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Amini M, Bahmani F, Foroozanfard F, Vahedpoor Z, Ghaderi A, Taghizadeh M, Karbassizadeh H, Asemi Z. Retracted article: The effects of fish oil omega-3 fatty acid supplementation on mental health parameters and metabolic status of patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. J Psychosom Obstet Gynaecol 2024; 45:1508282. [PMID: 30230402 DOI: 10.1080/0167482x.2018.1508282] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/24/2018] [Accepted: 07/29/2018] [Indexed: 01/28/2023] Open
Abstract
We, the Editor and Publisher of the Journal of Psychosomatic Obstetrics & Gynecology have retracted the following article:Mehrdad Amini, Fereshteh Bahmani, Fatemeh Foroozanfard, Zahra Vahedpoor, Amir Ghaderi, Mohsen Taghizadeh, Hassan Karbassizadeh & Zatollah Asemi (2018), The effects of fish oil omega-3 fatty acid supplementation on mental health parameters and metabolic status of patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Journal of Psychosomatic Obstetrics & Gynecology, DOI: 10.1080/0167482X.2018.1508282.Following publication, significant concerns were raised by a third party 1 about the integrity of the data and the reported findings in the article.When approached for an explanation, the authors and their institution have been cooperative in providing some responses and documents. To verify the reported findings, the article and the documents provided by the authors were further evaluated by the journal editorial team, and also sent for review by an external statistical reviewer.Both the journal editorial team and the external statistical reviewer were unable to confirm the integrity of the trial design and the main outcome of the external review was that the article's results and conclusions are unreliable. Therefore, as the editorial team no longer have confidence in the reported conclusions the decision has been made to retract the article.The authors listed in the publication have been informed. The authors do not agree with the retraction.We have been informed in our decision-making by our editorial policies and the COPE guidelines.The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as 'Retracted'.
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Affiliation(s)
- Mehrdad Amini
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Vahedpoor
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Ghaderi
- Department of Addiction studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Saxena A, Sherkane M, Bhoite R, Sadananda MP, Satyavrat V, Kareenhalli V. Efficacy of optimal nutraceutical combination in treating PCOS characteristics: an in-silico assessment. BMC Endocr Disord 2024; 24:44. [PMID: 38549084 PMCID: PMC10979615 DOI: 10.1186/s12902-024-01571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a serious health condition affecting women of reproductive age. High prevalence of PCOS and associated metabolic complications needs effective treatment and management. This study evaluated the efficacy of optimal nutraceutical combinations in improving PCOS characteristics using system biology-based mathematical modelling and simulation. METHODS A shortlisting of eight potent nutraceuticals was carried out with literature search. Menstrual cycle model was used to perform simulations on an in-silico population of 2000 individuals to test individual and combined effects of shortlisted nutraceuticals on five PCOS characteristics [oligomenorrhea, anovulation, hirsutism, infertility, and polycystic ovarian morphology (PCOM)] for a duration of 6 months. Efficacy was tested across lean and obese phenotypes and age groups. RESULTS Individual assessment of nutraceuticals revealed seven most potent compounds. Myo-inositol among them was observed to be the most effective in alleviating the PCOS characteristics. The in-silico population analysis showed that the combination of melatonin and ALA along with myo-inositol was efficacious in restoring the hormonal balance across age-groups and Body Mass Index (BMI) categories. CONCLUSION Supplementation with the combination of myo-inositol, melatonin, and ALA demonstrated potential in managing PCOS symptoms in our in-silico analysis of a heterogeneous population, including lean and obese phenotypes across various severities and age groups, over a 6-month period. Future clinical studies are recommended to validate these findings.
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Calcaterra V, Magenes VC, Massini G, De Sanctis L, Fabiano V, Zuccotti G. High Fat Diet and Polycystic Ovary Syndrome (PCOS) in Adolescence: An Overview of Nutritional Strategies. Nutrients 2024; 16:938. [PMID: 38612972 PMCID: PMC11013055 DOI: 10.3390/nu16070938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a multifaceted and heterogeneous disorder, linked with notable reproductive, metabolic, and psychological outcomes. During adolescence, key components of PCOS treatment involve weight loss achieved through lifestyle and dietary interventions, subsequently pursued by pharmacological or surgical therapies. Nutritional interventions represent the first-line therapeutic approach in adolescents affected by PCOS, but different kinds of dietary protocols exist, so it is necessary to clarify the effectiveness and benefits of the most well-known nutritional approaches. We provided a comprehensive review of the current literature concerning PCOS definition, pathophysiology, and treatment options, highlighting nutritional strategies, particularly those related to high-fat diets. The high-fat nutritional protocols proposed in the literature, such as the ketogenic diet (KD), appear to provide benefits to patients with PCOS in terms of weight loss and control of metabolic parameters. Among the different types of KD studies, very low-calorie ketogenic diets (VLCKD), can be considered an effective dietary intervention for the short-term treatment of patients with PCOS. It rapidly leads to weight loss alongside improvements in body composition and metabolic profile. Even though extremely advantageous, long-term adherence to the KD is a limiting factor. Indeed, this dietary regimen could become unsustainable due to the important restrictions required for ketosis development. Thus, a combination of high-fat diets with more nutrient-rich nutritional regimens, such as the Mediterranean diet, can amplify positive effects for individuals with PCOS.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
| | - Vittoria Carlotta Magenes
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
| | - Giulia Massini
- Pediatric Endocrinology, Regina Margherita Children Hospital, 10131 Torino, Italy; (G.M.); (L.D.S.)
- Department of Public Health and Pediatric Sciences, University of Torino, 10131 Torino, Italy
| | - Luisa De Sanctis
- Pediatric Endocrinology, Regina Margherita Children Hospital, 10131 Torino, Italy; (G.M.); (L.D.S.)
- Department of Public Health and Pediatric Sciences, University of Torino, 10131 Torino, Italy
| | - Valentina Fabiano
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milan, Italy
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Xing NN, Ren F, Yang H. Effects of ketogenic diet on weight loss parameters among obese or overweight patients with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trails. Food Nutr Res 2024; 68:9835. [PMID: 38571924 PMCID: PMC10989237 DOI: 10.29219/fnr.v68.9835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 04/05/2024] Open
Abstract
Aim To evaluate how effective a low carbohydrate ketogenic diet (KD) is for changing key physical measurements such as weight, waist circumference (WC), body mass index (BMI), and fat mass (FM) in women with polycystic ovary syndrome (PCOS) who were obese or overweight. Methods Several online databases, including PubMed, Scopus, EMBASE, Cochrane Library, and Web of Science (WOS), were searched systematically to find relevant randomized controlled trials (RCTs) up until June 2023. The Q-test and I2 statistics were used to assess the level of heterogeneity among the included studies. The data were then combined using either a fixed or random effects model and presented as a weighted mean difference (WMD) along with a 95% confidence interval (CI). Results Of the 682 citations, 11 RCTs were included. The pooled results showed a significant decrease in the WMD of weight levels [WMD = -9.13 kg; 95% CI, -11.88, -6.39, P < 0.001; I2 = 87.23%] following KD. Moreover, KD significantly reduced BMI levels [WMD = -2.93 kg/m2; 95% CI, -3.65, -2.21, P < 0.001; I2 = 78.81%] compared to the controls. Patients with PCOS received KD demonstrated significant decrease in WC [WMD = -7.62 cm; 95% CI, -10.73, -4.50, P < 0.001; I2 = 89.17%] and FM [WMD = -5.32 kg; 95% CI, -7.29, -3.36, P < 0.001; I2 = 83.97%]. Conclusion KD was associated with lower weight loss (WL) parameters, including weight, BMI, WC, and FM, in obese or overweight women with PCOS, highlighting the significance of physicians and nurses in taking care of the nutritional needs of overweight/obese patients with PCOS.
