多囊卵巢综合征(PCOS)发生在8%-13%的育龄女性中,并与生殖相关,新陈代谢,和心理功能障碍。超重和肥胖是普遍存在的,并加剧了PCOS的特征。这篇综述的目的是评估研究影响能量稳态的生理因素的证据范围,这可能会影响体重增加,减肥,在PCOS中保持体重,并确定研究差距和对未来研究的建议。使用MEDLINE进行文献检索,EMBASE,PsycInfo,AMED,CINAHL,和Cochrane中央控制试验登记册进行到2022年6月22日。摘要,非英语文章,和评论被排除在外。共包括n=78(n=55能量摄入和n=23能量消耗)主要研究论文。具有多个感兴趣结果的论文被视为单独的研究。能量摄入研究(n=89)侧重于评估食物,营养,或补充刺激,并分组为胃肠食欲激素的结果(n=43),脂肪因子(n=34),主观食欲(n=9),脑功能成像(n=3),和神经肽(n=0)。能量消耗研究(n=29)分为总能量消耗(n=1),静息能量消耗(n=15),膳食诱导的产热(n=3),养分氧化(n=5),和代谢灵活性(n=5)。在能量摄入和支出文件中,60%的研究比较了PCOS女性与对照组的结果反应。结果不一致,与对照组相比,57%的人报告PCOS没有差异,43%报告反应改变,包括食欲荷尔蒙反应减弱,代谢缺乏灵活性,减少能源消耗。作者发现存在不一致,但初步的,可能改变的生理因素的证据,这可能会影响能量平衡和体重管理。需要进一步的工作来解决已确定的临床和研究差距,以支持PCOS妇女和卫生专业人员为PCOS妇女提供信息并实现现实的体重管理目标。系统审查注册:该协议于2021年2月16日在开放科学框架中进行了前瞻性注册(https://osf.io/9jnsm)。
Polycystic ovary syndrome (PCOS) occurs in 8%-13% of reproductive-aged women and is associated with reproductive, metabolic, and psychological dysfunction. Overweight and obesity are prevalent and exacerbate the features of PCOS. The aim of this
review is to evaluate the extent of evidence examining the physiological factors affecting energy homeostasis, which may impact weight gain, weight loss, and weight maintenance in PCOS, and identify research gaps and recommendations for future research. Literature searches using MEDLINE, EMBASE, PsycInfo, AMED, CINAHL, and Cochrane Central Register of Controlled Trials were conducted up to June 22, 2022. Abstracts, non-English-language articles, and reviews were excluded. A total of n = 78 (n = 55 energy intake and n = 23 energy expenditure) primary research papers were included. Papers with multiple outcomes of interest were counted as separate studies. Energy-intake studies (n = 89) focussed on assessing food, nutrient, or supplements stimuli and were grouped into the outcomes of gastrointestinal appetite hormones (n = 43), adipokines (n = 34), subjective appetite (n = 9), functional brain imaging (n = 3), and neuropeptides (n = 0). Energy-expenditure studies (n = 29) were grouped into total energy expenditure (n = 1), resting energy expenditure (n = 15), meal-induced thermogenesis (n = 3), nutrient oxidation (n = 5), and metabolic flexibility (n = 5). Across both energy-intake and -expenditure papers, 60% of the studies compared outcome responses in women with PCOS with a control group. Results were inconsistent, with 57% reporting no differences and 43% reporting altered responses in PCOS compared with controls, including blunted appetite hormone responses, metabolic inflexibility, and reduced energy expenditure. The authors identified that there is inconsistent, yet preliminary, evidence of possible altered physiological factors, which may impact energy balance and weight management. Further work is needed to act on the identified clinical and research gaps to support women with PCOS and health professionals in informing and achieving realistic weight-management goals for women with PCOS. Systematic
Review Registration: The protocol was prospectively registered on the Open Science Framework on February 16, 2021 (https://osf.io/9jnsm).