Life-style intervention improves insulin resistance and ovulation in non-obese polycystic ovary syndrome patients based on the body composition analysis： a pilot study
10.3760/cma.j.cn101441-20190824-00372
- VernacularTitle:基于人体成分分析的生活方式干预在非肥胖型多囊卵巢综合征患者治疗作用的初步研究
- Author:
Chunlin SU
1
;
Yuzhu TANG
;
Jinfang LIN
Author Information
1. 复旦大学附属妇产科医院,上海 200011
- Publication Type:Journal Article
- Keywords:
Non-obese;
Polycystic ovary syndrome;
Body composition;
Insulin resistance;
Lifestyle intervention
- From:
Chinese Journal of Reproduction and Contraception
2020;40(9):716-722
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of life-style intervention on non-obese polycystic ovary syndrome (PCOS) patients.Methods:This was a prospective self-control study. Forty-three cases of non-obese [18.5 kg/m 2≤body mass index （BMI）<24.0 kg/m 2] PCOS patients were enrolled from May 2017 to March 2018 in Obstetrics and Gynecology Hospital of Fudan University. The individualized dietary and exercise lifestyle intervention was formulated based on the body composition. After 12 weeks, the correlations among body composition data, insulin resistance, reproductive hormone improvement， and ovulation recovery were analyzed. Results:Before intervention, 21 of 43 non-obese PCOS patients had normal body fat rate, 22 patients (51.2%) had higher body fat rate than normal, 17 patients had normal standard proportion of skeletal muscle weight (90%-110%), and 26 patients (60.5%) had lower standard proportion of skeletal muscle weight. Correlation analysis showed that fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR) were positively correlated with body fat rate ( r=0.442, P=0.003; r=0.395, P=0.010, respectively), and negatively correlated with the standard proportion of skeletal muscle weight ( r=-0.492, P=0.001; r=-0.536, P<0.001, respectively). After 12 weeks of lifestyle intervention, the body fat rate of non-obese PCOS patients decreased significantly ( P<0.01); standard proportion of skeletal muscle weight and skeletal muscle weight increased significantly ( P<0.001); HOMA-IR decreased significantly ( P<0.001); level of luteinizing hormone (LH) and decreased significantly （ P=0.005， P=0.004）; and 31 (70%) patients recovered with spontaneous ovulation ( P<0.001）. Correlation analysis showed that: 1) after treatment, standard proportion of skeletal muscle weight in non-obese PCOS patients was negatively correlated with HOMA-IR ( r=-0.512, P=0.001), and insulin-under-curve-area ( r=-0.421, P=0.007); 2)after treatment, the body fat rate was positively correlated with LH and total testerone ( r=0.455, P=0.003; r=0.377, P=0.015); after treatment, standard proportion of skeletal muscle weight was negatively correlated with total testerone ( r=-0.307, P=0.048); 3) after treatment, the LH was positively correlated with HOMA-IR ( r=0.39, P=0.011); 4) regression analysis showed that the recovery of spontaneous ovulation was closely related to the decrease of body weight, the increase of skeletal muscle standard proportion and the decrease of area under insulin curve ( P=0.016, P=0.004, P=0.003). Conclusion:Insulin resistance in non-obese PCOS patients is closely related to the increase of body fat rate and the decrease of the standard proportion of skeletal muscle weight. Individualized lifestyle interventions based on body composition results (focused on increasement of skeletal muscles) can increase insulin sensitivity, reduce LH and testosterone levels in non-obese PCOS patients, and promote the recovery of spontaneous ovulation.
