Weight Management Interventions in Women with and without PCOS: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Selection Criteria
2.2. Systematic Search for Evidence
2.3. Inclusion of Studies
2.4. Quality Appraisal of the Evidence
2.5. Data Extraction
2.6. Data Synthesis
3. Results
3.1. Characteristics and Quality of Included Studies
3.2. Outcomes: Anthropometric
3.2.1. Weight
3.2.2. Body Mass Index (BMI)
3.2.3. Waist Circumference (WC)
3.2.4. Body Composition
3.3. Outcomes: Fertility
Ovulation
3.4. Outcomes: Reproductive Non-Fertility
3.4.1. Total Testosterone
3.4.2. Sex Hormone-Binding Globulin (SHBG)
3.4.3. Free Androgen Index (FAI)
3.5. Outcomes: Metabolic
3.5.1. Fasting Glucose
3.5.2. Oral Glucose Tolerance Test (OGTT-Glucose)
3.5.3. Fasting Insulin
3.5.4. Lipids
3.5.5. Blood Pressure (BP)
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Study | Design | Country | PCOS Details at Baseline N (Completers) | Non-PCOS Details at Baseline N (Completers) | Attrition Rate | Current Medication | Specific Exclusion Criteria | Intervention | Outcomes | Risk of Bias |
---|---|---|---|---|---|---|---|---|---|---|
Diamanti-Kandarakis 2007 [30] | Comparative study | Greece | Age 27.5 ± 5.77 BMI 35.4 ± 5.31 ESHRE/ASRM n = 29 | Age 32.1 ± 5.64 BMI 36.4 ± 6.47 n = 18 | Not reported | Not reported | Galactorrhea | Duration: 24 weeks Normal protein diet, 600 kcal/day energy deficit, Orlistat (Xenical®, Roche) 120 mg × 3 times daily Aim of weight loss: not stated | Anthropo-metric: BMI Reproductive: T, SHBG Metabolic: FG, 2HRG, FI | Moderate |
Moran 2007 [34] | Comparative study | Australia | Age 31.7 ± 6.2 BMI 35.7 ± 5.8 ESHRE/ASRM n = 15 | Age 37.1 ± 4.7 BMI 35.5 ± 5.1 n = 17 | PCOS 17% Non-PCOS 11% | No hormonal or insulin-sensitising drugs pre study | Pregnancy, breastfeeding | Duration: 8 weeks Energy restricted diet (two meals daily replaced with commercially available meal replacements) Aim of weight loss: Yes | Anthropo-metric: Weight, WC Reproductive: T, SHBG, FAI Metabolic: FI, lipids Others: IL-6, TNF-α | Moderate |
Hutchison 2011 [31] Harrison 2012 [32] | Comparative study | Australia | BMI > 27 (37.4 ± 1.5) Age 20–40 (29.5 ± 1.4) NIH n = 13 | BMI > 27 (35.7 ± 1.3) Age 20-40 (35.0 ± 1.1) n = 8 | PCOS 35% Non-PCOS 43% | No hormonal or insulin-sensitising drugs pre study | Diabetes, adrenal disorders, recent weight change, regular physical activity, pregnancy, breastfeeding, smoking | Duration: 12 weeks supervised intensified exercise training 60 min three times weekly Aim of weight loss: not stated | Anthropo-metric: WC, Weight, BMI, VF, SCFAT Reproductive: T, SHBG, FAI Metabolic: FG, FI, lipids, BP | Moderate |