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Affiliation(s)
- Nan-nan Xing
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fang Ren
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hui Yang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
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Zhou J, Zuo W, Tan Y, Wang X, Zhu M, Zhang H. Effects of n-3 polyunsaturated fatty acid on metabolic status in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials. J Ovarian Res 2023; 16:54. [PMID: 36932420 PMCID: PMC10022207 DOI: 10.1186/s13048-023-01130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/27/2023] [Indexed: 03/19/2023] Open
Abstract
This meta-analysis was conducted to summarize the effects of n-3 polyunsaturated fatty acid (n-3 PUFA) on metabolic status including insulin metabolism and lipid metabolism in women with polycystic ovary syndrome (PCOS) by randomized controlled trials (RCTs). Four mainstream databases including PubMed, Cochrane Library, Embase and Web of Science were searched from their inception to October 2021. The registration number of this study was CRD42021285233. The quality assessment was performed referring the Cochrane Risk of Bias Tool. Mean differences (MD) and 95% confidence intervals (CIs) were generated for continuous variables by meta-analysis. Subgroup analyses were performed based on study duration (≤ 8 weeks or > 8 weeks), the source of n-3 PUFA (marine derived or plant origins) and dosage of n-3 PUFA (≤ 1000 mg/d or > 1000 mg/d). Eventually, 11 RCTs reporting 816 patients were enrolled. Compared with control group, n-3 PUFA treatment decreased waist circumference (MD = -2.76, 95% CI: -3.82 to -1.69; p < 0.00001), fasting plasma glucose (MD = -3.91, 95% CI: -5.69 to -2.13; p < 0.0001), fasting insulin (MD = -2.45, 95% CI: -3.19 to -1.71; p < 0.00001), homeostatic model assessment of insulin resistance (MD = -0.45, 95% CI: -0.80 to -0.11; p = 0.01), triglyceride (MD = -9.33, 95% CI: -10.56 to -8.10; p < 0.00001), total cholesterol (MD = -12.32, 95% CI: -19.15 to -5.50; p = 0.0004), low-density lipoprotein cholesterol (MD = -10.53, 95% CI: -19.31 to -1.75; p = 0.02), and increase quantitative insulin sensitivity check index (MD = 0.01, 95% CI: 0.01 to 0.02; p < 0.00001), Adiponectin (MD = 1.46, 95% CI: 1.12 to 1.80; p < 0.00001) in PCOS patients. However, n-3 PUFA failed to change body weight, body mass index, high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and hs-CRP in the overall analysis. Further subgroup analyses showed that supplements of n-3 PUFA for more than 8 weeks is more conducive to improve the metabolic status in insulin resistance and lipid profiles. The meta-analysis demonstrates that n-3 PUFA may be an effective intervention for alleviating metabolic status in PCOS. Hence, we recommend PCOS patients replenish n-3 PUFA with duration > 8 weeks regardless of the source and the dosage to retard the pathogenesis of PCOS related metabolic diseases.
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Grants
- project NO JC2020003 Project of Nantong Science and Technology Bureau, Jiangsu, China
- project NO JC2020003 Project of Nantong Science and Technology Bureau, Jiangsu, China
- project NO JC2020003 Project of Nantong Science and Technology Bureau, Jiangsu, China
- project NO JC2020003 Project of Nantong Science and Technology Bureau, Jiangsu, China
- project NO JC2020003 Project of Nantong Science and Technology Bureau, Jiangsu, China
- project NO JC2020003 Project of Nantong Science and Technology Bureau, Jiangsu, China
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Affiliation(s)
- Jie Zhou
- grid.410745.30000 0004 1765 1045Nanjing University of Chinese Medicine, Nanjing, 210023 People’s Republic of China
- Department of Chinese Medicine, The First People’s Hospital of Nantong, Nantong, 226001 Jiangsu People’s Republic of China
| | - Wenting Zuo
- grid.410745.30000 0004 1765 1045Department of Reproductive Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029 Jiangsu People’s Republic of China
| | - Yong Tan
- grid.410745.30000 0004 1765 1045Department of Reproductive Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029 Jiangsu People’s Republic of China
| | - Xudong Wang
- Department of Chinese Medicine, The First People’s Hospital of Nantong, Nantong, 226001 Jiangsu People’s Republic of China
| | - Meihong Zhu
- Department of Pharmacy, The First People’s Hospital of Nantong, Nantong, 226001 Jiangsu People’s Republic of China
| | - Huili Zhang
- Medical Department, The First People’s Hospital of Nantong, Nantong, 226001 Jiangsu People’s Republic of China
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Qin L, Mei Y, An C, Ning R, Zhang H. Docosahexaenoic acid administration improves diabetes-induced cardiac fibrosis through enhancing fatty acid oxidation in cardiac fibroblast. J Nutr Biochem 2023; 113:109244. [PMID: 36470335 DOI: 10.1016/j.jnutbio.2022.109244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Diabetes mellitus can lead to various complications, including organ fibrosis. Metabolic remodeling often occurs during the development of organ fibrosis. Docosahexaenoic acid (DHA), an essential ω-3 polyunsaturated fatty acid, shows great benefits in improving cardiovascular disease and organ fibrosis, including regulating cellular metabolism. In this study, we investigated whether DHA can inhibit diabetes-induced cardiac fibrosis by regulating the metabolism of cardiac fibroblasts. Type I diabetic mice were induced by streptozotocin and after supplementation with DHA for 16 weeks, clinical indicators of serum and heart were evaluated. DHA administration significantly improved serum lipid levels, cardiac function and cardiac interstitial fibrosis, but not blood glucose levels. Subsequently, immunofluorescences, western blot and label-free quantitative proteomics methods were used to study the mechanism. The results showed that the anti-fibrotic function of DHA was achieved through regulating extracellular matrix homeostasis including ECM synthesis and degradation. Our research demonstrated DHA regulated the energy metabolism of cardiac fibroblasts, especially fatty acid oxidation, and then affected the balance of ECM synthesis and degradation. It suggested that DHA supplementation could be considered an effective adjuvant therapy for cardiac fibrosis caused by hyperglycemia.
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Affiliation(s)
- Linhui Qin
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Yingwu Mei
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Chengcheng An
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Rui Ning
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Haifeng Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China.
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Heidari H, Hajhashemy Z, Saneei P. A meta-analysis of effects of vitamin E supplementation alone and in combination with omega-3 or magnesium on polycystic ovary syndrome. Sci Rep 2022; 12:19927. [PMID: 36402830 PMCID: PMC9675810 DOI: 10.1038/s41598-022-24467-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022] Open
Abstract
Vitamin E supplementation might have favorable effects on risk factors of polycystic ovary syndrome (PCOS). This systematic review and meta-analysis aimed to summarize the effects of vitamin E supplementation or vitamin E in combination with omega-3 or magnesium on PCOS. PubMed, Scopus, ISI Web of Science, Cochrane, Embase electronic databases, and Google scholar were searched for all available articles up to September 2022. Randomized controlled trials (RCTs) that examined the effect of vitamin E supplementation or vitamin E in combination with omega-3 or magnesium on lipid and glycemic profiles, anthropometric measurements, biomarkers of inflammation and oxidative stress, hormonal profile, and hirsutism score in patients with PCOS were included. Ten RCTs (with 504 participants) fulfilled the eligible criteria. Vitamin E supplementation or vitamin E in combination with omega-3 or magnesium in comparison to placebo could significantly reduce serum levels of TG (weighted mean difference: - 18.27 mg/dL, 95% CI - 34.68 to - 1.87), VLDL (- 5.88 mg/dL, 95% CI - 8.08 to - 3.68), LDL-c (- 12.84 mg/dL, 95% CI - 22.15 to - 3.52), TC (- 16.30 mg/dL, 95% CI - 29.74 to - 2.86), TC/HDL-c ratio (- 0.52, 95% CI - 0.87 to - 0.18), hs-CRP (- 0.60 ng/mL, 95% CI - 0.77 to - 0.44), hirsutism score (- 0.33, 95% CI - 0.65 to - 0.02) and significantly increase nitric oxide levels (2.79 µmol/L, 95% CI 0.79-4.79). No significant effect was found on HDL-c, glycemic indices, hormonal profile, anthropometric measurements, and other biomarkers of inflammation or oxidative stress. This meta-analysis highlights the potential anti-hyperlipidemic, anti-oxidant, and anti-inflammatory properties of vitamin E supplementation alone or in combination with omega-3 or magnesium on PCOS patients.
