Effects of ketogenic diet intervention on sex hormones levels, glucose metabolism and pregnancy outcome in patients with polycystic ovary syndrome complicated with overweight/obesity

Abstract

Objective To observe the effects of ketogenic diet on sex hormones levels, glucose metabolism and pregnancy outcome in patients with polycystic ovary syndrome (PCOS) complicated with overweight/obesity. Methods A total of 142 PCOS patients with overweight/obesity who were diagnosed and treated in Nanyang Central Hospital from January 2016 to June 2018 were enrolled in the study. According to the random number table method, the patients were divided into observation group and control group, with 71 cases in each group. After eliminated the inability to adhere to treatment, decommissioning and late loss of follow-up, 42 effective cases in observation group and 58 effective cases in control group were obtained finally. Control group was given Diane-35, metformin and routine dietary guidance, and observation group was given ketogenic dietary guidance on the basis of drug treatment. After 3 months of treatment, the body mass index (BMI), waist-to-hip ratio and ovarian volume were observed, and the sex hormones levels, such as estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), glucose metabolism indicators, including fasting blood glucose (FBG), postprandial 2 h blood glucose (2 h PBG), fasting insulin (FINS), insulin resistance index (HOMA-IR), and inflammation indexes, including serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) were compared between the two groups, and the menstrual recovery, ovulation and pregnancy were observed. Results After treatment, the BMI, waist-to-hip ratio and ovarian volume in observation group were significantly higher than those in control group (P<0.05). The improvements of sex hormones levels (E2, LH, FSH, T), glucose metabolism indicators (2 h PBG, FINS, HOMA-IR) and inflammation indexes (CRP, TNF-α, IL-6) in observation group were better than those in control group (P<0.05). The ovulation rate , total pregnancy rate and natural pregnancy rate within 1 year in observation group were significantly higher than those in control group (P<0.05). Conclusions Ketogenic diet intervention for PCOS patients with overweight/obesity can reduce the BMI, improve the sex hormones, glucose metabolism disorder and inflammatory response, and help to improve the pregnancy rate. Key words: Polycystic ovary syndrome; Overweight/obesity; Ketogenic diet intervention; Hormone levels; Glucose metabolism; Pregnancy rate