Cheang 2016 [43] | Comparative study | USA | Age 26.9 ± 4.6 BMI 36.6 ± 5.1 Modified ESHRE/ASRM n = 16 | Age 27.5 ± 5.7 BMI 35.8 ± 4.8 n = 15 | PCOS 53% Non-PCOS 44% | No unstable medication use for 6 months for disorders such as hypertension or dyslipidemia | Weight loss attempts in 3 months pre study, diabetes, pulmonary, cardiac, renal, neurologic, hepatic, psychiatric, infectious, neoplastic, malignant disease, pregnancy Non-PCOS: history gestational diabetes, family history abnormal glucose tolerance, hypertension, dyslipidemia | Duration: 8 weeks Standardized hypocaloric diet (50% carbohydrate, 20% protein, 30% fat) with 500–1000 kcal/day deficit. No modification of physical activity or other weight loss methods. Aim of weight loss: Yes | Anthropometric: Weight, BMI Metabolic: FG, FI | Moderate |
Kogure 2016 [44] | Comparative study | Brazil | Age 28.1 ± 5.4 BMI 28.4 ± 6.0 ESHRE/ASRM n = 45 | Age 29.6 ± 5.2 BMI 26.2 ± 5.7 n = 52 | PCOS 38% Non-PCOS 46% | No hormonal contraceptive us drugs pre or during study | Systemic diseases, smoking, pregnancy | Duration: 4 months Progressive resistance training (PRT) for 1 h/day three times per week. Aim of weight loss: not stated | Anthropometric: Weight, BMI, WC, TFFM, % body fat Reproductive: T, SHBG, FAI Metabolic: FG, FI, HOMA-IR | Moderate |
Villa 1999 [40] | Comparative study | Italy | Age 26.3 ± 5 BMI 27.5 ± 6.8 NIH n = 22 | Age not reported BMI 27.4 ± 6.8 n = 14 | Not reported | Not reported | Not reported | Duration: 4–5 weeks 50 mg Naltrexone daily Aim of weight loss: not stated | Anthropo-metric: BMI Reproductive: T, SHBG, FAI Metabolic: FG, FI | High |
Kowalska 2001 [33] | Comparative study | Poland | Age 25.3 ± 4.8 BMI 34.7 ± 6.0 NIH n = 11 | Age 27.9 ± 7.3 BMI 36.2 ± 6.0 n = 19 | PCOS 27% Non-PCOS 40% | Not reported | No additional | Duration: 4–5 months Hypocaloric diet (1200–1400 kcal/day), Metformin 500 mg three times daily Aim of weight loss: not stated | Anthropo-metric: BMI, WC Reproductive: T, FAI, SHBG Metabolic: FI | High |
Panidis 2014 [35] Vosnakis 2013 [36] Panidis 2008 [37] | Comparative study | Greece | Age 26.1 ± 6.4 BMI 34.5 ± 5.9 ESHRE/ASRM n = 101 | Age 31.5 ± 4.7 BMI 34.9 ± 5.4 n = 29 | Not reported | No hormonal or insulin-sensitising drugs pre or during study | Galactorrea | Duration: 6 months Normal protein, energy-restricted diet (600 kcal/day energy deficit, moderate intensity aerobic exercise, 1 h × 3 times/week, Orlistat 120 mg before each meal) Aim of weight loss: Yes | Anthropo-metric: WC, BMI Reproductive: T, FAI, SHBG Metabolic: FG, lipids | High |
Kahal 2015 [41] | Comparative study | UK | Age 33.9 ± 6.7 BMI 37.9 ± 5.0 ESHRE/ASRM n = 13 | Age 33.5 ± 7.1 BMI 36.5 ± 4.6 n = 12 | PCOS 32% Non-PCOS 29% | No medication | Alcohol intake >14 units/week Non-PCOS: history of hirsutism or menstrual irregularities | Duration: 6 months Liraglutide 0.6 mg o.d subcutaneous injection for 1 week, 1.2 mg o.d for 1 week, and 1.8 mg o.d thereafter for 6 months. No diet or exercise advice given. Aim of weight loss: Yes | Anthropometric: Weight, BMI | High |
