PCOS Alternatives
May 9, 2015 Written by JP [Font too small?]PCOS or polycystic ovary syndrome is estimated to affect between 5 – 10% of girls and women of childbearing age. Signs of PCOS vary, but are typically characterized by several of the following symptoms: acne, abnormal menstrual cycles, hair loss and/or excessive body and facial hair growth, infertility, mood disorders, ovarian cysts, overweight and sleep apnea. The commonality among most of these symptoms is an overproduction of male sex hormones (androgens) emanating from the ovaries. Insulin resistance is another factor in PCOS. Therefore, the conventional treatment of this prevalent condition usually involves birth control pills to moderate sex hormone concentrations, diabetes medications to improve insulin sensitivity and fertility aids for women who have difficulty getting pregnant.
In addition to medications, many endocrinologists recommend a low calorie diet and exercise to their PCOS patients. The primary goal is weight loss. Even small reductions in body weight can make a difference in normalizing blood sugar and menstrual cycle. Still, this is often not enough to be considered as a standalone treatment. Fortunately, there are alternatives to medications which many conventional doctors rarely prescribe.
For starters, a bit more about the general recommendations made by allopathic physicians. Recent studies describe particular ways to get the most out of a PCOS diet and exercise regimen. Specifically, a low carbohydrate diet appears best for lowering body weight, fasting glucose, insulin and intermuscular fat. Also of note, a current publication in the journal Advanced Biomedical Research determined that avoiding dairy and starches enhanced fat oxidation aka “fat burning” in overweight women with PCOS. As far as exercise goes, it doesn’t have to be over-the-top. As little as 60 minutes of aerobic exercise, thrice-weekly for 12 weeks, is enough to significantly lower multiple risk factors associated with diabetes and heart disease. Those living with PCOS are much more likely to develop diabetes and heart disease than the population at large.
Mind-body therapies and nutritional supplementation should be considered when diet and exercise aren’t enough to mitigate PCOS symptoms. Two trials published in December 2014 and March 2015 report that electroacupuncture can be as or more effective than exercise and a hormone-based medication. Positive changes in body weight, hormonal profiles and ovarian volume were documented. Supplemental dosages of several minerals may, likewise, reduce health threats relating to PCOS, such as high triglycerides and insulin resistance. The minerals in question include calcium (with Vitamin D), chromium, selenium and zinc. In an 8 week calcium trial, a daily dose of 1,000 mg was administered in addition to 50,000 IUs of Vitamin D weekly. The trace mineral studies utilized 1,000 mcg/day of chromium picolinate, 200 mcg/day of selenium, and 50 mg/day of zinc. These dosages of chromium, selenium, Vitamin D and zinc are higher than what could reasonably be attained in a natural diet.
Lastly, if additional support is needed, herbal remedies may be a powerful adjunct to other modalities. An example can be found in the February 2015 issue of the Journal of Human Nutrition and Dietetics. In it, marjoram tea, a traditional “medicine” or a placebo tea was given to a group of patients with PCOS. Blood samples were taken at the beginning and end of the one month experiment. During the study period all of the participants drank the respective teas twice-daily. The test results revealed that those ingesting marjoram tea had lower levels of DHEA-S, an adrenal hormone, and fasting insulin. Both of these effects are consistent with a normalization of hormonal profiles. The authors of the trial expressed optimism based on their preliminary findings. They urge additional research to confirm their conclusions. You can be sure that I’ll keep an eye out for just such confirmations and other research that may help put an end to the suffering caused by PCOS.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
To learn more about the studies referenced in today’s column, please click on the following links:
Study 1 – A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and … (link)
Study 2 – Effects of Aerobic Exercise on Plasma Lipoproteins in Overweight and … (link)
Study 3 – Efficacy Comparison Between Electroacupuncture and Dyne-35 in … (link)
Study 4 – Serum Anti-Müllerian Hormone and Ovarian Morphology Assessed … (link)
Study 5 – Effect of Calcium and Vitamin D Supplementation on Menstrual Cycle … (link)
Study 6 – Calcium Plus Vitamin D Supplementation Affects Glucose Metabolism … (link)
Study 7 – Effect of Chromium Supplementation on Polycystic Ovary Syndrome in … (link)
Study 8 – Metabolic Response to Selenium Supplementation in Women with … (link)
Study 9 – Effects of Zinc Supplementation on Markers of Insulin Resistance & Lipid … (link)
Study 10 – Effect of Marjoram (Origanum Majorana) Tea on the Hormonal Profile … (link)
Low Starch/Low Dairy Diet Increases Fasting & Postprandial Fat Oxidation
Source: Appl Physiol Nutr Metab. 2014 Nov; 39(11): 1237–1244. (link)
Tags: Exercise, Insulin, PCOS
Posted in Alternative Therapies, Nutrition, Women's Health
May 9th, 2015 at 11:46 pm
Update 05/09/15:
http://onlinelibrary.wiley.com/doi/10.1111/jog.12311/abstract
J Obstet Gynaecol Res. 2014 Apr;40(4):1067-76.
