Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet

Crosignani, Pier Giorgio; Colombo, M.; Vegetti, Walter; Somigliana, Edgardo; Gessati, Alessio; Ragni, G.

doi:10.1093/humrep/deg367

Cited by 302 publications

(169 citation statements)

References 39 publications

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“…In addition, a great inter-individual variability in the response to weight loss has been reported, and predictive factors are still largely under-evaluated (48,49). However, it has been shown that when the objectives are well defined, patient empowerment can be increased, and the extent of weight loss can, therefore, be amplified (50).…”

Section: Effect Of Weight Loss On Pcos: Lifestyle and Bariatric Surgerymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Pasquali

Diamanti-Kandarakis

Gambineri

2016

European Journal of Endocrinology

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PCOS is a clinical heterogeneous entity of female androgen excess diagnosed by exclusion of other disorders responsible for androgen excess. The concept of secondary PCOS implies that there is a primary well-defined cause leading to the PCOS phenotype with underlying androgen overproduction, regardless of the origin. In these cases, we presume the term of 'secondary PCOS' could be used. In all these conditions, the potential complete recovery of the hyperandrogenemic state as well as the remission of the PCOS phenotype should follow the removal of the cause. If accepted, these concepts could help clinicians to perform in-depth investigations of the potential factors or disorders responsible for the development of these specific forms of secondary PCOS. Additionally, this could contribute to develop further research on factors and mechanisms involved in the development of the classic and the nonclassic PCOS phenotypes. Invited author's profileRenato Pasquali is full professor of Endocrinology & Metabolism and Director of the division of Endocrinology of the S.Orsola-Malpighi Hospital, Bologna, Italy. He also heads the School of Specialization in Endocrinology and Metabolism, University Alma Mater Studiorum of Bologna, Italy. He is a member of numerous national and international scientific societies and serves on the editorial boards of international journals. His scientific interests relate to (i) the pathophysiology and treatment of the polycystic ovary syndrome; (ii) the endocrinology of obesity (sex hormones, the hypothalamic-pituitary-adrenal axis, and the endocannabinoid system).

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Section: Effect Of Weight Loss On Pcos: Lifestyle and Bariatric Surgerymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Pasquali

Diamanti-Kandarakis

Gambineri

2016

European Journal of Endocrinology

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“…Current anthropometric indices of adipose tissue amount and accumulation site in PCOS women have revealed there is a greater adipose tissue mass in the internal organs, waist and arms of PCOS women than in control subjects..A tendency to android fat distribution was observed even in lean PCOS women (Gennarelli et al 2000;Kirchengast and Huber 2001;Crosignani et al 2003;Hashimoto et al 2003;Snijder et al 2004;Toscani et al 2007;Moran and Teede 2009;March et al 2010 andPenaforte et al 2011). However, studies analysing skeletal, muscle and internal organ masses in PCOS women is currently lacking.…”

Section: Introductionmentioning

confidence: 99%

Body composition of lean women with polycystic ovary syndrome

Zabulienė

Urbonienė

Tutkuvienė

2013

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Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine and metabolic disorders in reproductive age women, and it is related to changes in body size, shape and composition. Anthropometric somatotype is a quantitative description of the individual's body shape and composition classified as endomorphy, mesomorphy or ectomorphy. Since PCOS somatotype has never previously been studied, here we evaluate body shape and composition phenomena in lean women with polycystic ovary syndrome and assess relationships with metabolic parameters. The study of 20-35 year-old women was carried out at the Department of Anatomy, Histology and Anthropology at Vilnius University. Standard anthropometric instruments and methods were used, and J. Matiegka's equations calculated skeletal mass, skin and subcutaneous adipose tissue and muscles and internal organs. In addition, Heath -Carter's somatotypes were computed, and the participants' glucose, insulin, testosterone, sex hormone-binding globulin and lipid levels were established. We analysed data from 120 women with a mean age of 27.30 ± 3.68 years. Lean women with PCOS had greater skeletal mass by 0.47 kg (p<0.05, Cohen's d=1.14), greater skin and subcutaneous adipose tissue mass by 2.79 kg (p<0.05, Cohen's d=6.07) and lower muscle mass by 1.47 kg (p<0.05, Cohen's d=2.84) compared to control women (p<0.05). The mean PCOS somatotype ratio was 4.96-4.38-3.00 (SD 1.50-1.26-1.11). This classified women with PCOS as mesomorphic endomorphs, in contrast to healthy women who were endomorphic mesomorphs. The PCOS subjects' skin and subcutaneous adipose tissue and endomorphy/mesomorphy somatotype positively correlated with insulin levels and the HOMA-IR. It was established that lean women with polycystic ovary syndrome had a mesomorphic endomorph somatotype and higher skin and subcutaneous adipose tissue mass, but less muscle mass than healthy lean women. In addition, skin and subcutaneous adipose tissue positively correlated with insulin level and HOMA-IR in lean PCOS women.

