MD, MPH, Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905.
J Clin Endocrinol Metab. 2013 Dec;98(12):4655-63. doi: 10.1210/jc.2013-2385. Epub 2013 Oct 3.
Polycystic ovary syndrome (PCOS) is a prevalent disorder that affects women of childbearing age and may be related to obesity and insulin resistance.
The purpose of this systematic review was to appraise the evidence of the impact of lifestyle modification (LSM) interventions on outcomes of women with PCOS.
Sources included Ovid Medline, OVID Embase, OVID Cochrane Library, Web of Science, Scopus, PsycINFO, and CINAHL (up to January 2011).
We included randomized controlled trials that enrolled woman of any age with PCOS who received LSM and compared them against women who received no intervention, minimal intervention, or metformin.
Two authors performed the data extraction independently.
We included 9 trials enrolling 583 women with a high loss to follow-up rate, lack of blinding, and short follow-up. Compared with minimal intervention, LSM significantly reduced fasting blood glucose (weighted mean difference, -2.3 mg/dL; 95% confidence interval, -4.5 to -0.1, I² = 72%, P = .04) and fasting blood insulin (weighted mean difference, -2.1 μU/mL, 95% confidence interval, -3.3 to -1.0, I² = 0%, P < .001). Changes in body mass index were associated with changes in fasting blood glucose (P < .001). Metformin was not significantly better than LSM in improving blood glucose or insulin levels. We found no significant effect of LSM on pregnancy rate, and the effect on hirsutism was unclear.
The available evidence suggests that LSM reduces fasting blood glucose and insulin levels in women with PCOS. Metformin has similar effects. Translation of these short-term effects to patient-important outcomes, beyond diabetes prevention, remains uncertain.
多囊卵巢综合征（PCOS）是一种常见疾病，影响育龄妇女，可能与肥胖和胰岛素抵抗有关。
本系统评价旨在评估生活方式干预（LSM）对 PCOS 妇女结局的影响。
检索了 Ovid Medline、OVID Embase、OVID Cochrane Library、Web of Science、Scopus、PsycINFO 和 CINAHL（截至 2011 年 1 月）。
我们纳入了年龄不限、接受 LSM 治疗的 PCOS 妇女的随机对照试验，并与未接受干预、最小干预或二甲双胍治疗的妇女进行比较。
两名作者独立进行数据提取。
我们纳入了 9 项试验，共 583 名高失访率、无盲法、随访时间短的妇女。与最小干预相比，LSM 可显著降低空腹血糖（加权均数差，-2.3mg/dL；95%置信区间，-4.5 至-0.1，I²=72%，P=0.04）和空腹血胰岛素（加权均数差，-2.1μU/mL，95%置信区间，-3.3 至-1.0，I²=0%，P<0.001）。体重指数的变化与空腹血糖的变化相关（P<0.001）。二甲双胍在改善血糖或胰岛素水平方面并不优于 LSM。我们未发现 LSM 对妊娠率有显著影响，对多毛症的影响尚不清楚。
现有证据表明，LSM 可降低 PCOS 妇女的空腹血糖和胰岛素水平。二甲双胍有类似作用。这些短期效果转化为患者重要结局（除糖尿病预防外）的效果仍不确定。
