背景:目前,解决多囊卵巢综合征(PCOS)的主要策略包括改变生活方式,专注于减肥。这项荟萃分析的目的是评估通过饮食干预减肥对PCOS女性炎症状态和高雄激素血症的影响。方法:进行了全面的搜索,以确定随机对照试验(RCT)和队列研究,评估饮食诱导的体重减轻对循环炎症标志物(CRP,IL-6,IL-1β,TNF-α),雄激素(睾酮,雄烯二酮),SHBG,和促黄体激素(LH)在PCOS妇女。使用CochraneCollaboration的RCT工具和纽卡斯尔-渥太华量表进行队列研究,对纳入研究的质量和偏倚风险进行评估。将数据输入到RevMan软件v5.9中,用于计算循环炎症标志物的标准平均差(SMD)和95%置信区间(95CI)。雄激素,和LH在基线和后体重减轻值之间。结果:11项研究(n=323)符合系统评价,其中9例(n=286)纳入荟萃分析。数据的汇总分析显示,循环CRP的统计学显着降低(SMD0.39,95CI0.22,0.56;9项研究,n=286),IL-6(SMD0.37,95%Cl,0.12、0.61;3项研究,n=140),TNF-α(SMD0.30,95%Cl,0.07,0.53;4项研究,n=162),雄烯二酮(SMD0.36,95%Cl,0.13,0.60;4项研究,n=147)和LH(SMD0.30,95%Cl,0.09,0.51;5项研究,与PCOS女性的基线水平相比,体重减轻后n=197)。对五项研究(n=173)的荟萃分析显示,与基线水平相比,体重减轻后循环SHBG的统计学显着增加(SMD-0.43,95%Cl,-0.65,-0.21)。结论:这些发现表明,饮食干预导致的体重减轻似乎可以改善PCOS相关的慢性炎症和高雄激素血症。炎症改善与雄激素过多症之间可能的因果关系尚待确定。
Background: Currently, the primary strategy for addressing polycystic ovarian syndrome (PCOS) involves lifestyle modifications, with a focus on weight loss. The purpose of this meta-analysis was to assess the impact of weight loss through dietary interventions on inflammatory status and
hyperandrogenism in PCOS women. Methods: A comprehensive search was conducted to identify randomised controlled trials (RCTs) and cohort studies assessing the impact of diet-induced weight loss on circulating inflammatory markers (CRP, IL-6, IL-1β, TNF-α), androgens (testosterone, androstenedione), SHBG, and luteinising hormone (LH) in PCOS women. The quality and risk of bias of the included studies were assessed using the Cochrane Collaboration\'s tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. Data were entered into RevMan software v5.9 for the calculation of standard mean difference (SMD) and the 95% confidence interval (95%CI) of circulating inflammatory markers, androgens, and LH between baseline and post-weight loss values. Results: Eleven studies (n = 323) were eligible for the systematic
review, of which nine (n = 286) were included in the meta-analysis. Pooled analysis of data revealed a statistically significant decrease in circulating CRP (SMD 0.39, 95%CI 0.22, 0.56; 9 studies, n = 286), IL-6 (SMD 0.37, 95%Cl, 0.12, 0.61; 3 Studies, n = 140), TNF-α (SMD 0.30, 95%Cl, 0.07, 0.53; 4 Studies, n = 162), androstenedione (SMD 0.36, 95%Cl, 0.13, 0.60; 4 studies, n = 147) and LH (SMD 0.30, 95% Cl, 0.09, 0.51; 5 studies, n = 197) after weight loss compared to baseline levels among PCOS women. A meta-analysis of five studies (n = 173) showed a statistically significant increase in circulating SHBG after weight loss compared to baseline levels (SMD -0.43, 95%Cl, -0.65, -0.21). Conclusions: These findings suggest that weight loss induced by dietary interventions seems to improve PCOS-related chronic inflammation and
hyperandrogenism. The possible causative relationship between the improvement in inflammation and
hyperandrogenism remains to be determined.