ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Anthropometric Measures ◽  
Positive Effects

Context: Phosphodiesterase (PDE) enzymes, including members of PDE4, have been investigated in the regulation of endocrine and reproductive functions of ovaries. In addition, selective inhibition of PDE4 enzyme has recently been implicated in the regulation of metabolism with positive effects on glucose homeostasis and weight reduction. Objective: The aim of this study was to evaluate whether the PDE4 inhibitor roflumilast affects body weight and hormonal and metabolic status in obese women with polycystic ovary syndrome (PCOS). Design/Participants/Main Outcome Measures: A 12-week prospective randomized open-label study was conducted with 36 obese women with PCOS diagnosed by the National Eunice Kennedy Shriver Institute of Child Health and Human Development criteria that had been pretreated with metformin (MET). They were randomized to MET 1000 mg twice a day or combined treatment (COM) with MET 1000 mg twice a day and roflumilast 500 μg every day. The primary outcome was change in anthropometric measures of obesity. Results: Thirty-one patients (aged 33.8 ± 7.4 y, twice a day 36.4 ± 5.1 kg/m2, mean ± SD) completed the study: 16 on MET and 15 on COM. Subjects treated with COM lost on average 4.2 ± 2.8 kg compared with a 0.9 ± 2.5 kg weight gain in the MET group (P = .025). Body mass index decreased for 1.6 ± 1.1 kg/m2 in COM arm compared with increase for 0.9 ± 2.4 kg/m2 in the MET arm (P = .046). Visceral adipose tissue area as assessed by dual-energy x-ray absorptiometry decreased from 136.7 ± 37.8 to 121.2 ± 36.2 cm2 in the COM arm compared with an increase from 155.3 ± 61.9 to 166.7 ± 67.2 cm2 in the MET arm (P = .02). From baseline to study end, both treatment interventions resulted in a significant reduction of androstenedione (P = .013), free T (P = .002), and homeostasis model assessment for insulin resistance score (P = .027) and a significant increase in SHBG (P = .024), although the between-treatment differences of the changes have not been statistically significant yet. Conclusion: Roflumilast added to metformin reduced body weight in obese women with PCOS, primarily due to a loss of fat mass.

scholarly journals Insulin sensitizing drugs increase the endogenous dopaminergic tone in obese insulin-resistant women with polycystic ovary syndrome

2005 ◽  
Vol 184 (1) ◽  
pp. 233-239 ◽  
Author(s):  
C Ortega-González ◽  
L Cardoza ◽  
B Coutiño ◽  
R Hidalgo ◽  
G Arteaga-Troncoso ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Weight ◽  
Polycystic Ovary Syndrome ◽  
Fasting Glucose ◽  
Polycystic Ovary ◽  
Serum Insulin ◽  
Oral Glucose ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Insulin Resistant

To investigate whether the long-term administration of metformin or pioglitazone to women with polycystic ovary syndrome (PCOS) could induce changes in their hypothalamic dopaminergic (DA) tone and to analyze whether these changes correlated with modifications in insulin resistance, we originally studied 57 obese hyperinsulinemic, non-diabetic, insulin resistant women with PCOS, but only 34 completed the study. They were randomly divided into two groups: group one (n=17) received pioglitazone (30 mg/day) and group 2 (n=17) received metformin (850 mg, three times a day) over 24 weeks. All women were identically studied before (basal) and 6 months after (T6) drug administration, including clinical evaluations, a 2 h oral glucose tolerance test (75 g) (OGTT) for glucose and insulin measurements, followed a week later by a 2 h intravenous metoclopramide test (10 mg bolus) for prolactin (PRL) determinations. The areas under the insulin (AUC-insulin) and PRL (AUC-PRL) curves were calculated, along with the index of insulin resistance (HOMA-IR) and the indexes of insulin sensitivity (QUICKI and fasting glucose–insulin ratio). At baseline, women in both groups were of similar age, body weight, body mass index (BMI) and Ferriman-Gallwey hirsutism score (F-G score). At completion of the study, body weight and BMI remained unchanged but the F-G score significantly decreased. Fasting serum insulin concentrations and the AUC-insulin significantly decreased by the end of the trial in a similar fashion in both groups, while the AUC-PRL significantly increased at the end of the trial in both groups. At no time were significant correlations between AUC-PRL and AUC-insulin or the indexes HOMA-IR, QUICKI or fasting glucose–insulin ratio observed. The present results suggests that either pioglitazone or metformin administration was associated with a clear improvement in the endogenous hypothalamic DA tone, simultaneously with an amelioration of the insulin resistance status in these obese women with PCOS.

