Lifestyle Intervention Improves Cardiometabolic Risk Factors in Women With PCOS

To reduce cardiometabolic risk, a short-term lifestyle intervention can be effective in improving weight, insulin resistance, and dyslipidemia in overweight and obese women with polycystic ovary syndrome (PCOS), according to study results published in Metabolic Syndrome and Related Disorders.

Researchers conducted a systematic search from April 2013 to December 2016 of databases, using relevant terms; studies were included if they evaluated the effect of lifestyle interventions on a range of health outcomes in women with overweight/obesity and PCOS, regardless of pregnancy status. Lifestyle intervention was defined as dietary intervention alone, a combination of diet and physical activity, or a behavioral intervention to modify either healthy eating alone or a combination of healthy eating and physical activity.

Outcomes included change in weight, insulin resistance, and lipid profile, including levels of total cholesterol, triglycerides, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). A total of 15 articles were identified in the systematic review, and 9 were included in the meta-analysis. The studies provided data on 290 women with PCOS; patient ages ranged from 18 to 40 years, and body mass indexes from 25 to 55 kg/m².

Overall, lifestyle intervention including both dietary and combination interventions did not have significant effects on weight in overweight and obese women with PCOS. After excluding trials that used metformin in the comparison group, lifestyle intervention vs comparator resulted in significant weight loss.

Lifestyle intervention compared with comparator groups resulted in significant improvement in insulin resistance and LDL level. After excluding trials that used metformin in the comparison group, both insulin resistance and LDL improved further. A downward but insignificant trend was found for total cholesterol, triglycerides, and HDL in the lifestyle intervention groups.

Of note, there was significant variability in the comparator groups of the included studies. The researchers chose studies that had comparison groups that underwent any type of physical activity change, followed a dietary intervention that differed from one received by the lifestyle intervention group, followed usual diet, or received antiobesity or PCOS medications. This likely contributed to the high overall heterogeneity between studies, which was stated as a limitation by the researchers.

“Our analyses reveal that short-term [lifestyle intervention] (both dietary and combination) results in beneficial effect on weight[,] insulin resistance[,] and lipid control,” the investigators concluded. “In addition, [lifestyle intervention] was not significantly different than Metformin in terms of its effect on weight change and insulin resistance and more effective than Metformin in reducing LDL.”

Reference

Khatlani K, Njike V, Costales VC. Effect of lifestyle intervention on cardiometabolic risk factors in overweight and obese women with polycystic ovary syndrome: a systematic review and meta-analysis. Metab Syndr Relat Disord. 2019;17(10):473-485.