Abstract
Objective To assess the effect of a low carbohydrate diet (LCD) on women with polycystic ovary syndrome (PCOS). Methods Data from randomized controlled trials (RCTs) were obtained to perform a meta-analysis of the effects of LCD in PCOS patients. The primary outcomes included the changes in BMI, homeostatic model assessment for insulin resistance (HOMA-IR), and blood lipids, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), follicle-stimulating hormone (FSH), luteotropic hormone (LH), total testosterone (T), and sex hormone-binding globulin (SHBG). Results Eight RCTs involving 327 patients were included. In comparison with the control group, the LCD decreased BMI (SMD = −1.04, 95% CI (−1.38, −0.70), P < 0.00001), HOMA-IR (SMD = −0.66, 95% CI (−1.01, −0.30), P < 0.05), TC (SMD = −0.68, 95% CI (−1.35, −0.02), P < 0.05), and LDL-C (SMD = −0.66, 95% CI (−1.30, −0.02), P < 0.05). Stratified analyses indicated that LCD lasting longer than 4 weeks had a stronger effect on increasing FSH levels (MD = 0.39, 95% CI (0.08, 0.71), P < 0.05), increasing SHBG levels (MD = 5.98, 95% CI (3.51, 8.46), P < 0.05), and decreasing T levels (SMD = −1.79, 95% CI (−3.22, −0.36), P < 0.05), and the low-fat and low-CHO LCD (fat <35% and CHO <45%) had a more significant effect on the levels of FSH (MD = 0.40, 95% CI (0.09, 0.71), P < 0.05) and SHBG (MD = 6.20, 95% CI (3.68, 8.72), P < 0.05) than the high-fat and low-CHO LCD (fat >35% and CHO <45%). Conclusion Based on the current evidence, LCD, particularly long-term LCD and low-fat/low-CHO LCD, may be recommended for the reduction of BMI, treatment of PCOS with insulin resistance, prevention of high LDL-C, increasing the levels of FSH and SHBG, and decreasing the level of T level. Together, the analyzed data indicate that proper control of carbohydrate intake provides beneficial effects on some aspects of PCOS and may represent one of the important interventions improving the clinical symptoms of affected patients.
Highlights
Polycystic ovary syndrome (PCOS) involves reproductive, metabolic, and hormonal disorders and accounts for 50– 70% cases of anovulatory infertility in women of childbearing age [1]. e worldwide prevalence of PCOS is 6–10% and tends to increase with economic development
Inclusion and Exclusion Criteria. e inclusion criteria were as follows: (1) the study represented original research; (2) the study was designed as a randomized control trial (RCTs); (3) the full text of the publication could be obtained; (4) the target population were women with PCOS; (5) PCOS diagnosis was based on the 2003 Rotterdam criteria; (6) the intervention group was on a low-carbohydrate diet in which carbohydrates accounted for less than 45% of the three major nutrients, and the control group was on a regular diet; and (7) availability of all raw data obtained in the trials for the primary and secondary indicators utilized in the current meta-analysis
Exclusion criteria were as follows: (1) combination of the low-carbohydrate diet (LCD) with other drugs, such as metformin; (2) data duplicated in conference papers and journal articles or in Chinese and English literature. e higher-quality source was selected in these instances; (3) in case of the came content being published in two articles, only one was selected; (4) the publication was an abstract, and a full-text version was not
Summary
Polycystic ovary syndrome (PCOS) involves reproductive, metabolic, and hormonal disorders and accounts for 50– 70% cases of anovulatory infertility in women of childbearing age [1]. e worldwide prevalence of PCOS is 6–10% and tends to increase with economic development. Polycystic ovary syndrome (PCOS) involves reproductive, metabolic, and hormonal disorders and accounts for 50– 70% cases of anovulatory infertility in women of childbearing age [1]. The etiology of PCOS is not completely understood, and this condition may represent the consequence of the interaction between genetic and environmental factors [2], including family history, low birth weight, obesity, poor dietary habits, and sedentary lifestyle. Dietary interventions have been reported to ameliorate clinical symptoms of PCOS, including menstrual disorders, and abnormal hormonal indicators and ovulation [4, 5]. Erefore, modification of diet appears as a critical therapeutic modality capable of improving the clinical symptoms of PCOS.
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