Sharifi Maryam, Saber Amir, Moludi Jalal, Salimi Yahya, Jahan-Mihan Alireza
Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Nutr J. 2024 Dec 2;23(1):152. doi: 10.1186/s12937-024-01056-7.
Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal disorders in reproductive-age women caused by hyperinsulinemia. The portfolio Moderate-carbohydrate diet (PMCD) is a plant-based diet with a carbohydrate content of 40% and incorporates five cholesterol-lowering foods. While, the ketogenic diet is a high-fat diet with 70% fat, promoting a ketosis state. To the best of our knowledge, no study compared the therapeutic effects of these two diets in PCOS patients. Thus, this study aimed to compare the impact of PLCD and KD on anthropometric indices, metabolic status, and hormonal levels in overweight or obese women with PCOS.
This open-label, randomized clinical trial was conducted on forty-six PCOS women. 21 women in PMCD and 19 in the KD group completed the study. The anthropometric indices including body mass index (BMI) and fat body mass (FBM), metabolic markers (fasting blood glucose (FBG)) and plasma lipid profiles including low-density lipoprotein (LDL), triglycerides, and high-density lipoproteins (HDL) were measured. Reproductive hormones such as luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-s) and free testosterone were assessed at the baseline and after the intervention.
However, after 8 weeks both diets demonstrated enhancement in anthropometric indices (BMI, FBM, lean body mass), metabolic status (FBG, insulin serum levels), and reproductive hormones such as LH, free testosterone, and DHEA-s. The mean difference in the KD improved more than the PMCD in the field of BMI reduction (MD (SD) 2.73 (0.351) vs. MD (SD) 1.71 (0.775)) and LH (MD 4.13 (1.375) vs.MD 2.46 (1.105)). Nevertheless, the lipid profile including LDL-C and triglycerides improved more in the PMCD compared to the KD (MD 33.95 (7.345) vs. MD 23.34 (14.136)) and (MD 38.20 (10.757) vs. MD 57.62 (21.688)) respectively. There were no significant changes in the Ferriman-Gallwey score within or between the two groups.
The findings revealed that both diets were effective in improving PCOS manifestations. However, the KD exhibited greater effectiveness in enhancing body measurements, metabolic factors, and reproductive hormone levels compared to the PMCD in obese PCOS women. Furthermore, PMCD could be more beneficial for PCOS women with lipide disorders.
IRCT20200912048693N3, Trial registered 2022-12-14. https://www.irct.ir/trial/67548.
多囊卵巢综合征（PCOS）是育龄女性中最常见的激素紊乱疾病之一，由高胰岛素血症引起。适度碳水化合物饮食方案（PMCD）是一种以植物为基础的饮食，碳水化合物含量为40%，并包含五种降胆固醇食物。而酮饮食是一种高脂肪饮食，脂肪含量为70%，可促进酮症状态。据我们所知，尚无研究比较这两种饮食对PCOS患者的治疗效果。因此，本研究旨在比较适度低碳水化合物饮食（PLCD）和酮饮食（KD）对超重或肥胖PCOS女性的人体测量指标、代谢状况和激素水平的影响。
本开放标签、随机临床试验针对46名PCOS女性进行。PMCD组21名女性和KD组19名女性完成了研究。测量了人体测量指标，包括体重指数（BMI）和脂肪量（FBM）、代谢标志物（空腹血糖（FBG））以及血脂谱，包括低密度脂蛋白（LDL）、甘油三酯和高密度脂蛋白（HDL）。在基线和干预后评估了生殖激素，如促黄体生成素（LH）、硫酸脱氢表雄酮（DHEA-s）和游离睾酮。
然而，8周后两种饮食均显示人体测量指标（BMI、FBM、瘦体重）、代谢状况（FBG、胰岛素血清水平）以及生殖激素如LH、游离睾酮和DHEA-s有所改善。在降低BMI方面，KD组的平均差异改善程度超过PMCD组（MD（SD）2.73（0.351）对MD（SD）1.71（0.775））以及LH方面（MD 4.13（1.375）对MD 2.46（1.105））。尽管如此，与KD组相比，PMCD组的血脂谱包括LDL-C和甘油三酯改善更为明显（分别为MD 33.95（7.345）对MD 23.34（14.136））和（MD 38.20（10.757）对MD 57.62（21.688））。两组内或两组间的费里曼 - 加维评分均无显著变化。
研究结果表明，两种饮食在改善PCOS表现方面均有效。然而，与PMCD相比，KD在改善肥胖PCOS女性的身体测量指标、代谢因素和生殖激素水平方面表现出更高的有效性。此外，PMCD可能对患有脂质紊乱的PCOS女性更有益。
IRCT20200912048693N3，试验于2022年12月14日注册。https://www.irct.ir/trial/67548
