Alenezi Salih Atalah, Elkmeshi Nusaiba, Alanazi Abdullah, Alanazi Sulaiman T, Khan Raheela, Amer Saad
Division of Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, UK.
Prince Mohammed Bin Abdulaziz Medical City, Ministry of Health, Riyadh 14214, Saudi Arabia.
J Clin Med. 2024 Aug 21;13(16):4934. doi: 10.3390/jcm13164934.
Currently, the primary strategy for addressing polycystic ovarian syndrome (PCOS) involves lifestyle modifications, with a focus on weight loss. The purpose of this meta-analysis was to assess the impact of weight loss through dietary interventions on inflammatory status and hyperandrogenism in PCOS women. A comprehensive search was conducted to identify randomised controlled trials (RCTs) and cohort studies assessing the impact of diet-induced weight loss on circulating inflammatory markers (CRP, IL-6, IL-1β, TNF-α), androgens (testosterone, androstenedione), SHBG, and luteinising hormone (LH) in PCOS women. The quality and risk of bias of the included studies were assessed using the Cochrane Collaboration's tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. Data were entered into RevMan software v5.9 for the calculation of standard mean difference (SMD) and the 95% confidence interval (95%CI) of circulating inflammatory markers, androgens, and LH between baseline and post-weight loss values. Eleven studies ( = 323) were eligible for the systematic review, of which nine ( = 286) were included in the meta-analysis. Pooled analysis of data revealed a statistically significant decrease in circulating CRP (SMD 0.39, 95%CI 0.22, 0.56; 9 studies, = 286), IL-6 (SMD 0.37, 95%Cl, 0.12, 0.61; 3 Studies, = 140), TNF-α (SMD 0.30, 95%Cl, 0.07, 0.53; 4 Studies, = 162), androstenedione (SMD 0.36, 95%Cl, 0.13, 0.60; 4 studies, = 147) and LH (SMD 0.30, 95% Cl, 0.09, 0.51; 5 studies, = 197) after weight loss compared to baseline levels among PCOS women. A meta-analysis of five studies ( = 173) showed a statistically significant increase in circulating SHBG after weight loss compared to baseline levels (SMD -0.43, 95%Cl, -0.65, -0.21). These findings suggest that weight loss induced by dietary interventions seems to improve PCOS-related chronic inflammation and hyperandrogenism. The possible causative relationship between the improvement in inflammation and hyperandrogenism remains to be determined.
目前，治疗多囊卵巢综合征（PCOS）的主要策略包括生活方式的改变，重点是减重。本荟萃分析的目的是评估通过饮食干预减重对PCOS女性炎症状态和高雄激素血症的影响。进行了全面检索，以确定评估饮食诱导的减重对PCOS女性循环炎症标志物（C反应蛋白、白细胞介素-6、白细胞介素-1β、肿瘤坏死因子-α）、雄激素（睾酮、雄烯二酮）、性激素结合球蛋白（SHBG）和促黄体生成素（LH）影响的随机对照试验（RCT）和队列研究。使用Cochrane协作网的RCT工具和纽卡斯尔-渥太华量表对纳入研究的质量和偏倚风险进行评估。数据录入RevMan软件v5.9，以计算基线和减重后循环炎症标志物、雄激素和LH的标准平均差（SMD）及95%置信区间（95%CI）。11项研究（n = 323）符合系统评价的纳入标准，其中9项研究（n = 286）纳入荟萃分析。数据的汇总分析显示，与PCOS女性的基线水平相比，减重后循环C反应蛋白（SMD 0.39，95%CI 0.22，0.56；9项研究，n = 286）、白细胞介素-6（SMD 0.37，95%CI 0.12，0.61；3项研究，n = 140）、肿瘤坏死因子-α（SMD 0.30，95%CI 0.07，0.53；4项研究，n = 162）、雄烯二酮（SMD 0.36，95%CI 0.13，0.60；4项研究，n = 147）和LH（SMD 0.30，95%CI 0.09，0.51；5项研究，n = 197）有统计学意义的下降。五项研究（n = 173）的荟萃分析显示，与基线水平相比，减重后循环SHBG有统计学意义的升高（SMD -0.43，95%CI -0.65，-0.21）。这些发现表明，饮食干预引起的减重似乎可改善PCOS相关的慢性炎症和高雄激素血症。炎症改善与高雄激素血症之间可能的因果关系仍有待确定。