Effects of raw red onion consumption on metabolic features in overweight or obese women with polycystic ovary syndrome: a randomized controlled clinical trial.
AIM: We aimed to evaluate the effects of raw red onion consumption on metabolic features in overweight and obese women with polycystic ovary syndrome.
MATERIAL AND METHODS: In this randomized controlled clinical trial, the patients (n=54) were randomly allocated to the intervention group as ‘high-onion’ (raw red onions: 2 × 40-50 g/day if overweight and 2 × 50-60 g/day if obese) or to the control group as ‘low-onion’ (raw red onions: 2 × 10-15 g/day) along with limited liliaceous vegetables for 8 weeks. Body mass index, dietary record, and metabolic parameters (fasting blood sugar, triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and lipoprotein (a)) were evaluated in the follicular phase of the menstrual cycle at baseline and after 8 weeks. Hormonal variables (progesterone, prolactin, and 17-OH progesterone) were also measured at baseline.
RESULTS: Onion significantly decreased the levels of total cholesterol within each group; however, these changes were stronger in the high-onion group (weighted mean differences [WMD]: -5.60 [95% confidence interval [CI]: -9.16, -2.03]; P=0.003) than in the low-onion group (WMD: -6.42 [95%CI: -11.97, -0.87]; P=0.025). Similarly, low-density lipoprotein cholesterol decreased significantly (WMD: -5.13 [95%CI: -9.46, -0.81); P=0.022) in the high-onion group, and (WMD: -2.90 [95%CI -5.57, -0.21]; P=0.035) in the low-onion group after treatment. The levels of fasting blood sugar, triglycerides, high-density lipoprotein cholesterol and lipoprotein (a) did not differ significantly after 8-week onion treatment. Adjustment for confounders did not make any significant changes in any of the parameters in post-treatment levels.
CONCLUSION: Raw red onion consumption appears to be effective as a cholesterol-lowering food agent in women with polycystic ovary syndrome. However, further investigation is warranted.
Be well!
JP
May 9th, 2015 at 11:57 pm
Update 05/09/15:
http://www.degruyter.com/view/j/jcim.ahead-of-print/jcim-2014-0021/jcim-2014-0021.xml;jsessionid=4034EBA30785734895EA27BB6C62AEAA
J Complement Integr Med. 2015 Feb 10.
The effect of ginger (Zingiber officinale) on glycemic markers in patients with type 2 diabetes.