Nikokavora 2015 [42] | Comparative study | UK | Age 35.7 ± 8.9 BMI 40.0 ± 6.3 Diagnostic criteria not reported n = 137 | Age 35.8 ± 8.9 BMI 40.0 ± 6.3 n = 137 | PCOS 73% Non-PCOS 73% | Not reported | Type 1 diabetes, porphyria, lactose intolerance, major cardio- or cerebrovascular disease, history of renal or hepatic disease, cancer, epilepsy, major psychological or eating disorders, breastfeeding, pregnant, birth or miscarriage prior 3 months | Duration: 12 weeks Commercial weight management program (LighterLife Total), 600 kcal (36% protein, 36% carbohydrate, 28% fat) as food packs alongside behavior change program Aim of weight loss: Yes | Anthropometric: Weight, BMI | High |
Bhandari 2016 [45] | Comparative study | India | Age 27.8 ± 4.50 BMI 42.5 ± 5.71 ESHRE/ASRM n = 43 | Age 29.3 ± 4.96 BMI 45.0 ± 6.11 n = 32 | Not reported | No hormonal, fertility or insulin-sensitising drugs pre or during study | Systemic diseases like hypothyroidism or hyperprolactinaemia, surgical complications intra or post operatively | Duration: 6 months post-surgery Sleeve gastrectomy (bariatric surgery) Aim of weight loss: Yes | Anthropometric: Weight, BMI Other: Abnormal menstrual cycles | High |
Al-Eisa 2017 [46] | Comparative study | Egypt | Age 27.9 ± 4.1 BMI 33.5 ± 2.75 ESHRE/ASRM n = 30 | Age 27.6 ± 5.7 BMI 31.7 ± 3.8 n = 30 | Not reported | No hormonal drugs pre or during study | Normal BMI, other diseases such as diabetes or viral infections | Duration: 12 weeks treadmill walking, 45 min three times per week for 12 weeks. Aim of weight loss: Yes | Anthropometric: Weight, BMI, WC Metabolic: FG, FI | High |
Pasquali 2000 [38] | RCT | Italy | BMI > 28 WHR > 0.80 NIH n = 18 | BMI > 28 WHR > 0.80 n = 17 | Diet: PCOS 0% Non-PCOS 25% Metform-in: PCOS 17% Non-PCOS 0% | No hormonal or insulin-sensitising drugs pre study | Diabetes, renal or liver dysfunction | Duration: 6 months One month hypocaloric diet (1200–1400 kcal daily), Metformin 850 mg twice daily. Aim of weight loss: Yes | Anthropo-metric: Weight, BMI, SAT, VAT Reproductive: T, SHBG Metabolic: FG, FI | Moderate |
Toscani 2011 [39] | RCT | Brazil | Age 22.7 + 5.68 Most participants BMI ≥ 25 NIH n = 18 | Age 29.4 + 5.74 Most participants BMI ≥ 25 n = 22 | Not reported | No hormonal drugs pre study | Diabetes, renal dysfunction | Duration: 2 months Diet 1: HP (30% protein, 40% carbohydrate, 30% fat) Diet 2: NP (15% protein, 55% carbohydrate, 30% fat) Aim of weight loss: Yes | Anthropo-metric: Weight, WC, BMI Reproductive: T, SHBG, FAI Metabolic: BP, FG, 2HRG, FI, 2HRI, lipids | High |
Outcome | Reference | Intervention | Baseline PCOS: Mean ± SD | Baseline Non-PCOS: Mean ± SD | p-Value * | Post-Intervention PCOS: Mean ± SD | Post-Intervention Non-PCOS: Mean ± SD | p-Value * |
---|---|---|---|---|---|---|---|---|
Weight (kg) | Pasquali 2000 [38] | Hypocaloric diet | 102 ± 19 | 106 ± 13 | NR | 97 ± 18 | 100 ± 13 | NR |
Cheang 2016 [43] | Hypocaloric diet | 99.2 ± 13.3 | 97.6 ± 15.4 | 0.7508 | −4.08 ± 3.65 | −4.69 ± 2.98 | 0.6281 | |
