Metabolic health during a randomized controlled lifestyle intervention in women with PCOS.

Alexandra Dietz De Loos,Annemerle Beerthuizen,Jan Busschbach,Joop Laven,Geranne Jiskoot

doi:10.1530/eje-21-0669

Alexandra Dietz De Loos, Annemerle Beerthuizen + Show 3 more

Open Access

https://doi.org/10.1530/eje-21-0669

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Abstract

ContextWomen with polycystic ovary syndrome (PCOS) have an increased risk of metabolic syndrome (MetS). Both PCOS and MetS are associated with excess weight.ObjectiveTo examine the effect of a three-component lifestyle intervention (LSI) with or without short message service (SMS+ or SMS−, respectively) on the prevalence and severity of MetS and metabolic parameters, compared to care as usual (CAU).DesignRandomized controlled trial.MethodsWomen diagnosed with PCOS and a BMI >25 kg/m2 (n = 183) were either assigned to a 1-year three-component (cognitive behavioural therapy, diet, and exercise) LSI, with or without SMS support, or to CAU which provided weight-loss advice only. Main outcome measures included changes in the prevalence of MetS, the continuous MetS severity z-score (cMetS z-score), metabolic parameters, and the impact of weight loss.ResultsAfter 1 year, the decrease in the cMetS z-score was greater in the SMS+ group than the CAU group (−0.39, P = 0.015). The prevalence of MetS changed with −21.6% (P = 0.037), −16.5% (P = 0.190), and +7.0% (P = 0.509) in both LSI groups and CAU group, respectively. A post hoc analysis for both LSI groups combined vs CAU resulted in a MetS difference of −25.9% (P = 0.046). Moreover, weight loss per se resulted in significantly favourable effects on all metabolic parameters.ConclusionsThis three-component LSI was more successful in improving metabolic health compared to CAU. Therefore, we recommend this intervention to women with PCOS and excess weight, provided that a clinically relevant weight loss is being pursued.

Highlights

With a prevalence of 8–13% [1, 2, 3, 4, 5], polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during their reproductive lifespan
We examined the effect of the lifestyle intervention (LSI) groups short message service (SMS)+ and SMS− compared to care as usual (CAU) on the metabolic syndrome (MetS) and on the different metabolic parameters (homeostasis model assessment (HOMA-IR), blood pressure (BP), waist circumference (WC), fasting glucose, fasting insulin, lipids)
This resulted in 183 women who were randomly assigned to the SMS+ group (n = 60), SMS− group (n = 63), and CAU group (n = 60)

Summary

Introduction

With a prevalence of 8–13% [1, 2, 3, 4, 5], polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during their reproductive lifespan. Women with PCOS present more often with individual metabolic features such as elevated blood pressure (BP), enlarged waist circumference (WC), and an impaired glucose tolerance [6]. Other key features of metabolic syndrome (MetS) are elevated triglyceride (TG) levels and reduced high-density lipoprotein (HDL). The increased prevalence of all these individual metabolic features leads to a higher prevalence of MetS among women with PCOS.

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