Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome

Amany Alsayed Salama, Ezzat Khamis Amine, Hesham Abd Elfattah Salem, Nesrin Kamal Abd El Fattah, Amany Alsayed Salama, Ezzat Khamis Amine, Hesham Abd Elfattah Salem, Nesrin Kamal Abd El Fattah

Abstract

Background: Polycystic ovary syndrome (PCOS) is of clinical and public health importance, affecting up to one in five women of reproductive age. It has significant and diverse clinical implications including reproductive, metabolic, and psychological features.

Aim: The study was to investigate the effect of anti-inflammatory dietary combo on metabolic, endocrine, inflammatory, and reproductive profiles in overweight and obese women with PCOS.

Materials and methods: A total of 100 nonpregnant, overweight, and obese adult females with PCOS according to the Rotterdam criteria, were screened during the year 2012, and 75 completed the trial. At baseline and study end, fasting blood samples were drawn to measure biological markers, body fat percent (BFP), and visceral fat area (VFA) were assessed by the InBody720 device and anthropometric measurements were done for all participants who were subjected to an anti-inflammatory hypocaloric diet and physical activity for 12 weeks.

Results: At study completion, we achieved moderate weight loss of (± 7%) and significant improvements in body composition, hormones and menstrual cyclicity, blood pressure, glucose homeostasis, dyslipidemia, C-reactive protein (CRP), and serum amyloid A (SAA) (surrogate measures of cardiovascular risk (CVR)). This was a clinically relevant weight loss that is associated with a reduced prevalence of type 2 diabetes mellitus (DM2) and metabolic syndrome (MS) in the general population and improved fertility outcomes in PCOS. We achieved 63% regain of menstrual cyclicity and 12% spontaneous pregnancy rate within 12 week.

Conclusions: We have explored an additional dietary treatment option with good prognostic metabolic and reproductive responses to weight loss that occur in overweight and obese PCOS.

Keywords: Acute-phase serum amyloid A; SAA; diet and inflammation; lifestyle modification; polycystic ovary syndrome; surrogates of cardiovascular risk.

