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J Clin Endocrinol Metab. 2011 Nov;96(11):3533-40. doi: 10.1210/jc.2011-1609. Epub 2011 Aug 31.

Effect of lifestyle intervention on features of polycystic ovarian syndrome, metabolic syndrome, and intima-media thickness in obese adolescent girls.

Author information

1
Department of Pediatric Endocrinology, Diabetes, and Nutrition Medicine, Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Dr. F. Steiner Strasse 5, D-45711 Datteln, Germany.

Abstract

CONTEXT:

Polycystic ovarian syndrome (PCOS) is associated with cardiovascular risk factors (CRF). Lifestyle intervention is regarded as therapy of choice even if studies in adolescent girls with PCOS are scarce.

OBJECTIVE:

Our objective was to analyze the impact of lifestyle intervention on menses irregularities, hyperandrogenemia, CRF, and intima-media thickness (IMT) in adolescent girls with PCOS.

PATIENTS:

Patients included 59 obese girls with PCOS aged 12-18 yr.

INTERVENTION:

Intervention was a 1-yr lifestyle intervention based on nutrition education, exercise training, and behavior therapy.

MAIN OUTCOME MEASURES:

Menses cycles, IMT, waist circumference, blood pressure, fasting lipids, insulin, glucose, testosterone, dehydroepiandrosterone sulfate, androstenedione, and SHBG were evaluated.

RESULTS:

In contrast to the 33 girls without weight loss, the 26 girls reducing their body mass index during the lifestyle intervention (by a mean of -3.9 kg/m(2)) improved most CRF and decreased their IMT (by a mean of -0.01 cm). Testosterone concentrations decreased (by a mean of -0.3 nmol/liter) and SHBG concentrations increased (by a mean of +8 ng/ml) significantly in girls with weight loss in contrast to girls with increasing weight. The prevalence of amenorrhea (-42%) and oligoamenorrhea (-19%) decreased in the girls with weight loss. The changes in insulin in the 1-yr follow-up were significantly correlated to changes in testosterone (r = 0.38; P = 0.002) and SHBG (r = -0.35; P = 0.048). A linear regression model with changes in IMT as dependent variable demonstrated a significant association with changes in blood pressure and weight status but not with changes in testosterone.

CONCLUSIONS:

Weight loss due to lifestyle intervention is effective to treat menses irregularities, normalize androgens, and improve CRF and IMT in obese adolescent girls with PCOS.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00435734.

Comment in

PMID:
21880803
DOI:
10.1210/jc.2011-1609
[Indexed for MEDLINE]

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