Moran 2007 [34] | Hypocaloric diet | 95.1 ± 19.3 | 95.5 ± 16.5 | NS | −3.9 ± 3.6 | −4.5 ± 4.1 | 0.642 | |
Toscani 2011 [39] | High protein diet | 74.62 ± 18.8 | 75.89 ± 13.49 | NR | 71.4 ± 15.45 | 74.54 ± 13.71 | NR | |
Toscani 2011 [39] | Normal protein diet | 82.85 ± 15.18 | 77.51 ± 13.31 | NR | 79.82 ± 16.51 | 74.31 ± 13.88 | NR | |
Nikokavoura 2015 [42] | VLCD + behaviour change | 108.3 ± 18.1 | 107.4 ± 19.8 | 0.713 | 89.8 ± 16.7 | 88.0 ± 17.6 | 0.19 | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 103 ± 18 | 101 ± 8 | NR | 94 ± 17 | 88 ± 7 | NR | |
Kahal 2015 [41] | AO drug (Liraglutide) | 102.1 ± 17.1 | 100.4 ± 15.1 | NS | −3.0 ± 4.2 | −3.8 ± 3.4 | 0.56 | |
Bhandari 2016 [45] | Bariatric surgery | 106.89 ± 17.79 | 117.03 ± 19.89 | NR | 77.27 ± 10.72 | 84.89 ± 13.18 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 100.5 ± 4.5 ! | 96.2 ± 3.5 ! | 0.42 | 95.3 ± 4.8 ! | 96.9 ± 4.5 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 73.1 ± 15.6 | 68.1 ± 15.4 | NS | 0.52 [−0.31, 1.36] ^ | 0.13 [−0.64, 0.90] ^ | 0.14 | |
Al−Eisa 2017 [46] | Aerobic training | 89.8 ± 6.95 | 84.9 ± 7.2 | NR | 84.8 ± 6.42 | 82.2 ± 5.72 | NR | |
BMI (kg/m2) | Pasquali 2000 [38] | Hypocaloric diet | 39.6 ± 6.9 | 40.1 ± 6.2 | NR | 38 ± 6.2 | 37.8 ± 5.7 | NR |
Cheang 2016 [43] | Hypocaloric diet | 36.6 ± 5.1 | 35.8 ± 4.8 | 0.6507 | −1.46 [−0.72, −2.20] # | −1.80 [−1.14, −2.45] # | 0.4829 | |
Nikokavoura 2015 [42] | VLCD + behaviour change | 40.0 ± 6.3 | 40.0 ± 6.3 | 0.955 | 33.2 ± 6.0 | 32.8 ± 5.7 | NR | |
Kowalska 2001 [33] | Hypocaloric diet + Metformin | 34.7 ± 6.0 | 36.2 ± 6.0 | NS | 31.4 ± 4.8 | 35.8 ± 7.9 | NR | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 39.8 ± 7.9 | 37.4 ± 3.0 | NR | 36.4 ± 7.4 | 32.9 ± 3.4 | NR | |
Diamanti−Kandarakis 2007 [30] | Hypocaloric diet + AO drug (Orlistat) | 35·43 ± 5·31 | 36·39 ± 6·47 | 0.58 | 29.7 ± 4.57 | 30.15 ± 4.13 | NR | |
Vosnakis 2013 [36] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 34.83 ± 6.39 | 36.79 ± 6.98 | NR | 30.21 ± 5.78 | 31.01 ± 4.93 | NR | |
Kahal 2015 [41] | AO drug (Liraglutide) | 37.9 ± 5.0 | 36.5 ± 4.6 | NS | −1.0 ± 1.5 | −1.4 ± 1.2 | 0.43 | |
Villa 1999 [40] | AO drug (Naltrexone) | 27.5 ± 6.8 | 27.4 ± 6.8 | NS | 26.8 ± 6.7 | 27 ± 6.8 | NR | |
Bhandari 2016 [45] | Bariatric surgery | 42.52 ± 5.66 | 45.03 ± 6.3 | 0.0717 | 30.76 ± 2.93 | 32.67 ± 3.51 | 0.013 | |
Hutchison 2001 [31] | Intensified exercise training | 37.4 ± 1.5 ! | 35.7 ± 1.3 ! | 0.43 | 35 ± 1.6 ! | 35.9 ± 1.8 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 28.4 ± 6.0 | 26.2 ± 5.7 | NS | 0.21 [−0.11, 0.54] ^ | 0.05 [−0.25, 0.35] ^ | 0.08 | |
Al−Eisa 2017 [46] | Aerobic training | 33.45 ± 2.75 | 31.7 ± 3.8 | NR | 28.5 ± 2.25 | 26.8 ± 2.54 | NR | |
WC (cm) | Pasquali 2000 [38] | Hypocaloric diet | 109 ± 19 | 109 ± 11 | NR | 104 ± 13 | 105 ± 12 | NR |
Toscani 2011 [39] | High protein diet | 87.74 ± 14.08 | 83.92 ± 9.13 | <0.05 | 86 ± 12.92 | 81.83 ± 9.13 | NR | |