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Affiliation(s)
- Hajar Heidari
- grid.411036.10000 0001 1498 685XDepartment of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Zahra Hajhashemy
- grid.411036.10000 0001 1498 685XDepartment of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran ,grid.411036.10000 0001 1498 685XStudents’ Scientific Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- grid.411036.10000 0001 1498 685XDepartment of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
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Lu L, Li X, Lv L, Xu Y, Wu B, Huang C. Associations between omega-3 fatty acids and insulin resistance and body composition in women with polycystic ovary syndrome. Front Nutr 2022; 9:1016943. [PMID: 36276838 PMCID: PMC9581053 DOI: 10.3389/fnut.2022.1016943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is strongly associated with abdominal obesity and insulin resistance and effective approaches to nutrition (e.g., omega-3 fatty acids intake) might improve the cardiometabolic risk profile. This study aimed to examine the associations of dietary and serum omega-3 fatty acids with insulin resistance (IR) and body composition among PCOS patients. Methods A total of 185 patients with PCOS were included in our analysis. Dietary information was collected through face-to-face interviews using a 102-item food frequency questionnaire (FFQ). Serum omega-3 fatty acid levels were measured with the gas chromatography method. Body composition was measured by both dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance (BIA) methods. The multivariable linear regression model was applied to analyze the associations of dietary and serum omega-3 fatty acids with the levels of Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) and body composition parameters among PCOS patients. Results Our results indicated that the dietary long-chain omega-3 polyunsaturated fatty acids (PUFA) intakes were negatively associated with HOMA-IR (β = -0.089, P = 0.040), fat mass (β = -0.022, P = 0.047), and body fat percentage (β = -0.026, P = 0.032). For serum biomarkers, higher total omega-3 PUFAs levels (β = -0.158, P = 0.021) and long-chain omega-3 PUFAs levels (β = -0.187, P < 0.001), particularly eicosapentaenoic acid (EPA) (β = -164, P = 0.011) and docosahexaenoic acid (DHA) (β = -0.158, P = 0.001) were also associated with decreased HOMA-IR. In addition, generally, dietary and serum long-chain omega-3 PUFA levels, DPA, and DHA levels were both positively associated with muscle mass measured by DXA; whereas serum total, long-chain and individual omega-3 PUFA levels (e.g., DPA, EPA, and DHA) were all negatively associated with fat mass and body fat percentage. These findings were further confirmed by the findings for body composition measured by the BIA method. Conclusion Higher levels of dietary and serum omega-3 PUFAs, particularly long-chain omega PUFAs (DPA and DHA), might have beneficial effects on metabolic parameters and body composition among PCOS patients.
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Affiliation(s)
- Ling Lu
- Department of Gynecology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Xiaoqin Li
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Lin Lv
- Department of Gynecology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yao Xu
- Department of Gynecology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Baohua Wu
- Department of Gynecology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Chaolin Huang
- Department of Gynecology, First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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Moslehi N, Zeraattalab-Motlagh S, Rahimi Sakak F, Shab-Bidar S, Tehrani FR, Mirmiran P. Effects of nutrition on metabolic and endocrine outcomes in women with polycystic ovary syndrome: an umbrella review of meta-analyses of randomized controlled trials. Nutr Rev 2022; 81:555-577. [PMID: 36099162 DOI: 10.1093/nutrit/nuac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Numerous meta-analyses have been conducted on the effects of nutritional interventions on various health outcomes in women with polycystic ovary syndrome (PCOS). However, the strength of the evidence and its clinical significance are unclear. OBJECTIVE This umbrella review aimed to summarize the effects of nutritional interventions on women with PCOS and assess the strength of the evidence. DATA SOURCES PubMed, Scopus, and Web of Science were searched from inception until March 17, 2021. DATA EXTRACTION Meta-analyses of randomized clinical trials (RCTs) that examined the impact of dietary modifications or supplementations on women with PCOS were selected. Data extraction, quality assessments of the meta-analyses, and evaluation of the strength of the evidence were conducted independently by 2 investigators and confirmed by a third. DATA ANALYSIS Twenty-eight RCT meta-analyses were included, reporting 40 different outcomes. Lower carbohydrate, Dietary Approaches to Stop Hypertension, or lower glycemic index/load diets in women with PCOS significantly improved some anthropometric and metabolic characteristics (with very low to low certainty). Probiotics/synbiotics reduced fasting plasma glucose, fasting insulin (FI), and homeostasis model assessment-estimated insulin resistance (HOMA-IR) (with moderate to high certainty). Curcumin supplementation decreased fasting plasma glucose, FI, and HOMA-IR (with moderate certainty). Fish oil supplementation decreased FI and HOMA-IR, and omega-3 reduced triglycerides (with moderate certainty). There were also improvements in FI after taking vitamin D or inositol supplements (with moderate certainty). Supplementation with fish oil increased adiponectin (with high certainty), and probiotics/synbiotics reduced total testosterone (with moderate certainty). In subfertile women with PCOS, inositol increased the ovulation rates (with moderate certainty). CONCLUSION There was no high-certainty evidence that diets alone in women with PCOS improved health or reproductive outcomes. Supplementation with vitamin D, probiotics/synbiotics, omega-3, inositol, and curcumin showed favorable effects on some metabolic outcomes. Probiotics/synbiotics possibly reduces total testosterone, and inositol stimulates ovulation in women with PCOS. REGISTRATION PROSPERO registration no. CRD42021251496.
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Affiliation(s)
- Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rahimi Sakak
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Omega-3 supplementation in the treatment of polycystic ovary syndrome (PCOS) - a review of clinical trials and cohort. Endocr Regul 2022; 56:66-79. [PMID: 35180821 DOI: 10.2478/enr-2022-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women associated with cardiovascular disease and obesity. The possible benefits of omega-3 supplementation in this syndrome have been discussed much. This study is aimed to verify, based on the scientific data published, if there are any benefits in the omega-3 supplementation in the treatment of PCOS and to indicate its possible dosages for the treatment of polycystic ovary. The work consists of a systematic review of clinical trials and cohort of the MEDLINE/PubMed database from 2009 to October 2019. All studies that analyzed the omega-3 supplementation in women with PCOS were included. Cross-sectional studies, review articles, systematic reviews, meta-analysis, duplicates, studies in animals or cell culture, studies with omega-3 supplementation via food or associated with other supplementations were not included, except those involving vitamin E. In total, 21 articles were selected. Despite the heterogeneity of the studies selected, indirect benefits were observed mainly regarding the glycemic profile, such as insulin resistance reduction, lipid profile modulation (i.e. decrease in total cholesterol, triglycerides, and elevation of high-density lipoprotein), and the regulation of the androgenic profile. As for the anthropometric profile, the studies were scarce and most of them had no significant meaning. Regarding the antioxidant profile and inflammatory biomarkers, the findings differ among studies, but promising results were observed with different doses over 12 weeks of use, such as C-reactive protein (CRP) reduction. Thus, omega-3 fatty acids promote indirect benefits in the treating of women with PCOS. However, to reveal well-defined standards for dosage and supplementation time, further studies are needed.
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Saadati N, Haidari F, Barati M, Nikbakht R, Mirmomeni G, Rahim F. The effect of low glycemic index diet on the reproductive and clinical profile in women with polycystic ovarian syndrome: A systematic review and meta-analysis. Heliyon 2021; 7:e08338. [PMID: 34820542 PMCID: PMC8600081 DOI: 10.1016/j.heliyon.2021.e08338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/07/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022] Open
Abstract
Background Treatment for polycystic ovary syndrome (PCOS) usually initiates with a series of lifestyle modifications such as diet, weight loss, and exercise. Aims We, therefore, conducted this meta-analysis to systematically review and evaluate the possible benefits of LGD on a range of anthropometric, clinical, and biochemical parameters in women with PCOS. Methods We performed a systematic search through major indexing databases, including Scopus, Pubmed/Medline, ISI web of science, Embase, Cochrane central, and CINAHL (1966-April 30, 2021) using key concepts of PCOS. Results Of 935 initial publications, 542 remain after duplicates removal. Then, 141 records were removed at the title and abstract screening level. After excluding 392 literatures, we finally included 8 articles. The final selected studies included 412 overweight and obese individuals with PCOS (207 cases in LGID group and 205 patients in comparators) with a mean age of 21-32 years. Measured emotional health (3 studies, 132 participants, SMD: -1.97; 95%CI:-3.54, -0.40, P = 0.01, I 2 = 89%) and body hair (3 studies, 132 participants, SMD: -0.40; 95%CI:-0.46, -0.35, P < 0.0001, I 2 = 0%), were found to be significantly lower in women in LGD vs control diet groups. Moreover, infertility (3 studies, 132 participants, SMD: 1.45; 95%CI: 0.30, 2.61, P = 0.01, I 2 = 79%) was significantly higher in women in LGD vs control diet groups. Conclusion The present meta-analysis has shown that LGD may play a significant role in reducing the risk and improving the clinical and biochemical features of PCOS. So far the evidences for choosing the best dietary modalities for PCOS are not strong to make a definite recommendation.