Abstract Background: Ginger (Zingiber officinale) is one of the functional foods which contains biological compounds including gingerol, shogaol, paradol and zingerone. Ginger has been proposed to have anti-cancer, anti-thrombotic, anti-inflammatory, anti-arthritic, hypolipidemic and analgesic properties. Here, we report the effect of ginger supplementation on glycemic indices in Iranian patients with type 2 diabetes. Methods: A double-blind, placebo-controlled, randomized clinical trial was conducted on 20-60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting. Results: Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (-19.41 ± 18.83 vs 1.63 ± 4.28 mg/dL, p < 0.001), HbA1c percentage (-0.77 ± 0.88 vs 0.02 ± 0.16 %, p < 0.001), insulin (-1.46 ± 1.7 vs 0.09 ± 0.34 μIU/mL, p < 0.001), insulin resistance (-16.38 ± 19.2 vs 0.68 ± 2.7, p < 0.001), high-sensitive CRP (-2.78 ± 4.07 vs 0.2 ± 0.77 mg/L, p < 0.001), paraoxonase-1 (PON-1) (22.04 ± 24.53 vs 1.71 ± 2.72 U/L, p < 0.006), TAC (0.78 ± 0.71 vs -0.04 ± 0.29 µIU/mL, p < 0.01) and MDA (-0.85 ± 1.08 vs 0.06 ± 0.08 µmol/L, p < 0.001) were significantly different. Conclusions: This report shows that the 3 months supplementation of ginger improved glycemic indices, TAC and PON-1 activity in patients with type 2 diabetes. Be well! JP
May 11th, 2015 at 1:18 pm
Update 05/11/15:
http://www.ncbi.nlm.nih.gov/pubmed/25951635
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2015 Mar;35(3):304-9.
[Effect of electro-acupuncture on the spindle and oocytes quality in patients with PCOS].
OBJECTIVE: To observe the effect of electro-acupuncture (EA) treatment on the oocyte quality in polycystic ovarian syndrome (PCOS) patients undergoing in vitro fertilization-embryo transfer (IVF-ET).
METHODS: Totally 217 PCOS patients undergoing IVF-ET were assigned to two groups by random digit table, the EA group (119 cases) and the control group (98 cases). All patients received long program ovarian hyperstimulation with gonadotropin-releasing hormone agonist. Patients in the EA group received EA treatment in the process of controlled ovarian hyperstimulation till the oocyte retrieval day. The position relation of the spindle to the polocyte, the number of retrieved oocytes, the fertilization rate,the cleavage rate,the high quality embryo rate, the ovarian hyperstimulation syndrome (OHSS) incidence rate, the clinical pregnancy rate, the early abortion rate, the gonadotropins (Gn) dose and time, levels of estradiol (E2), progesterone (P), and luteinizing hormone (LH) on the day of human chorionic gonadotropin (HCG) were observed between the two groups.
RESULTS: The ratio of oocytes in which the meiotic spindle deviation angle was < 60 degrees to the all oocytes was obviously higher in the EA group than in the control group (P < 0.05). The oocytes in which the meiotic spindle deviation angle was < 60 degrees was positively related to level of E2 on the HCG day and the high quality embryo rate (r = 0.19,P < 0.01). Compared with the control group, the high quality embryo rate increased significantly (P < 0.05), the dose and days of Gn decreased significantly (P < 0.05) in the EA group. The clinical pregnancy rate was improved by 8.36%. CONCLUSIONS: The spindle was positively correlated with the oocyte quality. EA could improve the quality of oocytes and the clinical pregnancy rate in PCOS patients undergoing IVF-ET. Be well! JP
May 13th, 2015 at 3:53 pm
Update 05/13/15:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387688/
Int J Prev Med. 2015 Mar 24;6:27.
Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome: A Randomized Double-blind Placebo-controlled Clinical Trial.
BACKGROUND: Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder in women of reproductive age that lead to infertility. The aim of this study was to investigate the effects of probiotic on pancreatic β-cell function and C-reactive protein (CRP) in PCOS patients.
METHODS: This randomized double-blind placebo-controlled clinical trial was conducted among 72 women aged 15-40 years old diagnosed with PCOS. Participants were randomly assigned to two groups receiving: (1) Probiotic supplements (n = 36), (2) placebo (n = 36) for 8-week. Fasting blood samples were taken at baseline and after 8-week of intervention.
