Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Nanjing University of Chinese Medicine, Nanjing, China.
J Clin Endocrinol Metab. 2020 Oct 1;105(10). doi: 10.1210/clinem/dgaa425.
The effect of diet on insulin resistance (IR) in polycystic ovary syndrome (PCOS) is controversial. Thus, we conducted this systematic review and meta-analysis to evaluate whether diet could reduce IR in women with PCOS while providing optimal and precise nutrition advice for clinical practice.
The search was conducted in 8 databases through June 30, 2019. The systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A random-effects model was adopted to calculate the overall effects.
A total of 19 trials (1193 participants) were included. The analysis showed that diet was significantly related to improvements in IR and body composition (eg, homeostasis model assessment of insulin resistance, fasting insulin, fasting plasma glucose, body mass index [BMI], weight, and waist circumference) in PCOS patients. The Dietary Approaches to Stop Hypertension diet and calorie-restricted diets might be the optimal choices for reducing IR and improving body composition, respectively, in the PCOS population. Additionally, the effects were associated with the course of treatment. The longer the duration, the greater the improvement was. Compared with metformin, diet was also advantageous for weight loss (including BMI and weight) and had the same effects on insulin regulation.
Overall, our findings suggest that diet is an effective, acceptable and safe intervention for relieving IR, and professional dietary advice should be offered to all PCOS patients.
饮食对多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）的影响存在争议。因此，我们进行了这项系统评价和荟萃分析，以评估饮食是否可以降低 PCOS 患者的 IR，同时为临床实践提供最佳和精确的营养建议。
该系统检索于 2019 年 6 月 30 日在 8 个数据库中进行。系统评价遵循系统评价和荟萃分析的首选报告项目指南进行。采用随机效应模型计算总体效果。
共纳入 19 项试验（1193 名参与者）。分析表明，饮食与 PCOS 患者的 IR 和身体成分（如稳态模型评估的胰岛素抵抗、空腹胰岛素、空腹血糖、体重指数[BMI]、体重和腰围）的改善显著相关。对于 PCOS 人群，高血压饮食和限制热量的饮食可能是降低 IR 和改善身体成分的最佳选择。此外，这些效果与治疗过程有关。治疗时间越长，改善越明显。与二甲双胍相比，饮食在减肥（包括 BMI 和体重）方面也具有优势，并且对胰岛素调节具有相同的效果。
总的来说，我们的研究结果表明，饮食是一种有效、可接受和安全的干预措施，可以缓解 IR，应向所有 PCOS 患者提供专业的饮食建议。