Toscani 2011 [39] | Normal protein diet | 93.32 ± 8.05 | 84.02 ± 9.03 | <0.05 | 90.03 ± 10.41 | 81.7 ± 11.72 | NR | |
Kowalska 2001 [33] | Hypocaloric diet + Metformin | 98.1 ± 14.8 | 102.3 ± 13.0 | NS | 93.4 ± 11.8 | 100 ± 19.5 | NR | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 107 ± 16 | 102 ± 6 | NR | 100 ± 15 | 94 ± 6 | NR | |
Panidis 2008 [37] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 101.52 ± 2.67 | 100.53 ± 3.94 | NS | 87.86 ± 2.29 | 87.67 ± 2.82 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 106.8 ± 3.4 ! | 102.8 ± 2.6 ! | 0.39 | 103.1 ± 4 ! | 99.9 ± 4.1 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 81.7 ± 12.8 | 76.2 ± 11.3 | <0.05 | 0.86 [0.32, 1.40] ^ | 0.27 [−0.21, 0.75] | 0.21 | |
Al−Eisa 2017 [46] | Aerobic training | 96.2 ± 3.52 | 94.2 ± 3.82 | NR | 93.8 ± 3.26 | 72.7 ± 2.6 | NR | |
VAT/VF (cm2) | Pasquali 2000 [38] | Hypocaloric diet | 121 ± 48 | 181 ± 94 | NR | 108 ± 36 | 159 ± 83 | NR |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 151 ± 91 | 133 ± 38 | NR | 113 ± 59 | 100 ± 37 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 129.2 ± 12.8 ! | 121.5 ± 9.4 ! | 0.65 | 107.6 ± 15.1 ! | 132.7 ± 18.1 ! | NR | |
SAT/SCFAT (cm2) | Pasquali 2000 [38] | Hypocaloric diet | 589 ± 127 | 554 ± 118 | NR | 574 ± 111 | 508 ± 107 | NR |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 535 ± 147 | 554 ± 79 | NR | 485 ± 170 | 462 ± 81 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 590.2 ± 35.2 ! | 550.3 ± 45.2 ! | 0.49 | 538.4 ± 40.2 ! | 558.5 ± 74.5 ! | NR |
Outcome | References | Intervention | Baseline PCOS: Mean ± SD | Baseline Non-PCOS: Mean ± SD | p-Value * | Post-intervention PCOS: Mean ± SD | Post-intervention Non-PCOS: Mean ± SD | p-Value * |
---|---|---|---|---|---|---|---|---|
Number of ovulations | Moran 2007 [34] | Hypocaloric diet | NR | NR | NR | 1.9 ovulations | 1.0 ovulations | <0.001 |
Total testosterone (nmol/L) | Pasquali 2000 [38] | Hypocaloric diet | 1.77 ± 0.59 | 1.32 ± 0.42 | <0.05 | 1.63 ± 0.45 | 1.14 ± 0.35 | NR |
Kowalska 2001 [33] | Hypocaloric diet + Metformin | 3.57 ± 1.01 | 1.91 ± 0.42 | <0.05 | 2.39 ± 1.11 | 1.7 ± 0.59 | NR | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 2.36 ± 1.21 | 1.46 ± 0.38 | <0.01 | 1.7 ± 0.87 | 1.25 ± 0.38 | NR | |
Diamanti-Kandarakis 2007 [30] | Hypocaloric diet + AO drug (Orlistat) | 3.01 ± 0.94 | 1.50 ± 0.43 | <0.001 | 2.28 ± 0.65 | 1.49 ± 0.36 | <0.05 | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 2.56 ± 1.00 | 1.33 ± 0.45 | <0.001 | 2.1 ± 0.78 | 1.41 ± 0.74 | 0.006 | |
Villa 1999 [40] | AO drug (Naltrexone) | 1.7 ± 0.5 | 1.4 ± 0.5 | NS | 1.9 ± 1.76 | 1.5 ± 1.2 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 2.9 ± 0.2! | 1.6 ± 0.2 ! | <0.01 | 2.8 ± 0.3 ! | 1.8 ± 0.3 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 3.12 ± 1.22 | 2.58 ± 1.02 | <0.05 | 0.59 [0.30, 0.89] ^ | 0.42 [0.16, 0.68] ^ | 0.15 # | |
SHBG (nmol/L) | Pasquali 2000 [38] | Hypocaloric diet | 16.0 ± 7.04 | 20.2 ± 10.7 | NS | 13.8 ± 2.1 | 28.1 ± 14.7 | NR |