RESULTS: Probiotic supplementation, compare with placebo, reduced fasting blood sugar (-4.15 ± 2.87 vs. 2.57 ± 5.66 mg/dL, respectively P = 0.7), serum insulin levels in crude model (-0.49 ± 0.67 vs. 0.34 ± 0.82 μIU/mL, respectively, P = 0.09), homeostasis model of assessment-insulin resistance score (-0.25 ± 0.18 vs. -0.05 ± 0.18, respectively, P = 0.14) nonsignificantly. Serum insulin levels after adjustment with covariates reduced significantly in probiotic group (P = 0.02). We did not found any significant differences in mean changes of CRP between groups (-0.25 ± 0.18 vs. -0.05 ± 0.18, respectively, P = 0.14).
CONCLUSIONS: A 8-week multispecies probiotics supplementation had nonsignificantly beneficial effect on pancreatic β-cell function and CRP in PCOS patients. After adjustment for some covariates, serum insulin changes were significantly different between groups.
Be well!
JP
May 15th, 2015 at 1:27 am
Update 05/14/15:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4387688/
Int J Prev Med. 2015 Mar 24;6:27.
Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome: A Randomized Double-blind Placebo-controlled Clinical Trial.
BACKGROUND: Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder in women of reproductive age that lead to infertility. The aim of this study was to investigate the effects of probiotic on pancreatic β-cell function and C-reactive protein (CRP) in PCOS patients.
METHODS: This randomized double-blind placebo-controlled clinical trial was conducted among 72 women aged 15-40 years old diagnosed with PCOS. Participants were randomly assigned to two groups receiving: (1) Probiotic supplements (n = 36), (2) placebo (n = 36) for 8-week. Fasting blood samples were taken at baseline and after 8-week of intervention.
RESULTS: Probiotic supplementation, compare with placebo, reduced fasting blood sugar (-4.15 ± 2.87 vs. 2.57 ± 5.66 mg/dL, respectively P = 0.7), serum insulin levels in crude model (-0.49 ± 0.67 vs. 0.34 ± 0.82 μIU/mL, respectively, P = 0.09), homeostasis model of assessment-insulin resistance score (-0.25 ± 0.18 vs. -0.05 ± 0.18, respectively, P = 0.14) nonsignificantly. Serum insulin levels after adjustment with covariates reduced significantly in probiotic group (P = 0.02). We did not found any significant differences in mean changes of CRP between groups (-0.25 ± 0.18 vs. -0.05 ± 0.18, respectively, P = 0.14).
CONCLUSIONS: A 8-week multispecies probiotics supplementation had nonsignificantly beneficial effect on pancreatic β-cell function and CRP in PCOS patients. After adjustment for some covariates, serum insulin changes were significantly different between groups.
Be well!
JP
July 10th, 2015 at 10:50 am
Update 07/10/15:
http://onlinelibrary.wiley.com/doi/10.1111/cen.12840/abstract
Clin Endocrinol (Oxf). 2015 Jun 28.
Calcium plus vitamin D supplementation influences biomarkers of inflammation and oxidative stress in overweight and vitamin D-deficient women with polycystic ovary syndrome: a randomized double-blind placebo-controlled clinical trial.
OBJECTIVE: This study was conducted to determine the effects of calcium plus vitamin D supplementation on inflammatory factors and biomarkers of oxidative stress among overweight vitamin D-deficient women with polycystic ovary syndrome (PCOS). Design, Patients and Measurements This randomized double-blind placebo-controlled clinical trial was performed among 104 overweight vitamin D-deficient women diagnosed with PCOS aged 18-40 years old. Participants were randomly divided into four groups. Group A received 1000 mg calcium daily and vitamin D placebo weekly (N=26), group B 50000 IU vitamin D weekly and calcium placebo daily (N=26), group C 1000 mg calcium daily plus 50000 IU vitamin D weekly (N=26) and group D calcium placebo daily plus vitamin D placebo weekly (N=26) for 8 weeks. Fasting blood samples were taken at baseline and 8 weeks after intervention to measure inflammatory factors and biomarkers of oxidative stress.
