Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Interventions
2.3. Clinical and Biochemical Measurements
2.4. Statistics
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Outcome | N | Mean ± SD |
---|---|---|
Age (years) | 221 | 30.7 ± 6.0 |
Weight (kg) | 201 | 99.8 ± 19.0 |
BMI (kg/m2) | 201 | 36.5 ± 6.3 |
BMI (categories) | 201 | Overweight: 29 (14.4%) |
Obese: 172 (85.6%) | ||
Obese class I: 66 (32.8%) | ||
Obese class II: 53 (26.4%) | ||
Obese class III: 53 (26.4%) | ||
Waist circumference (cm) | 155 | 103.5 ± 13.2 |
Fasting insulin (mU/L) | 186 | 16.9 ± 10.5 |
Fasting glucose (mmol/L) | 204 | 5.2 ± 0.6 |
HOMA-IR | 186 | 4.1 ± 2.8 |
Testosterone (nmol/L) | 204 | 2.4 ± 0.9 |
SHBG (nmol/L) | 204 | 29.6 ± 15.4 |
FAI | 204 | 11.5 ± 13.1 |
FG | 177 | 15.9 ± 8.3 |
QOL emotional state | 136 | 4.4 ± 1.1 |
QOL body hair | 136 | 3.6 ± 1.5 |
QOL weight status | 136 | 2.2 ± 1.0 |
QOL infertility | 136 | 4.5 ± 1.7 |
QOL menstrual irregularity | 136 | 3.6 ± 1.2 |
Depressive symptoms | 93 | 18.3 ± 9.9 |
Presence of mild depression | 93 | Yes: 49 (52.7%) |
No: 44 (47.3%) |
Outcome | Dropouts N = 104 | Non-Dropouts N = 117 | MD, 95% CI, p |
---|---|---|---|
Age (years) | 30.0 ± 6.1 | 31.4 ± 5.7 | 1.32 (−0.26, 2.90), p = 0.101 |
Weight (kg) | 100.0 ± 17.8 | 99.7 ± 19.9 | −0.33 (−5.69, 5.03), p = 0.903 |
BMI (kg/m2) | 36.5 ± 6.4 | 36.4 ± 6.2 | −0.08 (−1.85, 1.69), p = 0.933 |
BMI (categories) | Overweight (13.1%) Obese (86.9%) | Overweight (15.4%) Obese (84.6%) | p = 0.649 |
Waist circumference (cm) | 102.1 ± 12.0 | 104.7 ± 14.0 | 2.53 (−1.70, 6.77), p = 0.239 |
Fasting insulin (mU/L) | 16.0 ± 10.4 | 17.4 ± 10.6 | 1.43 (−1.72, 4.57), p = 0.373 |
Fasting glucose (mmol/L) | 5.1 ± 0.49 | 5.3 ± 0.63 | 0.19 (0.03, 0.35), p = 0.019 |
HOMA-IR | 3.7 ± 2.6 | 4.2 ± 2.9 | 0.51 (−0.33, 1.36), p = 0.235 |
Testosterone (nmol/L) | 2.4 ± 0.89 | 2.5 ± 0.93 | 0.06 (−0.19, 0.32), p = 0.627 |
SHBG (nmol/L) | 30.9 ± 17.2 | 28.6 ± 13.9 | −2.35 (−6.65, 1.96), p = 0.284 |
FAI | 10.0 ± 6.5 | 12.6 ± 16.3 | 2.60 (−1.04, 6.25), p = 0.161 |
FG | 14.8 ± 8.4 | 16.9 ± 8.1 | 2.13 (−0.33, 4.59), p = 0.089 |
QOL emotional state | 4.3 ± 1.1 | 4.5 ± 1.1 | 0.23 (−0.16, 0.61), p = 0.242 |
QOL body hair | 3.9 ± 1.6 | 3.4 ± 1.3 | −0.56 (−1.05, −0.07), p = 0.026 |
QOL weight status | 2.1 ± 1.0 | 2.3 ± 1.1 | 0.20 (−0.15, 0.55), p = 0.264 |
QOL infertility | 4.1 ± 1.8 | 4.8 ±1.5 | 0.62 (0.06, 1.18), p = 0.030 |
QOL menstrual irregularity | 3.6 ± 1.3 | 3.6 ± 1.1 | 0.02 (−0.38, 0.43), p = 0.906 |
Depressive symptoms | 20.5 ± 11.2 | 16.5 ± 8.4 | −4.02 (−8.06, 0.02), p = 0.051 |
Presence of mild depression | 57.1% | 49.0% | p = 0.435 |
Appointment attendance—2 months (%) | 59.6 ± 39.6 | 96.2 ± 14.9 | p < 0.001 |
Appointment attendance—full study weeks (%) | 24.1 ± 24.8% | 90.1 ± 18.7% | p < 0.001 |