References

    1. Teede H, Deeks A, Moran L. Polycystic ovary syndrome: A complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010;8:41.
    1. Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term health risks related to polycystic ovary syndrome (PCOS) Hum Reprod. 2004;19:41–7.
    1. Cho LW, Randeva HS, Atkin SL. Cardiometabolic aspects of polycystic ovarian syndrome. Vasc Health Risk Manag. 2007;3:55–63.
    1. Alexander CJ, Tangchitnob EP, Lepor NE. Polycystic ovary syndrome: A major unrecognized cardiovascular risk factor in women. Rev Obstet Gynecol. 2009;2:232–9.
    1. Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril. 2012;97:7–12.
    1. Wildman RP, Kaplan R, Manson JE, Rajkovic A, Connelly SA, Mackey RH, et al. Body size phenotypes and inflammation in the Women's Health Initiative Observational Study. Obesity (Silver Spring) 2011;19:1482–91.
    1. Tan BK, Adya R, Shan X, Aghilla M, Lehnert H, Keay SD, et al. The anti-atherogenic aspect of metformin treatment in insulin resistant women with the polycystic ovary syndrome: Role of the newly established pro-inflammatory adipokine Acute-Phase Serum Amyloid A; evidence of an adipose tissue-monocyte axis. Atherosclerosis. 2011;216:402–8.
    1. González F. Inflammation in polycystic ovary syndrome: Underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012;77:300–5.
    1. Esposito K, Giugliano D. Diet and inflammation: A link to metabolic and cardiovascular diseases. Eur Heart J. 2006;27:15–20.
    1. Sears B. Anti-inflammatory diets for obesity and diabetes. J Am Coll Nutr. 2009;28:482S–91S.
    1. Smith CIF, Wing RR. New directions in behavioral weight-loss programs. Diabetes Spectr. 2000;13:142–6.
    1. Landete JM. Plant and mammalian lignans: A review of source, intake, metabolism, intestinal bacteria and health. Food Res Int. 2012;46:410–24.
    1. Dodin S, Cunnane SC, Mâsse B, Lemay A, Jacques H, Asselin G, et al. Flaxseed on cardiovascular disease markers in healthy menopausal women: A randomized, double-blind, placebo-controlled trial. Nutrition. 2008;24:23–30.
    1. Nowak DA, Snyder DC, Brown AJ, Demark-Wahnefried W. The effect of flaxseed supplementation on hormonal levels associated with polycystic ovarian syndrome: A case study. Curr Top Nutraceutical Res. 2007;5:177–81.
    1. Moran LJ, Ko H, Misso M, Marsh K, Noakes M, Talbot M, et al. Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines. J Acad Nutr Diet. 2013;113:520–45.
    1. Sears B, Ricordi C. Anti-inflammatory nutrition as a pharmacological approach to treat obesity. J Obes. 2011;2011
    1. Jenkins DJ, Jones PJ, Lamarche B, Kendall CW, Faulkner D, Cermakova L, et al. Effect of a dietary portfolio of cholesterol-lowering foods given at 2 levels of intensity of dietary advice on serum lipids in hyperlipidemia. A randomized controlled trial. JAMA. 2011;306:831–9.
    1. Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92:83–92.
    1. Moran LJ, Noakes M, Clifton PM, Tomlinson L, Galletly C, Norman RJ. Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88:812–9.
    1. Hoeger KM, Kochman L, Wixom N, Craig K, Miller RK, Guzick DS. A randomized, 48-week, placebo-controlled trial of intensive lifestyle modification and/or metformin therapy in overweight women with polycystic ovary syndrome: A pilot study. Fertil Steril. 2004;82:421–9.
    1. Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, et al. Diabetes Prevention Program Research Group. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: The Diabetes Prevention Program randomized trial. Ann Intern Med. 2005;142:611–9.
    1. Talbott EO, Zborowski JV, Sutton-Tyrrell K, McHugh-Pemu KP, Guzick DS. Cardiovascular risk in women with polycystic ovary syndrome. Obstet Gynecol Clin North Am. 2001;28:111–33.
    1. Talbott EO, Guzick DS, Sutton-Tyrrell K, McHugh-Pemu KP, Zborowski JV, Remsberg KE, et al. Evidence for association between polycystic ovary syndrome and premature carotid atherosclerosis in middle-aged women. Arterioscler Thromb Vasc Biol. 2000;20:2414–21.
    1. Katcher HI, Kunselman AR, Dmitrovic R, Demers LM, Gnatuk CL, Kris-Etherton PM, et al. Comparison of hormonal and metabolic markers after a high-fat, Western meal versus a low-fat, high-fiber meal in women with polycystic ovary syndrome. Fertil Steril. 2009;91:1175–82.
    1. Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA, et al. Cooperative Multicenter Reproductive Medicine Network. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. N Engl J Med. 2007;356:551–66.
    1. Legro RS, Myers ER, Barnhart HX, Carson SA, Diamond MP, Carr BR, et al. Reproductive Medicine Network. The Pregnancy in Polycystic Ovary Syndrome study: Baseline characteristics of the randomized cohort including racial effects. Fertil Steril. 2006;86:914–33.
    1. Legro RS, Zaino RJ, Demers LM, Kunselman AR, Gnatuk CL, Williams NI, et al. The effects of metformin and rosiglitazone, alone and in combination, on the ovary and endometrium in polycystic ovary syndrome. Am J Obstet Gynecol. 2007;196:402.e1–11.
    1. Sutton-Tyrrell K, Wildman RP, Matthews KA, Chae C, Lasley BL, Brockwell S, et al. Sex hormone-binding globulin and the free androgen index are related to cardiovascular risk factors in multiethnic premenopausal and perimenopausal women enrolled in the Study of Women Across the Nation (SWAN) Circulation. 2005;111:1242–9.
    1. Gambineri A, Repaci A, Patton L, Grassi I, Pocognoli P, Cognigni GE, et al. Prominent role of low HDL-cholesterol in explaining the high prevalence of the metabolic syndrome in polycystic ovary syndrome. Nutr Metab Cardiovasc Dis. 2009;19:797–804.
    1. St-Onge MP, Zhang S, Darnell B, Allison DB. Baseline serum C-reactive protein is associated with lipid responses to low-fat and high-polyunsaturated fat diets. J Nutr. 2009;139:680–3.
    1. Ridker PM. JUPITER Study Group. Rosuvastatin in the primary prevention of cardiovascular disease among patients with low levels of low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: Rationale and design of the JUPITER trial. Circulation. 2003;108:2292–7.
    1. Ridker PM. The JUPITER trial. Results, controversies, and implications for prevention. Circ Cardiovasc Qual Outcomes. 2009;2:279–85.
    1. Hermusa L, Lefrandtb JD, Tioc RA, Breek JC, Zeebregts CJ. Carotid plaque formation and serum biomarkers. Atherosclerosis. 2010;213:21–9.
    1. Johnson BD, Kip KE, Marroquin OC, Ridker PM, Kelsey SF, Shaw LJ, et al. National Heart, Lung, and Blood Institute. Serum amyloid a as a predictor of coronary artery disease and cardiovascular outcome in women: The National Heart, Lung, and Blood Institute -Sponsored Women's Ischemia Syndrome Evaluation (WISE) Circulation. 2004;109:726–32.
    1. Zhao Y, He X, Shi X, Huang C, Liu J, Zhou S, et al. Association between serum amyloid A and obesity: A meta-analysis and systematic review. Inflamm Res. 2010;59:323–34.

Source: PubMed

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