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多囊卵巢综合征伴肝功能异常肥胖女性的生酮饮食:一项随机、开放标签、平行分组、对照的初步试验。

Ketogenic diet in women with polycystic ovary syndrome and liver dysfunction who are obese: A randomized, open-label, parallel-group, controlled pilot trial.

机构信息

Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Department of Gliomatology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

出版信息

J Obstet Gynaecol Res. 2021 Mar;47(3):1145-1152. doi: 10.1111/jog.14650. Epub 2021 Jan 18.

Abstract

AIM

To evaluate the effect of a ketogenic diet (KD) in women with polycystic ovary syndrome (PCOS) and liver dysfunction who were obese.

METHODS

Women with PCOS and liver dysfunction who were obese were enrolled in this prospective, open-label, parallel-group, controlled pilot trial, and randomly received KD (KD group) or conventional pharmacological treatment (Essentiale plus Yasmin, control group) in a 1:1 ratio for 12 weeks. The primary endpoint was the liver function markers. Secondary endpoints included the menstrual cycle, anthropometric characteristics, body composition, hormonal levels, and metabolic biomarkers.

RESULTS

Of the 20 eligible participants enrolled, 18 participants completed the study. The KD group reported a significant reduction in anthropometric characteristics and body composition from baseline to week 12 (all p < 0.05). In addition, there were significant reductions in menstrual cycle, plasma estradiol, and progesterone levels in two groups (all p < 0.05), but no significant between-group difference was observed. KD significantly reduced the liver function markers compared with control group (p < 0.05). The signs of fatty liver disappeared in six out of seven fatty liver participants in KD group after 12 weeks of intervention, while only one of 10 fatty liver participants in control group disappeared.

CONCLUSIONS

In addition to improving the menstrual cycle, KD had the additional benefits of reducing blood glucose and body weight, improving liver function, and treating fatty liver compared to traditional pharmacological treatment in women with PCOS and liver dysfunction who were obese.

摘要

目的

评估生酮饮食(KD)对肥胖多囊卵巢综合征(PCOS)合并肝功能异常女性的影响。

方法

本前瞻性、开放标签、平行组、对照试验纳入了肥胖的 PCOS 合并肝功能异常女性,将其以 1:1 的比例随机分为 KD 组(KD 组)或常规药物治疗组(Essentiale 加 Yasmin,对照组),治疗 12 周。主要终点为肝功能标志物。次要终点包括月经周期、人体测量学特征、体成分、激素水平和代谢生物标志物。

结果

20 名符合条件的参与者中,有 18 名完成了研究。KD 组从基线到第 12 周时,人体测量学特征和体成分显著降低(均 p<0.05)。此外,两组的月经周期、血浆雌二醇和孕酮水平均显著降低(均 p<0.05),但组间无显著差异。KD 组与对照组相比,肝功能标志物显著降低(p<0.05)。KD 干预 12 周后,7 名脂肪肝患者中有 6 名的脂肪肝迹象消失,而对照组 10 名脂肪肝患者中仅有 1 名消失。

结论

除了改善月经周期外,KD 还具有降低血糖和体重、改善肝功能以及治疗脂肪肝的额外益处,优于肥胖的 PCOS 合并肝功能异常女性的传统药物治疗。

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