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Affiliation(s)
- Najmieh Saadati
- Fertility, Infertility, and Perinatology, Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Haidari
- Department of Nutrition Sciences, Nutrition and Metabolic Diseases Research Center, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Mojgan Barati
- Department of Nutrition Sciences, Nutrition and Metabolic Diseases Research Center, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Roshan Nikbakht
- Department of Nutrition Sciences, Nutrition and Metabolic Diseases Research Center, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Golshan Mirmomeni
- School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Hearing Research Center, Department of Audiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Health Research Institute, Thalassemia and Hemoglobinopathies Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Hearing Research Center, Department of Audiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Iervolino M, Lepore E, Forte G, Laganà AS, Buzzaccarini G, Unfer V. Natural Molecules in the Management of Polycystic Ovary Syndrome (PCOS): An Analytical Review. Nutrients 2021; 13:nu13051677. [PMID: 34063339 PMCID: PMC8156462 DOI: 10.3390/nu13051677] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/12/2021] [Accepted: 05/12/2021] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogenous disorder characterized by chronic ovulation dysfunction and hyperandrogenism. It is considered the most common endocrinological disorder, affecting up to 25% of women of reproductive age, and associated with long-term metabolic abnormalities predisposing to cardiovascular risk, such as insulin resistance (IR), dyslipidemia, endothelial dysfunction, and systemic inflammation. PCOS is also characterized by elevated serum levels of luteinizing hormone (LH), causing a condition of hyperandrogenism and a consequent altered ratio between LH and the follicle stimulating hormone (FSH). Over the years, several different approaches have been proposed to alleviate PCOS symptoms. Supplementation with natural molecules such as inositols, resveratrol, flavonoids and flavones, vitamin C, vitamin E and vitamin D, and omega-3 fatty acids may contribute to overcoming PCOS pathological features, including the presence of immature oocyte, IR, hyperandrogenism, oxidative stress and inflammation. This review provides a comprehensive overview of the current knowledge about the efficacy of natural molecule supplementation in the management of PCOS.
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Affiliation(s)
- Matteo Iervolino
- R&D Department, Lo.Li. Pharma Srl, 00156 Rome, Italy; (M.I.); (E.L.); (G.F.)
| | - Elisa Lepore
- R&D Department, Lo.Li. Pharma Srl, 00156 Rome, Italy; (M.I.); (E.L.); (G.F.)
| | - Gianpiero Forte
- R&D Department, Lo.Li. Pharma Srl, 00156 Rome, Italy; (M.I.); (E.L.); (G.F.)
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 2100 Varese, Italy;
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00156 Rome, Italy
| | - Giovanni Buzzaccarini
- Unit of Gynecology and Obstetrics, Department of Women and Children’s Health, University of Padua, 35128 Padua, Italy;
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00156 Rome, Italy
- Systems Biology Group Lab, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
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Frias-Toral E, Garcia-Velasquez E, de Los Angeles Carignano M, Rodriguez-Veintimilla D, Alvarado-Aguilera I, Bautista-Litardo N. Polycystic ovary syndrome and obesity: clinical aspects and nutritional management. Minerva Endocrinol (Torino) 2021; 47:215-241. [PMID: 33792235 DOI: 10.23736/s2724-6507.21.03349-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrine and metabolic disorder characterized by androgen excess, oligo-anovulatory infertility, polycystic ovaries in ultrasound examination, insulin resistance, and cardiometabolic disorders, with overweight/obesity and visceral adiposity. This review aims to provide an overview of the clinical characteristics and nutritional therapy of PCOS and obesity. METHODS The authors analyzed the updated and relevant publications found on Pubmed about clinical aspects and nutritional management of PCOS and obesity in studies done in animal and human models. DISCUSSION It is crucial an early detection and intervention in PCOS patients to avoid the more challenging control of the onset of more impaired-health conditions that this pathology causes. It is presented evidence that clearly shows the close interaction among oxidative stress, low-grade inflammation, and PCOS. It is also analyzed the relevance of treating metabolic and nutritional correlations of PCOS with a complete therapeutic strategy that includes individualized medication, diet, and healthy habits. CONCLUSIONS By an integral approach and treatment that includes not only medications for PCOS symptoms, supplementation of minerals and vitamins to control PCOS complications but an antiinflammatory diet, nutritional education, exercise individualized program, lifestyle changes, it is possible to improve insulin resistance, sustained weight loss, ovulation rates, among other goals for the management of this disease. Further studies are needed to clarify mechanisms, beneficial effects, and doses of supplements and precise medication to determine the best combination of diets and exercise programs according to these patients' specific requirements.
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Affiliation(s)
- Evelyn Frias-Toral
- Research Committee, SOLCA Guayaquil, Av. Pedro Menendez Gilbert, Guayaquil, Ecuador - .,Palliative Care Residency from Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador -
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14
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Heshmati J, Moini A, Sepidarkish M, Morvaridzadeh M, Salehi M, Palmowski A, Mojtahedi MF, Shidfar F. Effects of curcumin supplementation on blood glucose, insulin resistance and androgens in patients with polycystic ovary syndrome: A randomized double-blind placebo-controlled clinical trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 80:153395. [PMID: 33137599 DOI: 10.1016/j.phymed.2020.153395] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND Curcumin is a biologically active phytochemical ingredient found in turmeric. It has several pharmacologic effects that might benefit patients with polycystic ovary syndrome (PCOS). OBJECTIVE We hypothesized curcumin to be effective in improving blood sugar levels, insulin resistance and hyperandrogenism in individuals with PCOS. METHODS In a randomized double-blind placebo-controlled trial, individuals with PCOS were treated with curcumin (500 mg three times daily) or placebo for 12 weeks. Primary outcome measures were fasting plasma glucose (FPG), fasting insulin (FI), sex hormone levels, and hirsutism (Ferriman-Gallwey [mFG] score). Secondary outcomes included anthropometric measurements. RESULTS Of 72 randomized individuals, 67 completed the trial. The two groups were comparable at baseline. At the end of the study, FPG and Dehydroepiandrosterone levels had decreased significantly in the intervention group compared to control (difference of change (post-pre) between intervention and placebo groups: -4.11 mg/dL; 95% CI: -8.35, -0.35 mg/dL; p = 0.033 and -26.53 microg/dL; 95% CI: -47.99, -4.34 µg/dL; p = 0.035, respectively). We also observed a statistically non-significant increase (p = 0.082) in Estradiol levels in the intervention group compared to control. No serious adverse events were reported throughout the trial. CONCLUSIONS Curcumin might be a safe and useful supplement to ameliorate PCOS-associated hyperandrogenemia and hyperglycemia. However, longer trials investigating different dosages in longer durations are needed to underpin these findings.