Appointment attendance—2 months (categories) | 75–100%: 53.9% <75%: 46.2% | 75–100%: 97.4% <75%: 2.6% | p < 0.001 |
Appointment attendance—full study (categories) | 75–100%: 5.8% <75%: 94.2% | 75–100%: 85.5% <75%: 14.5% | p < 0.001 |
2 Months | Full Study Duration | |||||
---|---|---|---|---|---|---|
Outcome | <5% weight loss N = 55 | ≥5% weight loss N = 85 | MD, 95% CI, p | <5% weight loss N = 44 | ≥5% weight loss N = 74 | MD, 95% CI, p |
Age (years) | 31.7 ± 5.9 | 31.2 ± 5.5 | −0.53 (−2.51, 1.44), p = 0.594 | 32.5±5.5 | 30.6±5.8 | -1.88 (-4.03, -0.27), p = 0.09 |
Weight (kg) | 98.3 ± 17.7 | 99.3 ± 20.3 | 0.96 (−5.84, 7.76), p = 0.780 | 97.1±19.3 | 101.0±20.1 | 3.93 (-3.54, 11.40), p = 0.300 |
BMI (kg/m2) | 36.9 ± 6.0 | 35.9 ± 6.3 | −1.03 (−3.20, 1.14), p = 0.348 | 35.9±6.1 | 36.7±6.2 | 0.77 (-1.57, 3.10), p = 0.517 |
BMI (WHO categories) | Overweight 11.8% Obese 88.2% | Overweight 18.8% Obese 81.2% | p = 0.279 | Overweight 20.5% Obese 79.6% | Overweight 13.5% Obese 86.5% | p = 0.321 |
Waist circumference (cm) | 103.9 ± 11.9 | 103.6 ± 15.0 | −0.23 (−5.74, 5.27), p = 0.933 | 105.0±12.5 | 104.4±15.2 | -0.57 (-6.56, 5.42), p = 0.851 |
Fasting insulin (mU/L) | 16.8 ± 10.4 | 16.6 ± 10.1 | −0.16 (−3.78, 3.45), p = 0.929 | 17.2±10.9 | 17.5±10.4 | 0.22 (-3.77, 4.21), p = 0.914 |
Fasting glucose (mmol/L) | 5.3 ± 0.65 | 5.3 ± 0.57 | 0.01 (−0.20, 0.22), p = 0.898 | 5.3±0.5 | 5.3±0.7 | -0.002 (-0.24, 0.24), p = 0.988 |
HOMA-IR | 4.0 ± 2.6 | 4.1 ± 3.0 | 0.07 (−0.93, 1.07), p = 0.894 | 4.2±2.8 | 4.3±3.0 | 0.07 (-1.04, 1.19), p = 0.895 |
Testosterone (nmol/L) | 2.6 ± 1.0 | 2.4 ± 0.92 | −0.13 (−0.47, 0.20), p = 0.432 | 2.6±0.84 | 2.4±0.96 | -0.25 (-0.59, 0.10), p = 0.163 |
SHBG (nmol/L) | 29.2 ± 13.2 | 28.5 ± 14.4 | −0.68 (−5.57, 4.22), p = 0.784 | 28.3±14.4 | 28.7±13.7 | 0.42 (-4.84, 5.67), p = 0.874 |
FAI | 12.1 ± 12.2 | 12.7 ± 17.1 | 0.63 (−4.79, 6.04), p = 0.819 | 13.2±13.6 | 12.2±17.7 | -0.95 (-7.09, 5.19), p = 0.760 |
2 months | Full study duration | |||||
FG | 16.4 ± 9.0 | 16.5 ± 7.9 | 0.08 (−3.13, 3.28), p = 0.962 | 15.8 ± 8.2 | 17.6 ± 8.0 | 1.75 (−1.65, 5.16), p = 0.309 |
QOL emotional state | 4.4 ± 1.2 | 4.5 ± 1.0 | 0.02 (−0.46, 0.51), p = 0.920 | 4.5 ± 1.0 | 4.5 ± 1.2 | 0.03 (−0.50, 0.57), p = 0.899 |
QOL body hair | 3.6 ± 1.4 | 3.5 ± 1.5 | −0.12 (−0.76, 0.52), p = 0.708 | 3.4 ± 1.3 | 3.3 ± 1.4 | −0.13 (−0.77, 0.51), p = 0.683 |
QOL weight status | 2.0 ± 0.9 | 2.4 ± 1.1 | 0.44 (−0.02, 0.91), p = 0.061 | 2.3 ± 1.1 | 2.3 ± 1.0 | −0.05(−0.55, 0.46), p = 0.857 |
QOL infertility | 4.3 ± 1.4 | 5.1 ± 1.5 | 0.76 (0.13, 1.40), p = 0.02 | 4.7 ± 1.5 | 4.8 ± 1.6 | 0.13 (−0.60, 0.86), p = 0.731 |
QOL menstrual irregularity | 3.7 ± 1.0 | 3.6 ± 1.1 | −0.09 (−0.56, 0.39), p = 0.720 | 3.7 ± 1.2 | 3.6 ± 1.1 | −0.13 (−0.66, 0.41), p = 0.640 |
