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生酮饮食对多囊卵巢综合征患者代谢和激素参数的影响:一项临床试验的系统评价和荟萃分析

The effects of ketogenic diet on metabolic and hormonal parameters in patients with polycystic ovary syndrome: a systematic review and meta-analysis of clinical trials.

作者信息

Eshaghhosseiny Niloofarsadaat, Ahmadi Mohammad, Izadi Bahareh, Vali Mohebat, Akbari Maryam, Azari Isaac, Akbari Hamed

机构信息

Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Diabetes Metab Disord. 2024 May 21;23(2):1573-1587. doi: 10.1007/s40200-024-01441-3. eCollection 2024 Dec.

Abstract

PURPOSE

In recent years, using the ketogenic diet (KD) as a potential intervention for polycystic ovary syndrome (PCOS) has gained attention. Therefore, this study aimed to conduct a meta-analysis to determine the effects of KD on sexual hormones, glycemic and lipid parameters in women diagnosed with PCOS.

METHODS

A comprehensive literature search was performed using online databases such as Medline/PubMed, Scopus, Web of Science (ISI), Embase, and the Cochrane Library and clinical trials were selected based on the inclusion criteria. Data extraction and quality assessment were conducted independently by two investigators using appropriate tools. The effects of a KD on metabolic biomarkers and hormonal parameters were pooled using a random-effects model and were considered as the weighted mean difference (WMD) with corresponding 95% confidence intervals (CIs). Heterogeneity across studies was assessed using Cochran's Q test and the I-square test.

RESULTS

Ten studies including 408 women were analyzed in this analysis. Findings showed that KD significantly decreased triglycerides levels (WMD = -44.03 mg/dL; 95% CI, -56.29, -31.76), total cholesterol (-18.95 mg/dL; -29.06, -8.83), and low-density lipoprotein cholesterol (LDL) (-18.11 mg/dL; -29.56, -6.67) compared to the control groups. KD also led to a notable reduction in fasting glucose (-10.30 mg/dL; -14.10, -6.50) and HOMA-IR (-1.93; -3.66, -0.19). Also, this diet led to a significant decrease in luteinizing hormone (LH) levels (-3.75 mIU/mL; -3.84, -3.65) and total testosterone levels (-7.71 ng/dL); -12.08, -3.35), while follicle-stimulating hormone (FSH) increased (0.43 mIU/mL; 0.29, 0.57).

CONCLUSION

The KD demonstrated promising outcomes in improving metabolic and hormonal parameters in women diagnosed with PCOS.

摘要

目的

近年来,采用生酮饮食(KD)作为多囊卵巢综合征(PCOS)的一种潜在干预措施受到了关注。因此,本研究旨在进行一项荟萃分析,以确定KD对诊断为PCOS的女性性激素、血糖和血脂参数的影响。

方法

使用Medline/PubMed、Scopus、科学网(ISI)、Embase和Cochrane图书馆等在线数据库进行全面的文献检索,并根据纳入标准选择临床试验。由两名研究人员使用适当工具独立进行数据提取和质量评估。使用随机效应模型汇总KD对代谢生物标志物和激素参数的影响,并将其视为加权平均差(WMD)及相应的95%置信区间(CI)。使用Cochran's Q检验和I²检验评估研究间的异质性。

结果

本分析纳入了10项研究,共408名女性。结果显示,与对照组相比,KD显著降低了甘油三酯水平(WMD = -44.03 mg/dL;95% CI,-56.29,-31.76)、总胆固醇(-18.95 mg/dL;-29.06,-8.83)和低密度脂蛋白胆固醇(LDL)(-18.11 mg/dL;-29.56,-6.67)。KD还使空腹血糖(-10.30 mg/dL;-14.10,-6.50)和胰岛素抵抗指数(HOMA-IR)(-1.93;-3.66,-0.19)显著降低。此外,这种饮食导致促黄体生成素(LH)水平(-3.75 mIU/mL;-3.84,-3.65)和总睾酮水平(-7.71 ng/dL;-12.08,-3.35)显著降低,而促卵泡生成素(FSH)升高(0.43 mIU/mL;0.29,0.57)。

结论

KD在改善诊断为PCOS的女性的代谢和激素参数方面显示出了有前景的结果。

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