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血清抗苗勒管激素对超重/肥胖多囊卵巢综合征患者饮食管理和/或体育锻炼的反应:一项随机对照试验的二次分析。

Serum antimüllerian hormone in response to dietary management and/or physical exercise in overweight/obese women with polycystic ovary syndrome: secondary analysis of a randomized controlled trial.

机构信息

Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Fertil Steril. 2013 Oct;100(4):1096-102. doi: 10.1016/j.fertnstert.2013.06.030. Epub 2013 Jul 19.

Abstract

OBJECTIVE

To investigate whether randomized diet and/or physical exercise influence serum levels of antimüllerian hormone (AMH) in obese women with polycystic ovary syndrome (PCOS).

DESIGN

Randomized, 4-month trial with three interventions.

SETTING

Women's health clinical research unit at a university hospital.

PATIENT(S): Fifty-seven overweight/obese women with PCOS.

INTERVENTION(S): Diet, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physiotherapist.

MAIN OUTCOME MEASURE(S): Serum AMH levels before and after the interventions and correlations to reproductive function, body composition, and endocrine and metabolic variables.

RESULT(S): After intervention, serum levels of AMH were significantly decreased only in the diet group, and the levels were significantly lower than in the exercise group. The strongest predictor of decreased AMH was a decrease in free T, whereas weight loss had no significant influence. Normalized levels of AMH were associated with improvements in menstrual cyclicity and hyperandrogenism but not in metabolic variables.

CONCLUSION(S): This randomized study supports that diet reduces serum AMH in association with decreased androgen levels in obese women with PCOS. Increased serum AMH may be used as a marker of ovulatory dysfunction and hyperandrogenism but not as a marker of insulin resistance.

CLINICAL TRIAL REGISTRY NUMBER

ISRCTN48342048.

摘要

目的

研究随机饮食和/或体育锻炼是否会影响多囊卵巢综合征(PCOS)肥胖女性的血清抗缪勒管激素(AMH)水平。

设计

随机、4 个月试验,共三种干预措施。

地点

大学医院的妇女健康临床研究单位。

患者

57 名超重/肥胖的 PCOS 患者。

干预措施

饮食、体育锻炼或两者兼用,由营养师和/或物理治疗师单独制定和监督适应性方案。

主要观察指标

干预前后血清 AMH 水平及与生殖功能、身体成分、内分泌和代谢变量的相关性。

结果

干预后,仅饮食组血清 AMH 水平显著下降,且低于运动组。AMH 下降的最强预测因子是游离 T 下降,而体重减轻无显著影响。AMH 正常化水平与月经周期和高雄激素血症的改善相关,但与代谢变量无关。

结论

这项随机研究支持饮食可降低肥胖 PCOS 女性的血清 AMH,与雄激素水平降低有关。增加的血清 AMH 可作为排卵功能障碍和高雄激素血症的标志物,但不能作为胰岛素抵抗的标志物。

临床试验注册号

ISRCTN48342048。

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