Kowalska 2001 [33] | Hypocaloric diet + Metformin | 32.0 ± 18.3 | 32.5 ± 16.5 | NS | 38.6 ± 19.3 | 36.5 ± 13.3 | NR | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 18.7 ± 15.0 | 23.4 ± 22.7 | NS | 16.7 ± 8.1 | 28.9 ± 16.5 | NR | |
Diamanti-Kandarakis 2007 [30] | Hypocaloric diet + AO drug (Orlistat) | 28.72 ± 12.48 | 40.92 ± 19.54 | 0.01 | 37.21 ± 17.59 | 58.6 ± 27.02 | <0.05 | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 30.3 ± 13.2 | 47.8 ± 34.7 | 0.012 | 40.3 ± 20.4 | 62.2 ± 35.5 | NS | |
Villa 1999 [40] | AO drug (Naltrexone) | 30.2 ± 20.4 | 38.2 ± 16.4 | NS | 32.5 ± 20.9 | 39.2 ± 15.7 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 29.0 ± 1.8! | 43.6 ± 7.8 ! | 0.04 | 30.7 ± 2.8 ! | 54.3 ± 10.6 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 54.9 ± 37.8 | 63.0 ± 35.7 | NS | 0.12 [0.02, 0.23] ^ | 0.09 [−0.01, 0.18] ^ | 0.37 # | |
FAI | Kowalska 2001 [33] | Hypocaloric diet + Metformin | 14.49 ± 8.49 | 9.97 ± 7.95 | <0.05 | 9.31 ± 9.95 | 5.49 ± 3.9 | NR |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 10.25 ± 6.31 | 3_71 ± 2.11 | <0.001 | 6.76 ± 4.32 | 2.71 ± 1.74 | 0.021 | |
Villa 1999 [40] | AO drug (Naltrexone) | 9.3 ± 6.5 | 4.9 ± 3.1 | <0.05 | 8.9 ± 5.7 | 5.2 ± 3.3 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 10.7 ± 1.1 ! | 4.6 ± 0.9 ! | <0.01 | 10.1 ± 1.6 ! | 4.1 ± 1.1 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 8.3 ± 6.3 | 5.6 ± 4.6 | <0.05 | 0.98 [−0.03, 1.99] ^ | 0.37 [−0.50, 1.24] ^ | 0.25 # |
Outcome | References | Intervention | Baseline PCOS: Mean ± SD | Baseline Non-PCOS: Mean ± SD | p-Value * | Post-Intervention PCOS: Mean ± SD | Post-Intervention Non-PCOS: Mean ± SD | p-Value * |
---|---|---|---|---|---|---|---|---|
Fasting glucose (mmol/L) | Pasquali 2000 [38] | Hypocaloric diet | 5.61 ± 1.0 | 5.11 ± 0.56 | NS | 5.27 ± 0.61 | 5.16 ± 0.94 | NR |
Cheang 2016 [43] | Hypocaloric diet | 4.75 ± 0.45 | 4.67 ± 0.21 | 0.60 | −0.06 (−0.25, 0.12) % | 0.01 (−0.13, 0.15) % | 0.5041 | |
Toscani 2011 [39] | High protein diet | 4.97 ± 0.34 | 4.95 ± 0.45 | NS | 5.02 ± 0.40 | 5.05 ± 0.54 | NR | |
Toscani 2011 [39] | Normal protein diet | 4.90 ± 0.36 | 4.98 ± 0.41 | NS | 4.98 ± 0.35 | 5.02 ± 0.35 | NR | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 5.49 ± 1.61 | 4.94 ± 0.56 | NS | 5 ± 0.94 | 4.94 ± 0.72 | NR | |
Diamanti-Kandarakis 2007 [30] | Hypocaloric diet + AO drug (Orlistat) | 5.72 ± 0.51 | 5.77 ± 0.61 | 0.92 | 5.52 ± 0.47 | 5.69 ± 0.52 | NR | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 5.58 ± 0.57 | 5.81 ± 0.66 | NS | 5.28 ± 0.56 | 5.58 ± 0.51 | NS | |
Villa 1999 [40] | AO drug (Naltrexone) | 4.65 ± 0.33 | 4.55 ± 0.22 | NS | 4.33 ± 0.56 | 4.48 ± 0.37 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 5.0 ± 0.1 ! | 4.8 ± 0.1 ! | 0.57 | 4.9 ± 0.1 ! | 4.9 ± 0.1 ! | NR | |
Kogure 2016 [44] | Progressive resistance training | 5.34 ± 0.91 | 5.31 ± 0.97 | NS | 0.37 [0.08, 0.66] $ | 0.30 [0.04, 0.56] $ | 0.12 ** | |