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Affiliation(s)
- Javad Heshmati
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ashraf Moini
- Breast Disease Research Center(BDRC), Tehran University Of Medical Sciences, Tehran, Iran; Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mojgan Morvaridzadeh
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Salehi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Andriko Palmowski
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maryam Farid Mojtahedi
- Department of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Panjeshahin A, Salehi-Abargouei A, Anari AG, Mohammadi M, Hosseinzadeh M. Association between empirically derived dietary patterns and polycystic ovary syndrome: A case-control study. Nutrition 2020; 79-80:110987. [DOI: 10.1016/j.nut.2020.110987] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 08/01/2020] [Accepted: 08/20/2020] [Indexed: 02/06/2023]
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Pundir J, Charles D, Sabatini L, Hiam D, Jitpiriyaroj S, Teede H, Coomarasamy A, Moran L, Thangaratinam S. Overview of systematic reviews of non-pharmacological interventions in women with polycystic ovary syndrome. Hum Reprod Update 2020; 25:243-256. [PMID: 30608609 DOI: 10.1093/humupd/dmy045] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/21/2018] [Accepted: 11/28/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a major contributor to subfertility, diabetes and cardiovascular disease in women. The role of non-pharmacological interventions to prevent these outcomes has been reported in many systematic reviews, but robust conclusions have not been made due to variations in the scope, quality and findings of these reviews. OBJECTIVE AND RATIONALE Our aim was to provide an overview of existing evidence on the effects of non-pharmacological interventions in women with PCOS on fertility and non-fertility outcomes by a review of existing systematic reviews. SEARCH METHODS We reviewed systematic reviews of randomized trials that have evaluated the effects of non-pharmacological interventions, such as lifestyle interventions, nutritional supplements or alternative medicine therapies in women with PCOS on fertility, endocrine, glycaemic and weight-related outcomes. We assessed the quality of systematic reviews with the AMSTAR tool, and reported the outcomes with regard to: fertility (live birth, clinical pregnancy, ovulation and menstrual cycle regularization); endocrine outcomes (Ferriman-Gallwey score, free androgen index, free testosterone and total testosterone levels); and glycaemic (fasting blood insulin, fasting blood glucose, homoeostatic model assessment) and weight-related (BMI) outcomes. We assessed the strength of evidence for significant outcomes as per the grading of recommendations assessment, development and evaluation (GRADE) system. OUTCOMES We found twelve eligible systematic reviews which included between three (143 women) and 27 randomized trials (2093 women). Four reviews assessed the effects of lifestyle interventions (diet, physical activity and/or behavioural interventions); four evaluated nutritional supplements (one each on n-acetylcysteine, omega-3 fatty acids, inositol and vitamin D); and four studied alternative medical therapies (Chinese herbal medicine and acupuncture). All of the included reviews were of high quality and scored between 8 and 11 with the AMSTAR tool (with a maximum score of 11).Randomized evidence is lacking for live birth rate. N-acetylcysteine, inositol and the addition of alternative medicine to ovulation induction agents show preliminary potential to improve fertility (odds ratios (OR) for clinical pregnancy rate range from 1.99 to 4.83). Lifestyle interventions show benefits in improving hirsutism (mean difference (MD): -1.01 to -1.19). Lifestyle interventions (MD: -1.10 to -2.02), inositol (MD: -2.1) and acupuncture (MD: -1.90 to -3.43) all show some evidence of improvement in glycaemic outcomes and there is some evidence of reduced BMI with lifestyle interventions (MD: -0.15 to -1.12). All of these outcomes scored either low or very low quality of evidence on the GRADE score. WIDER IMPLICATIONS Lifestyle interventions in women with PCOS appear to improve glycaemic results, androgenic symptoms and anthropometric outcomes. The role of inositol and N-acetylcysteine in women with PCOS needs further evaluation. Large primary trials on all interventions are needed for an agreed set of core outcomes.
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Affiliation(s)
- Jyotsna Pundir
- Centre for Reproductive Medicine, St. Bartholomew's Hospital, London, UK
| | - David Charles
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Luca Sabatini
- Centre for Reproductive Medicine, St. Bartholomew's Hospital, London, UK
| | - Danielle Hiam
- Institute of Health and Sport, Victoria University, Footscray, Australia
| | - Sonia Jitpiriyaroj
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Arri Coomarasamy
- Tommy's National Centre for Miscarriage Research, University of Birmingham, Birmingham, UK
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Shakila Thangaratinam
- Women's Health Research Unit, The Blizard Institute, Queen Mary University of London, London, UK
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Trent M, Gordon CM. Diagnosis and Management of Polycystic Ovary Syndrome in Adolescents. Pediatrics 2020; 145:S210-S218. [PMID: 32358213 DOI: 10.1542/peds.2019-2056j] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2020] [Indexed: 11/24/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common female reproductive disorder that often manifests during adolescence and is associated with disruptions in health-related quality of life. Prompt evaluation and clinical support after diagnosis may prevent associated complications and optimize overall health management. This article incorporates the most recent evidence and consensus guidelines to provide an updated review of the pathogenesis, clinical presentation, diagnostic evaluation, and management strategies for adolescents with this complex condition. We will review the recent international guidelines on PCOS; because the diagnosis of PCOS remains controversial, management of this condition is inconsistent. In 2019, PCOS remains a common, yet neglected, condition, in part, because of the lack of agreement around both diagnosis and management.
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Affiliation(s)
- Maria Trent
- Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland; and
| | - Catherine M Gordon
- Division of Adolescent/Young Adult Medicine, Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts
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Delarue J. Are marine n-3 fatty acids protective towards insulin resistance? From cell to human. Proc Nutr Soc 2020; 79:1-11. [PMID: 32138806 DOI: 10.1017/s0029665120000087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Marine n-3 fatty acids improve most of the biochemical alterations associated with insulin resistance (IR). Experimental models of dietary-induced IR in rodents have shown their ability (often at a very high dose) to prevent IR, but with sometimes a tissue specific effect. However, in a high sucrose diet-induced IR rat model, they are unable to reverse IR once installed; in other rodent models (dexamethasone, Zucker rats), they are inefficacious perhaps because of the severity of IR. The very low incidence of type-2 diabetes (T2D) in Inuits in the 1960s, which largely increased over the following decades in parallel to the replacement of their traditional marine food for a western diet strongly suggests a protective effect of marine n-3 towards the risk of T2D; this was confirmed by reversal of its incidence in intervention studies reintroducing their traditional food. In healthy subjects and insulin-resistant non-diabetic patients, most trials and meta-analyses conclude to an insulin-sensitising effect and to a very probable preventive or alleviating effect towards IR. Concerning the risk of T2D, concordant data allow us to conclude the protective effect of marine n-3 in Asians while suspicion exists of an aggravation of risk in Westerners, but with the possibility that it could be explained by a high heterogeneity of studies performed in this population. Some longitudinal cohorts in US/European people showed no association or a decreased risk. Further studies using more homogeneous doses, sources of n-3 and assessment of insulin sensitivity methods are required to better delineate their effects in Westerners.
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Affiliation(s)
- Jacques Delarue
- Department of Nutritional Sciences & Laboratory of Human Nutrition, University Hospital/Faculty of Medicine/University of Brest, Brittany, France
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Haidari F, Banaei-Jahromi N, Zakerkish M, Ahmadi K. The effects of flaxseed supplementation on metabolic status in women with polycystic ovary syndrome: a randomized open-labeled controlled clinical trial. Nutr J 2020; 19:8. [PMID: 31980022 PMCID: PMC6982376 DOI: 10.1186/s12937-020-0524-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 01/16/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is known as the most common endocrine disorder of women in reproductive ages. With the increasing prevalence of PCOS in different countries, the use of herbal medicine as an alternative treatment is growing in these patients. This study aimed to evaluate the effects of flaxseed powder supplementation on metabolic biomarkers of patients with PCOS. METHODS This randomized open-labeled controlled clinical trial was conducted on 41 patients with PCOS. The participants were randomized to take either flaxseed powder (30 g/day) plus lifestyle modification or only lifestyle modification for 12 weeks. Anthropometric and biochemical evaluations were performed for all patients at the beginning and end of the study. RESULTS The flaxseed group showed a significant reduction in body weight, insulin concentration, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Triglycerides (TG), high-sensitivity C-Reactive Protein (hs-CRP), and leptin and an increase in Quantitative Insulin-Sensitivity Check Index (QUICKI), High Density Lipoprotein (HDL), and adiponectin compared to the baseline (p < 0.05). Flaxseed supplementation also led to a significant reduction in insulin concentration, HOMA-IR, TG, hs-CRP, Interleukin 6 (IL- 6), and leptin and an increase in QUICKI, HDL, and adiponectin compared to the control group (p < 0.05). No significant changes were observed in other parameters. CONCLUSIONS Flaxseed supplementation plus lifestyle modification was more effective compared to lifestyle modification alone in biochemical and anthropometric variables in patients with PCOS. TRIAL REGISTRATION The trial protocol was approved by the Ethics Board at Ahvaz Jundishapur University of Medical Sciences and was registered at Iranian Registry of Clinical Trials (code: IRCT20120704010181N11).
