低血糖指数饮食与常规健康饮食对多囊卵巢综合征的影响。

Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome.

机构信息

School of Molecular Bioscience, University of Sydney, Sydney, Australia.

出版信息

Am J Clin Nutr. 2010 Jul;92(1):83-92. doi: 10.3945/ajcn.2010.29261. Epub 2010 May 19.

DOI:10.3945/ajcn.2010.29261

PMID:20484445

Abstract

BACKGROUND

Women with polycystic ovarian syndrome (PCOS) are intrinsically insulin resistant and have a high risk of cardiovascular disease and type 2 diabetes. Weight loss improves risk factors, but the optimal diet composition is unknown. Low-glycemic index (low-GI) diets are recommended without evidence of their clinical effectiveness.

OBJECTIVE

We compared changes in insulin sensitivity and clinical outcomes after similar weight losses after consumption of a low-GI diet compared with a conventional healthy diet in women with PCOS.

DESIGN

We assigned overweight and obese premenopausal women with PCOS (n = 96) to consume either an ad libitum low-GI diet or a macronutrient-matched healthy diet and followed the women for 12 mo or until they achieved a 7% weight loss. We compared changes in whole-body insulin sensitivity, which we assessed using the insulin sensitivity index derived from the oral-glucose-tolerance test (ISI(OGTT)); glucose tolerance; body composition; plasma lipids; reproductive hormones; health-related quality of life; and menstrual cycle regularity.

RESULTS

The attrition rate was high in both groups (49%). Among completers, ISI(OGTT) improved more with the low-GI diet than with the conventional healthy diet (mean +/- SEM: 2.2 +/- 0.7 compared with 0.7 +/- 0.6, respectively; P = 0.03). There was a significant diet-metformin interaction (P = 0.048), with greater improvement in ISI(OGTT) among women prescribed both metformin and the low-GI diet. Compared with women who consumed the conventional healthy diet, more women who consumed the low-GI diet showed improved menstrual cyclicity (95% compared with 63%, respectively; P = 0.03). Among the biochemical measures, only serum fibrinogen concentrations showed significant differences between diets (P < 0.05).

CONCLUSION

To the best of our knowledge, this study provides the first objective evidence to justify the use of low-GI diets in the management of PCOS.

摘要

背景

患有多囊卵巢综合征（PCOS）的女性本身存在胰岛素抵抗，并且心血管疾病和 2 型糖尿病的风险较高。减肥可以改善这些风险因素，但最佳的饮食结构尚不清楚。低升糖指数（low-GI）饮食是目前的推荐饮食，但没有临床效果的证据。

目的

我们比较了超重和肥胖的绝经前 PCOS 女性在接受低升糖指数饮食和常规健康饮食后，相似体重减轻时胰岛素敏感性和临床结局的变化。

设计

我们将 96 名患有 PCOS 的超重和肥胖绝经前女性随机分为两组，分别接受随意的低升糖指数饮食或宏量营养素匹配的健康饮食，并随访 12 个月或直至体重减轻 7%。我们比较了两组女性的全身胰岛素敏感性变化，我们使用口服葡萄糖耐量试验（OGTT）衍生的胰岛素敏感性指数（ISI(OGTT)）来评估胰岛素敏感性；葡萄糖耐量；身体成分；血浆脂质；生殖激素；健康相关生活质量；以及月经周期规律性。

结果

两组的脱落率都很高（49%）。在完成试验的患者中，低升糖指数饮食组的 ISI(OGTT)改善程度高于常规健康饮食组（平均值 +/- SEM：分别为 2.2 +/- 0.7 与 0.7 +/- 0.6，P = 0.03）。饮食-二甲双胍存在显著的交互作用（P = 0.048），服用二甲双胍和低升糖指数饮食的女性 ISI(OGTT)改善更明显。与服用常规健康饮食的女性相比，更多服用低升糖指数饮食的女性月经周期规律性得到改善（分别为 95%和 63%，P = 0.03）。在生化指标中，只有血清纤维蛋白原浓度在两种饮食之间存在显著差异（P < 0.05）。