Al-Eisa 2017 [46] | Aerobic training | 4.50 ± 2.80 | 5.59 ± 1.57 | NR | 4.50 ± 2.80 | 5.59 ± 1.57 | NR | |
OGTT-glucose (mmol/L) | Toscani 2011 [39] | High protein diet | 6.27 ± 1.60 | 5.02 ± 0.99 | NR | 6.92 ± 2.0 | 5.63 ± 1.56 | NR |
Toscani 2011 [39] | Normal protein diet | 6.55 ± 1.50 | 5.41 ± 1.02 | NR | 6.64 ± 2.16 | 5.18 ± 1.02 | NR | |
Diamanti-Kandarakis 2007 [30] | Hypocaloric diet + AO drug (Orlistat) | 6.35 ± 1.35 | 6.54 ± 1.54 | 0.65 | 6.17 ± 0.85 | 6.21 ± 1.77 | NR | |
Fasting insulin (pmol/L) | Pasquali 2000 [38] | Hypocaloric diet | 240.36 ± 214.53 | 149.24 ± 79.64 | NS | 136.33 ± 103.32 | 103.32 ± 76.06 | NR |
Toscani 2011 [39] | High protein diet | 76.05 (60.00–123.41) ^ | 57.85 (28.20–84.94) ^ | <0.05 | 61.67 (52.71–108.83) ^ | 56.74 (33.20–97.92) ^ | NR | |
Toscani 2011 [39] | Normal protein diet | 128.83 (93.06–213.28) ^ | 59.59 (41.04–84.52) ^ | <0.05 | 129.15 (76.99–233.04) ^ | 48.00 (31.14–80.14) ^ | NR | |
Pasquali 2000 [38] | Hypocaloric diet + Metformin | 308.53 ± 218.12 | 217.40 ± 58.84 | NS | 154.98 ± 223.86 | 102.6 ± 60.99 | NR | |
Kowalska 2001 [33] | Hypocaloric diet + Metformin | 26.2 ± 13.9 # | 18.3 ± 14.2 # | <0.05 | 16.9 ± 9.1 # | 20.0 ± 13.5 # | NR | |
Diamanti-Kandarakis 2007 [30] | Hypocaloric diet + AO drug (Orlistat) | 127.37 ± 61.12 | 125.5 ± 87.09 | 0.45 | 76.4 ± 34.93 | 77.02 ± 47.3 | NR | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 129.87 ± 75.01 | 133.34 ± 161.82 | NS | 81.08 ± 50.94 | 68.16 ± 40.18 | NS | |
Villa 1999 [40] | AO drug (Naltrexone) | 99.7 ± 75 | 104.3 ± 63.1 | NS | 90.4 ± 61 | 85.3 ± 39.4 | NR | |
Hutchison 2011 [31] | Intensified exercise training | 141.6 (100.8–181.2) ^ | 72.6 (58.8–115.8) ^ | 0.02 | 97.8 (66.6–231.0) ^ | 115.2 (76.2–177.6) ^ | NR | |
Kogure 2016 [44] | Progressive resistance training | 64.59 ± 47.92 | 36.11 ± 31.25 | <0.05 | 0.90 [−0.21, 1.94] $ | −0.90 [−1.88, 0.07] $ | 0.58 ** | |
Al-Eisa 2017 [46] | Aerobic training | 17.8 ± 4.20 @ | 20.6 ± 8.2 @ | NR | 14.8 ± 2.9 @ | 16.1 ± 5.1 @ | NR |
Outcome | References | Intervention | Baseline PCOS: Mean ± SD | Baseline Non-PCOS: Mean ± SD | p-Value * | Post-intervention PCOS: Mean ± SD | Post-intervention Non-PCOS: Mean ± SD | p-Value * |
---|---|---|---|---|---|---|---|---|
Total cholesterol (mmol/L) | Toscani 2011 [39] | High protein diet | 4.60 ± 1.15 | 4.24 ± 0.71 | NR | 4.32 ± 1.12 | 4.19 ± 0.82 | NR |
Toscani 2011 [39] | Normal protein diet | 4.31 ± 1.04 | 4.05 ± 1.13 | NR | 4.02 ± 0.82 | 3.86 ± 1.36 | NR | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 5.04 ± 1.00 | 5.48 ± 0.93 | NS | 4.52 ± 0.82 | 4.55 ± 0.87 | <0.001 | |
Hutchison 2011 [31] | Intensified exercise training | 5.0 ± 0.3 ! | 4.7 ± 0.2 ! | 0.81 | 4.4 ± 0.2 ! | 4.8 ± 0.4 ! | NR | |
LDL cholesterol (mmol/L) | Toscani 2011 [39] | High protein diet | 3.91 ± 1.09 | 3.66 ± 0.61 | NR | 3.78 ± 1.1 | 3.54 ± 0.76 | NR |