RESULTS: After 8 weeks, individuals taking calcium plus vitamin D supplements had greater decreases in homeostatic model assessment-Beta cell function (HOMA-B) score (-11.1 vs. -8.6, -3.4 and 13.7, respectively, P=0.03), serum high sensitivity C-reactive protein (hs-CRP) (-948.3 vs. 802.3, -383.8 and 618.2 ng/mL, respectively, P=0.04), plasma malondialdehyde (MDA) concentrations (-0.6 vs. -0.5, -0.1 and 0.6 μmol/L, respectively, P=0.009) and significant increases in plasma total antioxidant capacity (TAC) (35.2 vs. 21.1, 22.5 and -153.8 mmol/L, respectively, P=0.006) and glutathione (GSH) levels (216.0 vs. 3.9, -47.5 and -160.8 μmol/L, respectively, P=0.001) compared with calcium alone, vitamin D alone and placebo groups. Calcium plus vitamin D co-supplementation did not influence plasma NO and catalase levels.
CONCLUSIONS: We found that calcium plus vitamin D co-supplementation for 8 weeks among overweight and vitamin D-deficient women with PCOS had beneficial effects on inflammatory factor and biomarkers of oxidative stress.
Be well!
JP
August 21st, 2015 at 7:19 pm
Updated 08/21/15:
http://www.ncbi.nlm.nih.gov/pubmed/26279073?dopt=Abstract
Ann Nutr Metab. 2015 Jul 31;67(1):42-48.
Chromium Supplementation and the Effects on Metabolic Status in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
BACKGROUND: The aim of the present study was to evaluate the beneficial effects of chromium intake on markers of insulin metabolism and lipid profiles in women with polycystic ovary syndrome (PCOS).
METHODS: In a prospective, randomized, double-blind, placebo-controlled trial, 64 women with PCOS were randomized to receive 200 µg chromium picolinate supplements (n = 32) or placebo (n = 32) for 8 weeks. Fasting blood samples were obtained at baseline and 8 weeks after the intervention to quantify markers of insulin metabolism and lipid concentrations.
RESULTS: Chromium supplementation in women with PCOS resulted in significant decreases in serum insulin levels (-3.6 ± 7.4 vs. +3.6 ± 6.2 µIU/ml, p < 0.001), homeostasis model of assessment-insulin resistance (HOMA-IR; -0.8 ± 1.6 vs. +0.9 ± 1.5, p < 0.001), homeostatic model assessment-beta cell function (HOMA-B; -15.5 ± 32.3 vs. +13.6 ± 23.1, p < 0.001), and a significant increase in quantitative insulin sensitivity check index (QUICKI) score (+0.02 ± 0.03 vs. -0.008 ± 0.02, p = 0.001) compared with the placebo. In addition, a trend toward a significant effect of chromium supplementation on decreasing serum triglycerides (-12.4 ± 74.4 vs. +15.2 ± 32.4 mg/dl, p = 0.05), very low-density lipoprotein-cholesterol (-2.5 ± 14.9 vs. +3.0 ± 6.5 mg/dl, p = 0.05), and cholesterol concentrations (-8.6 ± 21.9 vs. +0.7 ± 22.4 mg/dl, p = 0.09) was seen. CONCLUSIONS: Eight weeks of chromium supplementation among PCOS women had favorable effects on markers of insulin metabolism. Be well! JP
September 2nd, 2015 at 12:18 am
Updated 09/01/15:
http://link.springer.com/article/10.1007%2Fs12011-015-0480-7
Biol Trace Elem Res. 2015 Aug 28.
Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial.