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Affiliation(s)
- Fatemeh Haidari
- Department of Nutrition, Nutrition and Metabolic Diseases Research Center, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Nasrin Banaei-Jahromi
- Department of Nutrition, Nutrition and Metabolic Diseases Research Center, Faculty of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran.
| | - Mehrnoosh Zakerkish
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kambiz Ahmadi
- Department of Statistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Salek M, Clark CCT, Taghizadeh M, Jafarnejad S. N-3 fatty acids as preventive and therapeutic agents in attenuating PCOS complications. EXCLI JOURNAL 2019; 18:558-575. [PMID: 31611740 PMCID: PMC6785778 DOI: 10.17179/excli2019-1534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/23/2019] [Indexed: 12/20/2022]
Abstract
To our knowledge, in spite of several trials exploring the beneficial effect of n-3 polyunsaturated fatty acids (PUFA) on polycystic ovary syndrome (PCOS), no comprehensive evidence has investigated the effects of n-3 PUFA consumption on PCOS complications. Therefore, our aim was to conduct a review to investigate the possible effect and related mechanisms. A comprehensive systematic search was conducted in Embase, MEDLINE/PubMed, Google Scholar, and SCOPUS, to identify studies investigating n-3 fatty acids as a preventative or therapeutic agent for the attenuation of PCOS complications. Subsequently, the impact of omega-3 on PCOS, omega-3 and inflammation, omega-3 and insulin resistance, omega-3 and adipokines, omega-3 and lipid metabolism, omega-3 and endothelial function and omega-3 and hormonal factors were discussed. There are multiple mechanisms by which n-3 PUFAs may exert their beneficial effects on PCOS, including anti-obesity, glycemic and hormonal hemostasis, anti-inflammatory, regulation of adipokine production and enhancement of endothelial function.N-3 PUFAs are a promising agent in relieving complications associated with PCOS. Although most of the studies in patients with PCOS reported an improvement in most complications after administration of omega-3 supplements, there is a distinct dearth of studies investigating the dietary intake of these types of fatty acids. Moreover, favorable effects regarding the improvement of dyslipidemia, regulation of adipokines, regulation of hormonal factors and enhancement of endothelial function are limited. Therefore, more trials are warranted to investigate palatable mechanisms for clarifying the metabolic and hormonal effects of these agents in PCOS.
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Affiliation(s)
- Mina Salek
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Cain C T Clark
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Sadegh Jafarnejad
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
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Hu S, Wang J, Yan X, Yang H, Li S, Jiang W, Liu Y. Egg oil from Portunus trituberculatus alleviates insulin resistance through activation of insulin signaling in mice. Appl Physiol Nutr Metab 2019; 44:1081-1088. [PMID: 30802144 DOI: 10.1139/apnm-2018-0718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
Marine bioactive lipids have been utilized to overcome insulin resistance. However, oil from swimming crab has never been studied. Here, we analyzed the constituents of egg oil from Portunus trituberculatus (Pt-egg oil) and investigated its protective effects against insulin resistance in mice on a high-fat diet. The results showed that Pt-egg oil contained 52.05% phospholipids, 8.61% free fatty acids (especially eicosapentaenoic acid and docosahexaenoic acid), 32.38% triglyceride, 4.79% total cholesterol, and ditissimus astaxanthin. Animal experiments showed that Pt-egg oil significantly mitigated insulin resistance and was associated with reductions in blood glucose, insulin, glucose tolerance, insulin tolerance, serum lipids, and hepatic glycogen. Pt-egg oil activated the phosphatidylinositol 3-hydroxy kinase (PI3K)/protein kinase B (Akt)/glucose transporter 4 pathway in skeletal muscle both at the transcriptional level and at the translational level. Pt-egg oil also promoted hepatic glycogen synthesis through activation of the PI3K/Akt/glycogen synthase kinase-3 beta pathway. These indicate that Pt-egg oil can be used as an alternative to marine bioactive lipids to improve insulin resistance.
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Affiliation(s)
- Shiwei Hu
- Innovation Application Institute, Zhejiang Ocean University, Zhoushan, Zhoushan, 316022, China
| | - Jingfeng Wang
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266003, China
| | - Xiaojun Yan
- Innovation Application Institute, Zhejiang Ocean University, Zhoushan, Zhoushan, 316022, China
| | - Huicheng Yang
- Zhejiang Marine Development Research Institute, Zhoushan 316021, China
| | - Shijie Li
- Innovation Application Institute, Zhejiang Ocean University, Zhoushan, Zhoushan, 316022, China
| | - Wei Jiang
- Innovation Application Institute, Zhejiang Ocean University, Zhoushan, Zhoushan, 316022, China
| | - Yu Liu
- Innovation Application Institute, Zhejiang Ocean University, Zhoushan, Zhoushan, 316022, China
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Effect of Foeniculum vulgare essence on symptoms of polycystic ovarian syndrome (PCOS): A randomized double-blind, placebo-controlled trial. J Herb Med 2019. [DOI: 10.1016/j.hermed.2019.100277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Li T, Ruan DG, Lin ZM, Liu TY, Wang K, Xu XY, Duan R. Endurance Training Counteracts the High-Fat Diet-Induced Profiling Changes of ω-3 Polyunsaturated Fatty Acids in Skeletal Muscle of Middle-Aged Rats. Front Physiol 2019; 10:971. [PMID: 31417429 PMCID: PMC6683664 DOI: 10.3389/fphys.2019.00971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/11/2019] [Indexed: 12/20/2022] Open
Abstract
Purpose To investigate the effects of endurance training on the content of ω-3 polyunsaturated fatty acids (PUFAs) and their distribution among lipid classes in skeletal muscle in middle aged, high-fat diet fed rats. Method Thirty 10-month old male Sprague Dawley (SD) rats were assigned to four groups. Two groups of rats remained sedentary and were fed chow diet (C group), or high-fat diet (H group), respectively. The other two groups of rats were subjected to endurance training while maintaining their chow diet (EC group), or high-fat diet (EH group). After 16 weeks endurance training and/or diet intervention, the content of ω-3 PUFAs and ω-3 PUFA-containing lipids in rat soleus muscle were analyzed by lipidomics. Results Rats fed a high-fat diet exhibited decreased overall amount of ω-3 PUFAs in soleus muscle, while endurance training preserved the total amount of ω-3 PUFAs. Both the endurance training and high-fat diet alone changed the profiles of ω-3 PUFAs in different lipid classes. Specifically, the amount of triacylglycerol (TG), lysophosphatidylcholine (LPC), phosphatidylcholine (PC), and phosphatidylglycerol (PG) containing ω-3 PUFAs in soleus muscle was increased by endurance training, but the amount of lysophosphatidylenthanol (LPE), lysophosphatidylinositol (LPI), lysophosphatidylserine (LPS), cardiolipin (CL), phosphatidic acid (PA), and phosphatidylinositol (PI) was decreased. The high-fat diet induced a decrease of ω-3 PUFAs in TG, LPE, LPS, CL, platelet activating factor (PAF), PC, phosphatidylethanolamine (PE), and phosphatidylserine (PS), and an increase in LPC, LPI, PA, and PG. In addition, the effects of the endurance training on ω-3 PUFAs in skeletal muscle was also evident in high-fat diets fed rats, which counteracts the profiling changes caused by high-fat diet feeding. Conclusion The beneficial effects of endurance training on skeletal muscle may be achieved to some extent through recovering the content of ω-3 PUFAs that has been decreased by high-fat diet feeding.
