Gorczyca Anna M, Steger Felicia L, Ptomey Lauren T, Montgomery Robert N, Mickelsen Riley, Smith Patricia, Donnelly Joseph E, Marsh Courtney A
Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, MO, United States.
Division of Endocrinology, Diabetes and Clinical Pharmacology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, MO, United States.
Front Reprod Health. 2022 Jul 22;4:940945. doi: 10.3389/frph.2022.940945. eCollection 2022.
Obesity and visceral adiposity are associated with anovulation. The most common cause of anovulatory infertility in women of reproductive age is polycystic ovary syndrome (PCOS). We conducted this formative study to examine the effects of a remotely delivered, group-based lifestyle program for women with overweight/obesity and PCOS on ovulation, PCOS related quality of life (PCOSQ) and body composition.
Women with anovulatory infertility caused by PCOS ( = 12) were enrolled in a 6-month high-intensity weight management intervention. Participants were asked to attend 45 min., group behavioral lifestyle sessions, delivered remotely by a registered dietitian weekly across the 6-mo. study and comply with a reduced energy diet, increased physical activity (225 min/wk.), and self-monitoring of weight, physical activity and diet. Diets consisted of five portion-controlled meals (three shakes + two entrees), at least five servings of fruits/vegetables, and ad libitum non-caloric beverages daily. Wilcoxon signed-rank tests were used to assess changes in outcomes across the intervention.
Twelve women received the weight loss intervention (mean age = 32.7 ± 4.2 yrs., BMI = 36.8 ± 4.5 kg/m, 92% college educated), and 8 completed the intervention. Eight (67%) women reported ovulating during the intervention with an average time to ovulation of 57 ± 45 days. Women lost an average of 3.85 ± 5.94 kg ( = 0.02), decreased their BMI (-1.61 ± 1.09 kg/m; = 0.04), and waist circumference (-4.54 ± 3.03 cm; = 0.04) over the 6-mo. intervention. Additionally, self-reported menstrual problems measured by PCOSQ significantly improved over the study ( = 0.03).
A multicomponent group-based, remotely delivered, lifestyle intervention delivered remotely is a feasible and potentially scalable option to achieve clinically relevant (>3%) weight loss in women with PCOS.
www.clinicaltrials.gov, identifier: NCT03677362.
肥胖和内脏脂肪过多与无排卵有关。育龄女性无排卵性不孕最常见的原因是多囊卵巢综合征(PCOS)。我们开展了这项形成性研究,以检验一项针对超重/肥胖且患有PCOS的女性的远程小组式生活方式项目对排卵、PCOS相关生活质量(PCOSQ)和身体成分的影响。
因PCOS导致无排卵性不孕的女性(n = 12)参加了为期6个月的高强度体重管理干预。参与者被要求参加45分钟的小组行为生活方式课程,由注册营养师在为期6个月的研究期间每周远程授课,并遵循低能量饮食、增加身体活动(225分钟/周)以及自我监测体重、身体活动和饮食。饮食包括五份控制分量的餐食(三份奶昔 + 两份主菜)、每天至少五份水果/蔬菜以及随意饮用的无热量饮料。采用Wilcoxon符号秩检验来评估干预期间各项结果的变化。
12名女性接受了体重减轻干预(平均年龄 = 32.7 ± 4.2岁,BMI = 36.8 ± 4.5 kg/m²,92%为大学学历),8名完成了干预。8名(67%)女性报告在干预期间排卵,平均排卵时间为57 ± 45天。在为期6个月的干预期间,女性平均体重减轻3.85 ± 5.94 kg(P = 0.02),BMI降低(-1.61 ± 1.09 kg/m²;P = 0.04),腰围减小(-4.54 ± 3.03 cm;P = 0.04)。此外,通过PCOSQ测量的自我报告的月经问题在研究期间显著改善(P = 0.03)。
一项多组分的基于小组的远程生活方式干预对于患有PCOS的女性实现具有临床意义(>3%)的体重减轻是一种可行且可能可扩展的选择。