The current study was conducted to evaluate the effects of zinc supplementation on endocrine outcomes, biomarkers of inflammation, and oxidative stress in patients with polycystic ovary syndrome (PCOS). This study was a randomized double-blind, placebo-controlled trial. Forty-eight women (18-40 years) with PCOS diagnosed according to Rotterdam criteria were randomly assigned to receive either 220 mg zinc sulfate (containing 50 mg zinc) (group 1; n = 24) and/or placebo (group 2; n = 24) for 8 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were measured at study baseline and after 8-week intervention. After 8 weeks of intervention, alopecia (41.7 vs. 12.5 %, P = 0.02) decreased compared with the placebo. Additionally, patients who received zinc supplements had significantly decreased hirsutism (modified Ferriman-Gallwey scores) (-1.71 ± 0.99 vs. -0.29 ± 0.95, P < 0.001) and plasma malondialdehyde (MDA) levels (-0.09 ± 1.31 vs. +2.34 ± 5.53 μmol/L, P = 0.04) compared with the placebo. A trend toward a significant effect of zinc intake on reducing high-sensitivity C-reactive protein (hs-CRP) levels (P = 0.06) was also observed. We did observe no significant changes of zinc supplementation on hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress. In conclusion, using 50 mg/day elemental zinc for 8 weeks among PCOS women had beneficial effects on alopecia, hirsutism, and plasma MDA levels; however, it did not affect hormonal profiles, inflammatory cytokines, and other biomarkers of oxidative stress. Be well! JP
October 22nd, 2015 at 10:43 pm
Updated 10/22/15:
http://press.endocrine.org/doi/pdf/10.1210/jc.2015-2580
J Clin Endocrinol Metab. 2015 Oct 20:jc20152580.
Vitamin D Supplementation Decreases TGF-β1 Bioavailability in PCOS: A Randomized Placebo-Controlled Trial.
CONTEXT: There is an abnormal increase in TGF-β1 bioavailability in women with polycystic ovary syndrome (PCOS), which might play a role in the pathophysiology of this syndrome. Vitamin D (VD) supplementation improves various clinical manifestations of PCOS and decreases TGF-β1 levels in several diseases including myelofibrosis.
OBJECTIVE: The objective of the study was to determine the effect of VD supplementation on TGF-β1 bioavailability in VD-deficient women with PCOS and assess whether changes in TGF-β1/soluble endoglin (sENG) levels correlate with an improvement in PCOS clinical manifestations.
DESIGN: This was a prospective, randomized, placebo-controlled trial.
SETTING: The study was conducted at an academic-affiliated medical center.
PARTICIPANTS: Sixty-eight VD-deficient women with PCOS who were not pregnant or taking any exogenous hormones were recruited between October 2013 and January 2015.
INTERVENTIONS: Forty-five women received 50 000 IU of oral vitamin D3 and 23 women received oral placebo once weekly for 8 weeks.
MAIN OUTCOMES MEASURES: Serum TGF-β1, sENG, lipid profile, testosterone, dehydroepiandrosterone sulfate, and insulin resistance were measured. The clinical parameters were evaluated before and 2 months after treatment.
RESULTS: The VD level significantly increased and normalized after VD supplementation (16.3 ± 0.9 [SEM] to 43.2 ± 2.4 ng/mL; P < .01), whereas it did not significantly change after placebo. After the VD supplementation, there was a significant decrease in the following: the interval between menstrual periods (80 ± 9 to 60 ± 6 d; P = .04), Ferriman-Gallwey score (9.8 ± 1.5 to 8.1 ± 1.5; P < .01), triglycerides (138 ± 22 to 117 ± 20 mg/dL; P = .03), and TGF-β1 to sENG ratio (6.7 ± 0.4 to 5.9 ± 0.4; P = .04). In addition, the ΔTGF-β1 to sENG ratio was positively correlated with Δtriglycerides (r = 0.59; P = .03). CONCLUSIONS: VD supplementation in VD-deficient women with PCOS significantly decreases the bioavailability of TGF-β1, which correlates with an improvement in some abnormal clinical parameters associated with PCOS. This is a novel mechanism that could explain the beneficial effects of VD supplementation in women with PCOS. These findings may support new treatment modalities for PCOS, such as the development of anti-TGF-β drugs. Be well! JP
November 10th, 2015 at 6:02 pm
Updated 11/10/15:
http://www.fertstert.org/article/S0015-0282%2815%2902031-2/abstract
Fertil Steril. 2015 Nov 6. pii: S0015-0282(15)02031-2.