Toscani 2011 [39] | Normal protein diet | 3.62 ± 0.95 | 3.30 ± 1.11 | NR | 3.33 ± 0.75 | 3.13 ± 1.34 | NR | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 3.30 ± 0.90 | 3.65 ± 0.68 | NS | 2.87 ± 0.84 | 2.98 ± 0.47 | 0.001 | |
Hutchison 2011 [31] | Intensified exercise training | 3.3 ± 0.2 ! | 3.0 ± 0.2 ! | 0.48 | 3 ± 0.2 ! | 3.1 ± 0.4 ! | NR | |
HDL cholesterol (mmol/L) | Toscani 2011 [39] | High protein diet | 1.30 ± 0.19 | 1.35 ± 0.38 | NR | 1.27 ± 0.2 | 1.34 ± 0.39 | NR |
Toscani 2011 [39] | Normal protein diet | 1.19 ± 0.32 | 1.39 ± 0.26 | NR | 1.18 ± 0.32 | 1.5 ± 0.25 | NR | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic exercise | 1.20 ± 0.22 | 1.32 ± 0.31 | NS | 1.21 ± 0.23 | 1.21 ± 0.26 | 0.006 | |
Hutchison 2011 [31] | Intensified exercise training | 1.0 ± 0.1 ! | 1.2 ± 0.1 ! | 0.04 | 1 ± 0.1 ! | 1.2 ± 0.1 ! | NR | |
Triglycerides (mmol/L) | Toscani 2011 [39] | High protein diet | 0.86 (0.47–1.47) ^ | 0.68 (0.47–0.76) ^ | NR | 0.55 (0.49–0.71) ^ | 0.92 (0.55–1.02) ^ | NR |
Toscani 2011 [39] | Normal protein diet | 0.97 (0.67–1.30) ^ | 0.71 (0.41–1.62) ^ | NR | 0.94 (0.81–1.15) ^ | 0.88 (0.64–1.21) ^ | NR | |
Panidis 2014 [35] | Hypocaloric diet + AO drug (Orlistat) + moderate intensity aerobic training | 1.17 ± 0.56 | 1.28 ± 0.62 | NS | 0.99 ± 0.44 | 0.87 ± 0.25 | NS | |
Hutchison 2011 [31] | Intensified exercise training | 1.4 ± 0.2 ! | 1.2 ± 0.2 ! | 0.46 | 0.9 ± 0.1 ! | 1.3 ± 0.1 ! | NR | |
BP systolic (mmHg) | Toscani 2011 [39] | High protein diet | 125.7 ± 19.0 | 116.1 ± 10.41 | NR | 126 ± 23.1 | 117.85 ± 10.18 | NR |
Toscani 2011 [39] | Normal protein diet | 119.1 ± 16.4 | 116.43 ± 10.3 | NR | 119.36 ± 15.38 | 110.71 ± 7.32 | NR | |
Harrison 2012 [32] | Intensified exercise training | 108 ± 14.6 ! | 118 ± 16.7 ! | NS | 109 ± 10.4 ! | 116 ± 16.2 ! | NR | |
BP diastolic (mmHg) | Toscani 2011 [39] | High protein diet | 77.9 ± 10.75 | 74.6 ± 8.46 | NR | 80 ± 11.2 | 74 ± 8.83 | NR |
Toscani 2011 [39] | Normal protein diet | 78 ± 11.83 | 75.14 ± 9.6 | NR | 77.82 ± 12.02 | 72.57 ± 7.72 | NR | |
Harrison 2012 [32] | Intensified exercise training | 72 ± 10.2 ! | 75 ± 8.8 ! | NS | 69 ± 7.4 ! | 73 ± 10.5 ! | NR |
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Kataoka, J.; Tassone, E.C.; Misso, M.; Joham, A.E.; Stener-Victorin, E.; Teede, H.; Moran, L.J. Weight Management Interventions in Women with and without PCOS: A Systematic Review. Nutrients 2017, 9, 996. https://doi.org/10.3390/nu9090996
Kataoka J, Tassone EC, Misso M, Joham AE, Stener-Victorin E, Teede H, Moran LJ. Weight Management Interventions in Women with and without PCOS: A Systematic Review. Nutrients. 2017; 9(9):996. https://doi.org/10.3390/nu9090996
Chicago/Turabian StyleKataoka, Josefin, Eliza C. Tassone, Marie Misso, Anju E. Joham, Elisabet Stener-Victorin, Helena Teede, and Lisa J. Moran. 2017. "Weight Management Interventions in Women with and without PCOS: A Systematic Review" Nutrients 9, no. 9: 996. https://doi.org/10.3390/nu9090996