Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam, The Netherlands.
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands.
Brain Behav. 2022 Jul;12(7):e2621. doi: 10.1002/brb3.2621. Epub 2022 Jun 2.
Polycystic ovary syndrome (PCOS) affects 5%-10% of women in their reproductive years. Most women with PCOS struggle with obesity during their entire life. Knowing which determinants contribute to a successful lifestyle change is important to optimize treatment options for women with PCOS.
This analysis of secondary outcome measures aimed to determine factors of ≥5% weight loss and dropout in all arms of the study and separately in the lifestyle intervention (LI) and control (care as usual [CAU]) groups.
Women diagnosed with PCOS (N = 183) and a Body Mass Index (BMI) above 25 kg/m were included. Participants were assigned to (1) 20 lifestyle sessions involving cognitive behavioral therapy (CBT), (2) 20 lifestyle sessions involving CBT with additional short message service (SMS), or (3) to control (CAU). A generalized linear regression was performed to identify determinants of ≥5% weight loss. Logistic regression was performed to identify determinants of dropout. All models were corrected by including baseline weight as a covariate.
LI (OR 4.906, p = .001) was associated with ≥5% weight loss, while higher depression scores (OR 0.549, p = .013) had a negative association. Restraint eating was a positive factor for ≥5% weight loss in LI but a negative in CAU. Higher baseline weight (OR 1.033, p = .006), LI with SMS (OR 4.424, p = .002), and higher levels of androstenedione (OR 1.167, p = .026) were associated with dropout.
Depression and eating behavior were associated with ≥5% weight loss. Women with PCOS should be screened for depression and eating behavior before a LI.
多囊卵巢综合征（PCOS）影响 5%-10%的育龄妇女。大多数患有 PCOS 的女性在其整个生命周期中都与肥胖作斗争。了解哪些决定因素有助于成功改变生活方式对于优化 PCOS 女性的治疗选择很重要。
本研究对次要结局指标的分析旨在确定所有研究组和生活方式干预（LI）组和对照组（常规护理[CAU]）中体重减轻≥5%和脱落的因素。
纳入了 183 名被诊断患有 PCOS 和 BMI 高于 25kg/m2的女性。参与者被分配到以下三组：（1）20 节涉及认知行为疗法（CBT）的生活方式课程，（2）20 节涉及 CBT 加短信服务（SMS）的生活方式课程，或（3）对照组（CAU）。进行了广义线性回归以确定体重减轻≥5%的决定因素。进行逻辑回归以确定脱落的决定因素。所有模型均通过纳入基线体重作为协变量进行校正。
LI（OR 4.906，p=.001）与体重减轻≥5%相关，而较高的抑郁评分（OR 0.549，p=.013）则呈负相关。在 LI 中，约束性进食是体重减轻≥5%的积极因素，但在 CAU 中则是消极因素。较高的基线体重（OR 1.033，p=.006）、LI 加 SMS（OR 4.424，p=.002）和较高的雄烯二酮水平（OR 1.167，p=.026）与脱落相关。
抑郁和饮食行为与体重减轻≥5%相关。患有 PCOS 的女性在进行 LI 之前应进行抑郁和饮食行为筛查。