Vigorous exercise is associated with superior metabolic profiles in polycystic ovary syndrome independent of total exercise expenditure.
OBJECTIVE: To characterize metabolic features of women with polycystic ovary syndrome (PCOS) by exercise behavior and determine relative health benefits of different exercise intensities.
DESIGN: Cross-sectional study.
SETTING: Multidisciplinary PCOS clinic at a tertiary academic institution.
PATIENT(S): Three hundred and twenty-six women aged 14-52 with PCOS by Rotterdam criteria examined between 2006 and 2013.
INTERVENTION(S): International Physical Activity Questionnaire (IPAQ) administered to classify patients into three groups based on Department of Health and Human Services (DHHS) Guidelines of vigorous, moderate, and inactive, along with physical examination and serum testing.
MAIN OUTCOME MEASURE(S): Blood pressure, body mass index (BMI), waist circumference, fasting lipids, fasting glucose and insulin, 2-hour 75-gram oral glucose tolerance, homeostatic model assessment of insulin resistance (HOMA-IR).
RESULT(S): The DHHS guidelines for adequate physical activity were met by 182 (56%) women. Compared with moderate exercisers and inactive women, the vigorous exercisers had lower BMI and lower HOMA-IR; higher levels of high-density lipoprotein cholesterol and sex hormone-binding globulin; and a reduced prevalence of the metabolic syndrome. In a multivariate logistic regression analysis controlling for age, BMI, and total energy expenditure, every hour of vigorous exercise reduced a patient’s odds of metabolic syndrome by 22% (odds ratio 0.78; 95% confidence interval, 0.62, 0.99).
CONCLUSION(S): Women with PCOS who met DHHS guidelines for exercise demonstrated superior metabolic health parameters. Vigorous but not moderate activity is associated with reduced odds of the metabolic syndrome, independent of age, BMI, and total energy expenditure. PCOS patients should be encouraged to meet activity guidelines via vigorous physical activity.
Be well!
JP
December 18th, 2015 at 12:38 am
Updated 12/17/15:
http://onlinelibrary.wiley.com/doi/10.1111/cen.13003/abstract
Clin Endocrinol (Oxf). 2015 Dec 15.
Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial.
OBJECTIVE: Limited data are available evaluating the effects of oral carnitine supplementation on weight loss and metabolic profiles of women with polycystic ovary syndrome (PCOS). This study was designed to determine the effects of oral carnitine supplementation on weight loss, and glycaemic and lipid profiles in women with PCOS.
DESIGN, PATIENTS AND MEASUREMENTS: In a prospective, randomized, double-blind, placebo-controlled trial, 60 overweight patients diagnosed with PCOS were randomized to receive either 250 mg carnitine supplements (n=30) or placebo (n=30) for 12 weeks. Fasting blood samples were obtained at the beginning and end of the study to quantify parameters of glucose homeostasis and lipid concentrations.
RESULTS: At the end of the 12 weeks, taking carnitine supplements resulted in a significant reduction in weight (-2.7±1.5 vs. +0.1±1.8 kg, P<0.001), BMI (-1.1±0.6 vs. +0.1±0.7 kg/m2 , P<0.001), waist circumference (WC) (-2.0±1.3 vs. -0.3±2.0 cm, P<0.001) and hip circumference (HC) (-2.5±1.5 vs. -0.3±1.8 cm, P<0.001) compared with placebo. In addition, compared with placebo, carnitine administration in women with PCOS led to a significant reduction in fasting plasma glucose (-0.38±0.36 vs. +0.11±0.97 mmol/L, P=0.01), serum insulin levels (-14.39±25.80 vs. +3.01±37.25 pmol/L, P=0.04), homeostasis model of assessment-insulin resistance (-0.61±1.03 vs. +0.11±1.43, P=0.04) and dehydroepiandrosterone sulfate (-3.64±7.00 vs. -0.59±3.20 μmol/L, P=0.03).
