Moran L J, Brown W J, McNaughton S A, Joham A E, Teede H J
Monash Centre for Health Research Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 3168, Australia.
The Robinson Research Institute, Discipline of Obstetrics and Gynaecology, University of Adelaide, North Adelaide 5006, Australia.
Hum Reprod. 2017 Mar 1;32(3):669-678. doi: 10.1093/humrep/dew348.
Do weight management practices differ in women with and without PCOS?
Women in the general population with self-reported PCOS are more likely to be using healthy weight management practices and alternative non-lifestyle measures for weight management than women without PCOS.
Lifestyle management is the first-line treatment in PCOS. However, the specific weight management practices used by women with PCOS and their effect on diet and physical activity are unclear.
STUDY DESIGN, SIZE, DURATION: The study was a population-based observational cross-sectional study involving women in the 1973-1978 cohort (n = 7767 total; n = 556 with PCOS, n = 7211 without PCOS).
PARTICIPANTS/MATERIALS, SETTING, METHODS: Women with and without self-reported PCOS were included. Self-reported outcome measures included healthy lifestyle-related or alternative non-lifestyle-related (e.g. laxatives or smoking) weight management practices, dietary intake and physical activity.
Women with PCOS were more likely to be following both healthy [reducing meal or snack size (odds ratio (OR) 1.50, 95% CI 1.14, 1.96, P = 0.004) and reducing fat or sugar intake (OR 1.32, 95% CI 1.03, 1.69, P = 0.027) or following a low glycaemic index diet (OR 2.88, 95% CI 2.30, 3.59, P < 0.001)] and alternative [smoking (OR 1.60, 95% CI 1.02, 2.52, P = 0.043) or use of laxative, diet pills, fasting or diuretics (OR 1.45, 95% CI 1.07, 1.97, P = 0.017)] weight management practices than women without PCOS. In PCOS, the use of a range of healthy weight management practices was associated with increases in physical activity (P < 0.001), diet quality (P < 0.001), percentage protein intake (P < 0.001) and decreases in glycaemic index (P < 0.001), and percentages of fat (P = 0.001), saturated fat (P < 0.001) or fibre (P = 0.003). Use of alternative weight management practices was associated with decreases in diet quality.
LIMITATIONS, REASONS FOR CAUTION: Limitations include the use of self-reported data for PCOS, height, weight, diet, physical activity and weight management behaviours.
In PCOS, we should focus on improving healthy weight practices across both diet quality and quantity, and on assessing alternative weight practices and their potential adverse effect on dietary intake.
STUDY FUNDING/COMPETING INTEREST(S): L.M. is supported by a South Australian Cardiovascular Research Development Program Fellowship (ID AC11S374); a program collaboratively funded by the National Heart Foundation, the South Australian Department of Health and the South Australian Health and Medical Research Institute. H.T. is supported by the NHMRC. S.A.M. is supported by an NHMRC Career Development Fellowship Level 2, ID1104636 and was previously supported by an ARC Future Fellowship (2011-2015, FT100100581). The authors declare no conflict of interest.
Not applicable.
患有多囊卵巢综合征（PCOS）和未患该病的女性在体重管理方法上是否存在差异？
自我报告患有PCOS的普通人群中的女性，比未患PCOS的女性更有可能采用健康的体重管理方法以及替代性非生活方式措施来控制体重。
生活方式管理是PCOS的一线治疗方法。然而，PCOS女性所采用的具体体重管理方法及其对饮食和身体活动的影响尚不清楚。
研究设计、规模、持续时间：该研究是一项基于人群的观察性横断面研究，涉及1973 - 1978年队列中的女性（总计n = 7767；患有PCOS的n = 556，未患PCOS的n = 7211）。
参与者/材料、设置、方法：纳入了自我报告患有和未患PCOS的女性。自我报告的结果指标包括与健康生活方式相关或替代性非生活方式相关（如泻药或吸烟）的体重管理方法、饮食摄入和身体活动。
与未患PCOS的女性相比，患有PCOS的女性更有可能采用健康的[减少餐量或零食量（优势比（OR）1.50，95%置信区间1.14，1.96，P = 0.004）以及减少脂肪或糖的摄入量（OR 1.32，95%置信区间1.03，1.69，P = 0.027）或遵循低血糖指数饮食（OR 2.88，95%置信区间2.30，3.59，P < 0.001）]和替代性的[吸烟（OR 1.60，95%置信区间1.02，2.52，P = 0.043）或使用泻药、减肥药、禁食或利尿剂（OR 1.45，95%置信区间1.07，1.97，P = 0.017）]体重管理方法。在PCOS患者中，采用一系列健康的体重管理方法与身体活动增加（P < 0.001）、饮食质量提高（P < 0.001）、蛋白质摄入百分比增加（P < 0.001）以及血糖指数降低（P < 0.001），脂肪百分比（P = 0.001）、饱和脂肪百分比（P < 0.001）或纤维百分比（P = 0.003）降低相关。采用替代性体重管理方法与饮食质量下降相关。
局限性、谨慎理由：局限性包括使用自我报告的数据来评估PCOS、身高、体重、饮食、身体活动和体重管理行为。
在PCOS患者中，我们应专注于改善饮食质量和数量方面的健康体重管理方法，并评估替代性体重管理方法及其对饮食摄入的潜在不良影响。
研究资金/利益冲突：L.M. 得到南澳大利亚心血管研究发展项目奖学金（ID AC11S374）的支持；该项目由国家心脏基金会、南澳大利亚卫生部和南澳大利亚健康与医学研究所联合资助。H.T. 得到澳大利亚国家健康与医学研究委员会（NHMRC）的支持。S.A.M. 得到NHMRC职业发展奖学金二级（ID1104636）的支持，并且之前得到澳大利亚研究理事会（ARC）未来奖学金（2011 - 2015年，FT100100581）的支持。作者声明无利益冲突。
不适用。
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