Long Jessica R, Parker Megan, Jumani Sanjay, Ahmed Aisha, Huynh Victoria, Gomez-Lobo Veronica
University of Chicago Obstetrics & Gynecology Department, Chicago, IL.
Uniformed Services University, Bethesda, MD.
J Pediatr Adolesc Gynecol. 2025 Apr;38(2):139-147.e4. doi: 10.1016/j.jpag.2024.11.003. Epub 2024 Nov 21.
To improve counseling and outcomes for the adolescent population (ages 10-24-years-old), with polycystic ovary syndrome we conducted a systematic review of randomized controlled trials with the primary objective to generate evidence-based recommendations for which lifestyle interventions with or without medications lead to the best outcomes.
A literature search was conducted. Randomized controlled trials on lifestyle interventions with or without medications in the adolescent population were included. Nonrandomized trials, case-control studies, observational studies, and animal studies were excluded. Of 3,699 articles, 13 studies including 789 participants were included. Each included study was assessed for bias using the Cochrane Risk of Bias 2 tool. Due to significant interstudy heterogeneity, meta-analysis was infeasible; we synthesized results across lifestyle intervention/control types and outcome.
Thirteen studies met inclusion criteria. These studies offer mixed support for lifestyle interventions improving hyperandrogenism. There is some evidence that lifestyle interventions improve menstrual regularity, cardiometabolic health, and metabolic function. Almost all studies found reduced body mass index, adiposity among participants who completed combined exercise and diet, exercise only, and diet only interventions.
The studies in this systematic review demonstrated that lifestyle interventions incorporating increased physical activity and/or healthy dietary choices show beneficial effects in the adolescent population aged ≥ 18-years-old with polycystic ovary syndrome. Medications may also play a key role in treating the disorder. More quality research is needed to identify specific lifestyle interventions that optimize the management of polycystic ovary syndrome amongst those aged 10-17-years-old as well.
为改善患有多囊卵巢综合征的青少年人群(10 - 24岁)的咨询服务及治疗效果,我们对随机对照试验进行了系统评价,主要目的是为有或没有药物治疗的哪种生活方式干预能带来最佳效果生成基于证据的建议。
进行了文献检索。纳入了关于青少年人群有或没有药物治疗的生活方式干预的随机对照试验。排除了非随机试验、病例对照研究、观察性研究和动物研究。在3699篇文章中,纳入了13项研究,包括789名参与者。使用Cochrane偏倚风险2工具对每项纳入研究的偏倚进行评估。由于研究间存在显著异质性,无法进行荟萃分析;我们综合了不同生活方式干预/对照类型及结果的研究结果。
13项研究符合纳入标准。这些研究对生活方式干预改善高雄激素血症提供了混合支持。有一些证据表明生活方式干预可改善月经规律性、心脏代谢健康和代谢功能。几乎所有研究都发现,在完成联合运动与饮食、仅运动以及仅饮食干预的参与者中,体重指数和肥胖程度有所降低。
本系统评价中的研究表明,纳入增加体力活动和/或健康饮食选择的生活方式干预对≥18岁患有多囊卵巢综合征的青少年人群显示出有益效果。药物治疗在该疾病的治疗中可能也起着关键作用。还需要更多高质量研究来确定能优化10 - 17岁人群多囊卵巢综合征管理的具体生活方式干预措施。