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Affiliation(s)
- Ting Li
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
| | - Ding-Guo Ruan
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
| | - Zhen-Mao Lin
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
| | - Tai-Yang Liu
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
| | - Kou Wang
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
| | - Xiao-Yang Xu
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
| | - Rui Duan
- Laboratory of Exercise Biochemistry and Nutrition, School of Sports Science, South China Normal University, Guangzhou, China
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Hager M, Nouri K, Imhof M, Egarter C, Ott J. The impact of a standardized micronutrient supplementation on PCOS-typical parameters: a randomized controlled trial. Arch Gynecol Obstet 2019; 300:455-460. [PMID: 31101977 PMCID: PMC6592962 DOI: 10.1007/s00404-019-05194-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/10/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate whether a micronutrient supplementation preparation that includes a high amount of omega-3 unsaturated acids, other anti-oxidants and co-enzyme Q10 would have an impact on specific serum parameters in women with polycystic ovary syndrome (PCOS). METHODS The study was designed as a monocentral, randomized, controlled, double-blinded trial, from June 2017 to March 2018 (Clinical Trials ID: NCT03306745). Sixty women with PCOS were assigned to either the "multinutrient supplementation group" (one unlabeled soft capsule containing omega-3 fatty acids and one unlabeled tablet containing folic acid, selenium, vitamin E, catechin, glycyrrhizin, and co-enzyme Q10, for 3 months) or the "control group" (two unlabeled soft capsules containing 200 μg folic acid each, for 3 months). The main outcome parameters were anti-Mullerian hormone (AMH), total testosterone, and androstenedione. In addition, the focus was on luteinizing hormone (LH), follicle-stimulating hormone (FSH), the LH:FSH ratio, sexual hormone-binding globulin (SHBG), and estradiol. RESULTS In the multinutrient supplementation group, the LH:FSH ratio (2.5 ± 1.1 versus 1.9 ± 0.5, p = 0.001), testosterone (0.50 ± 0.19 versus 0.43 ± 0.15, p = 0.001), and AMH (8.2 ± 4.2 versus 7.3 ± 3.6, p < 0.001) declined significantly, whereas the other parameters, namely estradiol, LH, FSH, androstenedione, and SHBG remained stable. CONCLUSION A micronutrient supplementation that includes omega-3 fatty acids, folic acid, selenium, vitamin E, catechin, glycyrrhizin, and co-enzyme Q10, given for a minimum of 3 months, is beneficial for women with PCOS in terms of PCOS-specific parameters (LH:FSH ratio, serum testosterone and serum AMH).
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Affiliation(s)
- Marlene Hager
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Kazem Nouri
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Martin Imhof
- Department of Obstetrics and Gynecology, Landesklinikum Korneuburg, Korneuburg, Lower Austria, Austria
| | - Christian Egarter
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Johannes Ott
- Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Shah R. Emerging Topics in Cardiometabolic and Psychologic Sequelae, Pathogenesis, and Treatment of Polycystic Ovarian Syndrome: A Review. CHILDREN-BASEL 2019; 6:children6080089. [PMID: 31370287 PMCID: PMC6721393 DOI: 10.3390/children6080089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 02/06/2023]
Abstract
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder, affecting 6–10% of reproductive age women and influences the reproductive, metabolic, dermatologic, and psychiatric health of affected girls and women. Despite its prevalence, the pathogenesis of the disease is largely unknown, and treatment options are limited. Thus, PCOS has been a ripe area for research in recent years, and novel etiologic pathways, diagnostic parameters, and treatment options are being explored. This review focuses on recent data suggesting pathogenic and therapeutic considerations, as well as the psychiatric and metabolic sequelae of PCOS.
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Affiliation(s)
- Rachana Shah
- Division of Pediatric Endocrinology, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, 3615 Civic Center Blvd, 802F Philadelphia, PA 19104, USA.
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Liao D, Zhong C, Li C, Mo L, Liu Y. Meta-analysis of the effects of probiotic supplementation on glycemia, lipidic profiles, weight loss and C-reactive protein in women with polycystic ovarian syndrome. Minerva Med 2018; 109:479-487. [PMID: 30256077 DOI: 10.23736/s0026-4806.18.05728-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Several studies have been designed to investigate the beneficial effects of probiotic supplementation on metabolic parameters and inflammation status in women with polycystic ovarian syndrome (PCOS), but results have been inconsistent. Herein, we perform a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of probiotic supplementation on glycemia control, lipidic profiles, weight loss and C-reactive protein (CRP) in women with PCOS. EVIDENCE ACQUISITION MELINE, EMBASE, and Cochrane Library were searched for RCTs that investigated the effects of probiotic in women with PCOS. Two investigators independently performed the screening, data extraction, and methodological quality assessment. Data were pooled as mean differences (MDs) with 95% confidence intervals (CIs). The statistical heterogeneity was assessed with the I2 test. Sensitivity analyses were performed by the leave-one-out approach. EVIDENCE SYNTHESIS From the literature search, 26 publications were screened and 6 RCTs involving 406 PCOS participants (aged 25-28.5 years) with follow-up period between 8-12 weeks were included. The pooled results showed that probiotic supplement significantly affected the levels of fasting blood insulin (FBI), quantitative insulin sensitivity check index (QUICKI), triglycerides (TG), and very low density lipoprotein-cholesterol (VLDL-C). However, no significant changes were found in other markers, including fasting plasma glucose, homeostatic model assessment-insulin resistance, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, body weight, CRP, and dehydroepiandrosterone sulfate levels. The pooled result was robust after the sensitivity analysis. CONCLUSIONS Our finding provides evidence that daily probiotic consumption has beneficial effects on decreasing FBI, TG, and VLDL-C, and increasing the QUICKI score in PCOS patients.
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Affiliation(s)
- Dan Liao
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Chunhua Zhong
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Cuifen Li
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Lifang Mo
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China
| | - Yanyan Liu
- Department of Gynecology and Obstetrics, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan, Guangdong, China -
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Yang K, Zeng L, Bao T, Ge J. Effectiveness of Omega-3 fatty acid for polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrinol 2018; 16:27. [PMID: 29580250 PMCID: PMC5870911 DOI: 10.1186/s12958-018-0346-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/13/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess the effectiveness and safety of omega-3 fatty acid for patients with PCOS. METHODS In this meta-analysis, data from randomized controlled trials were obtained to assess the effects of omega-3 fatty acid versus placebo or western medicine in women with PCOS. The study's registration number is CRD42017065859. The primary outcomes included the change of homeostatic model assessment (HOMA) of insulin resistance, total cholesterol (TC), triglyceride (TG) and adiponectin. RESULT Nine trials involving 591 patients were included. Comparing with the control group, omega-3 fatty acid may improve HOMA index (WMD -0.80; 95% CI -0.89, - 0.71; P<0. 00001), decrease TC and TG level [TC: (WMD -9.43; 95% CI -11.90, - 6.95; P<0. 00001); TG: (WMD -29.21; 95% CI -48.08, - 10.34; P = 0. 002)], and increase adiponectin level (WMD 1.34; 95% CI 0.51, 2.17; P = 0. 002). CONCLUSION Based on current evidence, omega-3 fatty acid may be recommended for the treatment of PCOS with insulin resistance as well as high TC (especially LDL-C) and TG.
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Affiliation(s)
- Kailin Yang
- 0000 0004 1765 5169grid.488482.aHunan University of Chinese Medicine, Changsha, 410208 Hunan Province China
| | - Liuting Zeng
- 0000 0004 1765 5169grid.488482.aHunan University of Chinese Medicine, Changsha, 410208 Hunan Province China
| | - Tingting Bao
- 0000 0001 1431 9176grid.24695.3cBeijing University of Chinese Medicine, Beijing, 100029 Beijing China
| | - Jinwen Ge
- 0000 0004 1765 5169grid.488482.aHunan University of Chinese Medicine, Changsha, 410208 Hunan Province China
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Yanai H, Masui Y, Katsuyama H, Adachi H, Kawaguchi A, Hakoshima M, Waragai Y, Harigae T, Sako A. An Improvement of Cardiovascular Risk Factors by Omega-3 Polyunsaturated Fatty Acids. J Clin Med Res 2018; 10:281-289. [PMID: 29511415 PMCID: PMC5827911 DOI: 10.14740/jocmr3362w] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 02/07/2018] [Indexed: 12/27/2022] Open
Abstract
An epidemiological survey in the Northwest Greenland reported that the Greenlanders have a lower frequency of acute myocardial infarction and diabetes mellitus. The very low incidence of ischemic heart disease in the Greenlanders was explained by consumption of a diet rich in omega-3 polyunsaturated fatty acids (PUFAs). Possible anti-atherothrombotic effects of omega-3 PUFA include an improvement of lipid metabolism such as a reduction of triglyceride and an increase of high-density lipoprotein-cholesterol (HDL-C), and glucose metabolism, anti-platelet activity, anti-inflammatory effects, an improvement of endothelial function and stabilization of atherosclerotic plaque. The present study reviews an improvement of cardiovascular risk factors such as dyslipidemia and diabetes due to consumption of omega-3 PUFA. A sufficient number of studies suggest that omega-3 PUFA supplementation reduces serum triglyceride and increases HDL-cholesterol. The mechanisms for omega-3 PUFA-mediated improvements of lipid metabolism have been partially elucidated. The studies using experimental animals, part of trials in humans, have shown the beneficial effects of omega-3 PUFA on glucose metabolism and insulin sensitivity. The meta-analysis showed that omega-3 PUFA might prevent development of diabetes in part of population. Further studies should be performed to elucidate the association of omega-3 PUFA supplementation with diabetes, in the future.