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“…28 16 weeks Diet (RCT) 6000 KJ/day HP: 40% C, 30% P, 30% F LP: 55% C ,15% P, 30% F -7.7 kg Decreased fasting insulin, LDL cholesterol, triglyceride 44% had improvement in ovulation [50] Crosignani et al (2003) 33 12 months Diet (non-RCT) 5000 KJ/day 55% C, 20% P, 25% F Exercise: Advised to do some swimming or aerobics at least twice weekly 76% lost >5% 33% lost >10% NA Among those who lost >5% weight: 7% had resumed normal menstrual cyclicity, 10 were pregnant, 8 live births [52] Moran et al Decreased fasting insulin Decreased free T and LH:FSH ratio [42] Tolino et al Decreased free T, increased SHBG, decreased hirsutism, 25% conceived. Improved ovulation and menstrual cyclicity [46] Hoeger et al 57% had improved menstrual cyclicity [44] In a non-PCOS-specific meta-regression of 87 studies, Krieger and colleagues found that lowercarbohydrate diets were associated with greater weight loss, fat mass loss, and decrease in percentage body fat [72].…”

Section: Moderate Carbohydrate High-protein Low-fat Diets (~40% Carmentioning

confidence: 99%

Obesity Management in Women with Polycystic Ovary Syndrome

Lim

Clifton

Noakes

et al. 2007

Womens Health (Lond Engl)

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Obesity and insulin resistance play an important role in initiating or maintaining ill health in polycystic ovary syndrome (PCOS). This implies that treatment that reduces body weight and insulin resistance would alleviate the symptoms of PCOS. Lifestyle modification has been found to be effective in restoring reproductive function in up to 80% of individuals who achieve at least 5% weight loss. However, long-term weight maintenance is a challenge. This article provides a review of reduced glycemic load diets, including low glycemic index, very low carbohydrate, high-protein and high monounsaturated fat diets, on metabolic and reproductive health in PCOS and non-PCOS populations. Dietary trials in non-PCOS women suggest that higher-protein, reduced glycemic load diets were probably more beneficial than the conventional low-fat, high-carbohydrate diet but further studies are required to confirm this in PCOS women. Similarly, the optimal exercise regime for PCOS women remains to be investigated.Obesity & polycystic ovary syndrome Polycystic ovary syndrome (PCOS) is one of the most common endocrine conditions that affects obese and nonobese women during reproductive age. Its symptoms include irregular menses, infertility, acne and hirsutism (excessive hair growth). During pregnancy, PCOS probably also increases the risk of early miscarriages and complications such as pre-eclampsia and gestational diabetes [1]. As a result of these physical manifestations, women with PCOS tend to have poorer psychological health and lower quality of life [2]. Increasing evidence also suggests that women with PCOS may be at greater risk of developing metabolic diseases such as type 2 diabetes and cardiovascular disease in the long term [3,4].Owing to its heterogeneity, the diagnostic criteria for PCOS have been a contentious issue among experts. The 1990 National Institutes of Health (NIH) meeting defined PCOS as the coexistence of chronic anovulation and hyperandrogenism, with the exclusion of other diseases such as thyroid disorder, hyperprolactinemia, congenital adrenal hyperplasia, androgensecreting tumors and Cushing syndrome [5]. In 2003, this definition was broadened to include women with either hyperandrogenism or anovulation in addition to having polycystic ovaries. Using the previous NIH definition, the prevalence of PCOS was estimated to be 5-8% of women of reproductive age [6][7][8][9]. This number is estimated to increase by 65% using the latest revised diagnostic criteria [10]. Obesity & fat distribution in PCOS womenIt is estimated that 30-60% of women with PCOS are overweight or obese in the Western world [7,[11][12][13][14]. Some suggest that the prevalence of obesity is higher in PCOS women compared with healthy controls [7,15,16]. In a study involving 3094 women, Glueck and colleagues found that approximately 73-78% of women with PCOS aged between 20 and 41 years were obese (body mass index [BMI]>30 kg/m 2 ) compared with 7-14% in the general population [16]. In addition to being potentially predisposed to obesity,...

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Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet

Abstract: Weight loss through a controlled low-calorie diet improves anthropometric indices in obese PCOS patients, reduces ovarian volume and microfollicle number and can restore ovulatory cycles, allowing spontaneous pregnancy.

Cited by 302 publications

References 39 publications

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

MANAGEMENT OF ENDOCRINE DISEASE: Secondary polycystic ovary syndrome: theoretical and practical aspects

Body composition of lean women with polycystic ovary syndrome

Obesity Management in Women with Polycystic Ovary Syndrome

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