scholarly journals Association between Insulin Resistance and Cardiovascular Risk Factors in Polycystic Ovary Syndrome Patients

2018 ◽  
Vol 40 (04) ◽  
pp. 188-195 ◽  
Author(s):  
Miriam Wanderley ◽  
Lara Pereira ◽  
Carla Santos ◽  
Vinícius Cunha ◽  
Mariam Neves
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Normal Body Mass Index ◽  
Fisher Exact Test ◽  
Model Assessment ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Indirect Methods ◽  
Significant Difference

Objective To analyze the association between the indirect methods of evaluating insulin resistance (IR) and blood pressure, anthropometric and biochemical parameters in a population of polycystic ovary syndrome (PCOS) patients. Methods Cross-sectional study performed at the Hospital Universitário de Brasília (HUB, in the Portuguese acronym) involving PCOS patients diagnosed from January 2011 to January 2013. Four indirect methods, namely, fasting blood insulin level, fasting glucose/insulin ratio (G/I), homeostatic model-assessment-insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI), were used to obtain the IR diagnosis. The data were analyzed using the test of proportions, the Chi-square test, and Fisher exact test, when indicated. Results Out of the 83 patients assessed, aged 28.79 ± 5.85, IR was found in 51.81–66.2% of them using the G/I ratio and the QUICKI, respectively. The test of proportions did not show a significant difference between the methods analyzed. The proportion of IR diagnoses was statistically higher in obese women than in women with normal body mass index (BMI). We observed a statistically significant association between all the methods for diagnosing IR and BMI, waist circumference (WC) and lipid accumulation product (LAP). With regards to arterial hypertension (AH), we observed a significant association according to three methods, with the exception of the ratio G/I. Conclusion Insulin resistance prevalence varied according to the diagnostic method employed, with no statistical difference between them. The proportion of IR diagnoses was statistically higher in obese women than in women with normal BMI. We observed a significant association between IR and WC, BMI, LAP, as well as dyslipidemia and AH in a high proportion of patients.

scholarly journals Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin

2014 ◽  
Vol 170 (3) ◽  
pp. 451-459 ◽  
Author(s):  
Mojca Jensterle Sever ◽  
Tomaz Kocjan ◽  
Marija Pfeifer ◽  
Nika Aleksandra Kravos ◽  
Andrej Janez
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Waist Circumference ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Combined Treatment ◽  
Obese Women ◽  
Significant Weight Loss ◽  
Short Term ◽  
Ovary Syndrome

ObjectiveThe effect of metformin on weight reduction in polycystic ovary syndrome (PCOS) is often unsatisfactory. In this study, we investigated the potential add-on effect of treatment with the glucagon-like peptide-1 receptor agonist liraglutide on weight loss in obese nondiabetic women with PCOS who had lost <5% body weight during pretreatment with metformin.MethodsA total of 40 obese women with PCOS, who had been pretreated with metformin for at least 6 months, participated in a 12-week open-label, prospective study. They were randomized to one of three treatment arms: metformin (MET) arm 1000 mg BID, liraglutide (LIRA) arm 1.2 mg QD s.c., or combined MET 1000 mg BID and LIRA (COMBI) 1.2 mg QD s.c. Lifestyle intervention was not actively promoted. The primary outcome was change in body weight.ResultsThirty six patients (aged 31.3±7.1 years, BMI 37.1±4.6 kg/m2) completed the study: 14 on MET, 11 on LIRA, and 11 on combined treatment. COMBI therapy was superior to LIRA and MET monotherapy in reducing weight, BMI, and waist circumference. Subjects treated with COMBI lost on average 6.5±2.8 kg compared with a 3.8±3.7 kg loss in the LIRA group and a 1.2±1.4 kg loss in the MET group (P<0.001). The extent of weight loss was stratified: a total of 38% of subjects were high responders who lost ≥5% body weight, 22% of them in the COMBI arm compared with 16 and 0% in the LIRA and MET arm respectively. BMI decreased by 2.4±1.0 in the COMBI arm compared with 1.3±1.3 in LIRA and 0.5±0.5 in the MET arm (P<0.001). Waist circumference also decreased by 5.5±3.8 cm in the COMBI arm compared with 3.2±2.9 cm in LIRA and 1.6±2.9 cm in the MET arm (P=0.029). Subjects treated with liraglutide experienced more nausea than those treated with metformin, but severity of nausea decreased over time and did not correlate with weight loss.ConclusionsShort-term combined treatment with liraglutide and metformin was associated with significant weight loss and decrease in waist circumference in obese women with PCOS who had previously been poor responders regarding weight reduction on metformin monotherapy.

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