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Affiliation(s)
- Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoshinori Masui
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hiroki Adachi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akiko Kawaguchi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Mariko Hakoshima
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoko Waragai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Tadanao Harigae
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
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Mirmasoumi G, Fazilati M, Foroozanfard F, Vahedpoor Z, Mahmoodi S, Taghizadeh M, Esfeh N, Mohseni M, Karbassizadeh H, Asemi Z. The Effects of Flaxseed Oil Omega-3 Fatty Acids Supplementation on Metabolic Status of Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Exp Clin Endocrinol Diabetes 2017; 126:222-228. [DOI: 10.1055/s-0043-119751] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Objective This study was conducted to evaluate the effects of flaxseed oil omega-3 fatty acids supplementation on metabolic status of patients with polycystic ovary syndrome (PCOS).
Methods This randomized double-blind, placebo-controlled trial was conducted on 60 women with PCOS according to the Rotterdam criteria aged 18–40 years old. Participants were randomly assigned into two groups to receive either 1,000 mg flaxseed oil omega-3 fatty acids (n=30) or placebo (n=30) twice a day for 12 weeks. Metabolic, endocrine, inflammatory factors were quantified at baseline and after the 12-week intervention.
Results After the 12-week intervention, compared to the placebo, flaxseed oil omega-3 supplementation significantly decreased insulin values (−2.6±7.7 vs.+1.3±3.9 µIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (−0.7±1.7 vs.+0.3±0.9, P=0.01), mF-G scores (−1.2±1.7 vs. -0.1±0.4, P=0.001), and increased quantitative insulin sensitivity check index (+0.01±0.02 vs. −0.01±0.02, P=0.01). In addition, supplementation with flaxseed oil omega-3 resulted in significant decreases in serum triglycerides (−5.1±20.9 vs.+9.7±26.1 mg/dL, P=0.01), VLDL-cholesterol (−1.0±4.2 vs.+1.9±5.2 mg/dL, P=0.01) and high-sensitivity C-reactive protein (hs-CRP) (−1.6±3.1 vs.+0.2±1.5 mg/L, P=0.004) compared to the placebo. We did not see any significant effect of flaxseed oil omega-3 supplementation on hormonal and other lipid profiles, and plasma nitric oxide levels.
Conclusions Overall, flaxseed oil omega-3 supplementation for 12 weeks in women with PCOS had beneficial effects on insulin metabolism, mF-G scores, serum triglycerides, VLDL-cholesterol and hs-CRP levels, but did not affect hormonal and other lipid profiles, and plasma nitric oxide levels.
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Affiliation(s)
- Golara Mirmasoumi
- Department of Biochemistry, Shahreza Branch, Islamic Azad University, Shahreza, Isfahan, I.R. Iran
| | - Mohammad Fazilati
- Department of Biochemistry, Shahreza Branch, Islamic Azad University, Shahreza, Isfahan, I.R. Iran
- Department of Biology, Pyamenoor University, Tehran, Iran
| | - Fatemeh Foroozanfard
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Vahedpoor
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Samaneh Mahmoodi
- Department of Gynecology and Obstetrics, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Nazanin Esfeh
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Maryam Mohseni
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | | | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
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Tang XL, Sun Z, Gong L. Chromium supplementation in women with polycystic ovary syndrome: Systematic review and meta-analysis. J Obstet Gynaecol Res 2017; 44:134-143. [PMID: 28929602 DOI: 10.1111/jog.13462] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/20/2017] [Accepted: 07/09/2017] [Indexed: 01/20/2023]
Abstract
AIM Increasing evidence has suggested that chromium supplementation may improve the clinical symptoms of polycystic ovary syndrome (PCOS), yet the results have been inconsistent. To derive a more precise estimation of the efficacy of chromium, a meta-analysis was performed. METHODS Studies published in PubMed, EMBASE and the Cochrane Library up to April 2017 were retrieved. Standardized mean differences (SMD) with 95%CI were calculated for net changes using random-effects or fixed-effects models. RESULTS A total of six randomized clinical trials (RCT) with 351 PCOS women were ultimately collected in this meta-analysis. All included RCT were of moderate-high quality. On pooled analysis, insulin resistance was significantly decreased (SMD, -0.84; 95%CI: -1.30 to -0.38; P = 0.0004), while the total testosterone (SMD, 0.36; 95%CI: 0.07-0.65; P = 0.02) and free testosterone (SMD, 0.80; 95%CI: 0.48-1.12; P < 0.00001) were markedly increased in chromium-treated PCOS patients compared with control groups. No significant difference was found in other indexes of insulin metabolism (body mass index, fasting insulin, fasting blood sugar and quantitative insulin sensitivity check index), hormone status (luteinizing hormone, follicle-stimulating hormone and prolactin) and lipid profiles (cholesterol and triglycerides) between the two groups. CONCLUSION Supplementation with chromium may not have significant benefits for women with PCOS. More RCT with low heterogeneity, however, are required to corroborate the present findings.
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Affiliation(s)
- Xiao-Lei Tang
- Taishan Medical College, Taian, Shandong Province, China
| | - Zheng Sun
- Taishan Medical College, Taian, Shandong Province, China
| | - Lei Gong
- Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, China
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Khani B, Mardanian F, Fesharaki SJ. Omega-3 supplementation effects on polycystic ovary syndrome symptoms and metabolic syndrome. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:64. [PMID: 28616051 PMCID: PMC5461594 DOI: 10.4103/jrms.jrms_644_16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/09/2016] [Accepted: 02/25/2017] [Indexed: 12/29/2022]
Abstract
Background: Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder with unknown etiology and with different complications. The aim of this study was to evaluate the effect of omega-3 supplementation on PCOS symptoms and metabolic syndrome. Materials and Methods: This double-blind clinical trial was performed in 2015 in Alzahra and Shahid Beheshti Hospitals, Isfahan, Iran, on 88 patients with PCOS. Intervention group took omega-3 supplements with dose of 2 g/day for 6 months (two capsules), but control group received two olive oil capsules. Finally, ultrasound and laboratory findings and the recovery rate of menstrual disorders in both groups were compared. Results: After 6 months’ intervention, waist circumference (WC) was significantly lower in omega-3 as compared to control (81.18 ± 2.87 vs. 84.22 ± 2.61 cm, respectively, P < 0.0001). High-density lipoprotein was increased (47.2 ± 1.37 vs. 41.56 ± 1.34 mg/dl, respectively, P < 0.0001) while low-density lipoprotein (107.79 ± 1.68 vs. 117.4 ± 1.57 mg/dl, respectively), triglyceride (116.02 ± 3.13 vs. 125.06 ± 2.91 mg/dl, respectively), and cholesterol (180.34 ± 6.34 vs. 189.56 ± 5.93 mg/dl, respectively) in omega-3 were significantly lower than control (P < 0.0001). The interval between periods in omega-3 was significantly shorter than control (29.83 ± 4.68 vs. 47.11 ± 8.72 days, respectively, P < 0.001). Conclusion: Omega-3 decrease lipid profiles, WC, and interval between periods while weight, hip circumference, fasting blood sugar, number of ovarian follicle, size of ovary, bleeding volume, menstrual bleeding, and hirsutism score did not change by administration of omega-3.
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Affiliation(s)
- Behnaz Khani
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farahnaz Mardanian
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sajadeh Jafari Fesharaki
- Department of Obstetrics and Gynecology, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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