Depressive symptoms | 15.6 ± 7.6 | 17.8 ± 9.1 | 2.13 (−2.57, 6.83), p = 0.368 | 14.3 ± 5.3 | 17.6 ± 9.4 | 3.32 (−1.74, 8.38), p = 0.193 |
Presence of depression | 45.5% | 55.9% | p = 0.446 | 37.5% | 54.3% | p = 0.266 |
Appointment attendance (%) | 96.1 ± 10.5 | 97.1 ± 15.6 | 0.98 (−3.90, 5.86), p = 0.692 | 84.0 ± 22.4 | 93.9 ± 15.0 | 9.87 (3.06, 16.69), p = 0.005 |
Appointment attendance (%)-categories | 75–100%: 98.0% <75%: 2.0% | 75–100%: 91.7% <75%: 8.3% | p = 0.880 | 75–100%: 72.7% <75%: 27.3%% | 75–100%:93.2% <75%: 6.9% | p = 0.002 |
Age | BMI | Depressive Symptoms | Attendance | Full Model | |
---|---|---|---|---|---|
Dropouts | |||||
OR (95% CI), P | 0.96 (0.89, 1.05) p = 0.406 | 1.01 (0.92, 1.11) p = 0.800 | 1.07 (0.88, 0.96) p = 0.032 | 0.92 (0.88, 0.96) p < 0.001 | - |
ROC AUC, 95% CI | 0.57 (0.49, 0.64) | 0.50 (0.41, 0.58) | 0.60 (0.48, 0.72) | 0.77 (0.72, 0.83) | 0.82 (0.72, 0.91) |
ROC optimal sensitivity (%), optimal specificity (%) | 0.49, 0.67 | 0.07, 0.99 | 0.33, 0.90 | 0.62, 0.91 | 0.79, 0.75 |
<5% weight loss 2 months | |||||
OR (95% CI), P | 1.05 (0.96, 1.15) p = 0.313 | 0.94 (0.85, 1.05) p = 0.276 | 0.97 (0.91, 1.04) p = 0.406 | 0.94 (0.87, 1.01) p = 0.088 | - |
ROC AUC, 95% CI | 0.54 (0.43, 0.64) | 0.55 (0.45, 0.65) | 0.56 (0.41, 0.71) | 0.54 (0.49, 0.60) | 0.71 (0.57, 0.84) |
ROC optimal sensitivity (%), optimal specificity (%) | 0.59, 0.54 | 0.84, 0.57 | 0.62, 0.58 | 0.14, 0.95 | 0.77, 0.56 |
<5% weight loss full study | |||||
OR (95% CI), P | 1.06 (0.95, 1.18) p = 0.298 | 1.01 (0.90, 1.13) p = 0.845 | 0.96 (0.88, 1.04) p = 0.335 | 0.95 (0.92, 0.99) p = 0.020 | - |
ROC AUC, 95% CI | 0.59 (0.48, 0.70) | 0.53 (0.42, 0.64) | 0.60 (0.44, 0.75) | 0.64 (0.54, 0.73) | 0.75 (0.60, 0.90) |
ROC optimal sensitivity (%), optimal specificity (%) | 0.55, 0.68 | 0.32, 0.80 | 0.94, 0.37 | 0.50, 0.73 | 0.75, 0.74 |
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Moran, L.J.; Noakes, M.; Clifton, P.; Buckley, J.; Brinkworth, G.; Thomson, R.; Norman, R.J. Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese. Nutrients 2019, 11, 492. https://doi.org/10.3390/nu11030492
Moran LJ, Noakes M, Clifton P, Buckley J, Brinkworth G, Thomson R, Norman RJ. Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese. Nutrients. 2019; 11(3):492. https://doi.org/10.3390/nu11030492
Chicago/Turabian StyleMoran, Lisa J., Manny Noakes, Peter Clifton, Jon Buckley, Grant Brinkworth, Rebecca Thomson, and Robert J. Norman. 2019. "Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese" Nutrients 11, no. 3: 492. https://doi.org/10.3390/nu11030492
APA StyleMoran, L. J., Noakes, M., Clifton, P., Buckley, J., Brinkworth, G., Thomson, R., & Norman, R. J. (2019). Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese. Nutrients, 11(3), 492. https://doi.org/10.3390/nu11030492