School of Medicine, Robinson Research Institute, University of Adelaide, Adelaide, SA 5000, Australia.
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3163, Australia.
Nutrients. 2019 Feb 26;11(3):492. doi: 10.3390/nu11030492.
Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. Weight management is a first-line treatment for PCOS according to international evidence-based guidelines. However, the factors associated with attrition or success in weight loss interventions are not known for women with PCOS. The objective of this study was to identify characteristics associated with attrition and weight loss success in women with PCOS and overweight or obesity undergoing weight loss interventions. Four randomised controlled clinical weight loss trials comprising energy restricted diets and/or exercise interventions of 2⁻8 months duration. The interventions were conducted over 2001⁻2007 in outpatient clinical research centres with = 221 premenopausal women with PCOS and overweight/obesity recruited through community advertisement. The main outcome measures were attrition and ≥5% weight loss at 2 months and study completion. Weight loss was 5.7 ± 2.9 kg at 2 months and 7.4 ± 5.3 kg after study completion ( < 0.001). Attrition was 47.1% and ≥5% weight loss occurred in 62.5% and 62.7% of women at 2 months and study completion respectively. Baseline depressive symptoms (OR 1.07 95% CI 0.88, 0.96, = 0.032) and lower appointment attendance by 2 months (OR 0.92 95% CI 0.88, 0.96, < 0.001) were independently associated with attrition. Lower appointment attendance over the whole study was independently associated with not achieving ≥5% weight loss at study completion (OR 0.95 95% CI 0.92, 0.99, = 0.020). Despite high attrition, successful weight loss was achieved by 63% of women with PCOS in a clinical research setting. Higher baseline depressive symptoms were associated with greater attrition and higher appointment attendance was associated with lower attrition and greater weight loss success. These finding have implications for development of successful weight management programs in PCOS.
多囊卵巢综合征（PCOS）是生育期妇女常见的疾病。根据国际循证指南，体重管理是 PCOS 的一线治疗方法。然而，对于患有 PCOS 的超重或肥胖女性，体重减轻干预的损失或成功的相关因素尚不清楚。本研究的目的是确定与 PCOS 且超重或肥胖女性在接受体重减轻干预时的损失和体重减轻成功相关的特征。
四项随机对照临床减重试验，包括能量限制饮食和/或运动干预，持续 2-8 个月。这些干预措施于 2001-2007 年在门诊临床研究中心进行，共有 221 名绝经前患有 PCOS 和超重/肥胖的女性通过社区广告招募。主要结局指标为 2 个月时的损失和≥5%的体重减轻以及研究完成。2 个月时体重减轻 5.7 ± 2.9kg，研究完成时体重减轻 7.4 ± 5.3kg（<0.001）。损失率为 47.1%，2 个月和研究完成时分别有 62.5%和 62.7%的女性体重减轻≥5%。基线抑郁症状（OR 1.07，95%CI 0.88，0.96，=0.032）和 2 个月时预约出勤率较低（OR 0.92，95%CI 0.88，0.96，<0.001）与损失独立相关。整个研究期间预约出勤率较低与研究完成时未达到≥5%的体重减轻独立相关（OR 0.95，95%CI 0.92，0.99，=0.020）。尽管损失率较高，但在临床研究环境中，仍有 63%的 PCOS 女性成功减轻体重。较高的基线抑郁症状与较高的损失率相关，较高的预约出勤率与较低的损失率和较高的体重减轻成功率相关。这些发现对 PCOS 成功管理计划的制定具有启示意义。