CONCLUSIONS: Overall, 12 weeks of carnitine administration in PCOS women resulted in reductions in weight, BMI, WC and HC, and beneficial effects on glycaemic control; however, it did not affect lipid profiles or free testosterone.
Be well!
JP
December 28th, 2015 at 7:28 pm
Updated 12/28/15:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615243/
Int J Med Sci. 2015 Oct 3;12(10):825-31.
Efficacy of a Novel Fenugreek Seed Extract (Trigonella foenum-graecum, Furocyst(TM)) in Polycystic Ovary Syndrome (PCOS).
Polycystic ovary syndrome (PCOS) is one of the most prevalent hormonal disorders among women of reproductive age causing irregular menstrual cycles, excessive body or facial hair, miscarriage and infertility. The latter being a most common PCOS symptoms. Because the symptoms are seemingly unrelated to one another, PCOS is often overlooked and undiagnosed. The present study is an open label, one-arm, non-randomized, post-marketing surveillance study in 50 premenopausal women (18-45 years, BMI<42) diagnosed with PCOS using a novel Trigonella foenum-graecum seed extract (fenugreek seed extract, Furocyst, 2 capsules of 500 mg each/day) extract, enriched in approximately 40% furostanolic saponins, over a period of 90 consecutive days. The study was conducted to determine its efficacy on the reduction of ovarian volume and the number of ovarian cysts. Ethical committee approval was obtained for this study. Furocyst treatment caused significant reduction in ovary volume. Approximately 46% of study population showed reduction in cyst size, while 36% of subjects showed complete dissolution of cyst. It is important to mention that 71% of subjects reported the return of regular menstrual cycle on completion of the treatment and 12% of subjects subsequently became pregnant. Overall, 94% of patients benefitted from the regimen. Significant increases in luteinizing hormone (LH) and follicular stimulating hormone (FSH) levels were observed compared to the baseline values. Extensive blood chemistry, hematological and biochemical assays demonstrated the broad-spectrum safety. Furocyst caused significant decrease in both ovarian volume and the number of ovarian cysts. Serum ALT, BUN and CK were assessed to demonstrate the broad-spectrum safety of Furocyst. No significant adverse effects were observed. In summary, Furocyst was efficacious in ameliorating the symptoms of PCOS.
Be well!
JP
February 9th, 2016 at 1:45 pm
Updated 2/9/16:
http://www.ncbi.nlm.nih.gov/pubmed/26854246
J Trace Elem Med Biol. 2016 Mar;34:56-61.
Effects of selenium supplementation on glucose homeostasis and free androgen index in women with polycystic ovary syndrome: A randomized, double blinded, placebo controlled clinical trial.
BACKGROUND/OBJECTIVES: Insulin resistance (IR) is a main pathophysiologic feature in polycystic ovary syndrome (PCOS) patients which is triggered by elevated oxidative stress in these patients. Selenium, an essential micronutrient, is a major constituent of antioxidant enzymes such as glutathione peroxidase. Recently, decreased plasma selenium concentrations were reported in PCOS patients. So, the present study was carried out in order to assess whether selenium consumption can improve the metabolic response to insulin and reduce the insulin resistance in these women.
SUBJECTS/METHODS: A total of 53 PCOS patients (diagnosed by Rotterdam criteria), 18-42 years old, participated in this randomized, double-blind and placebo controlled trial for 12 weeks (selenium, n=26; placebo, n=27). The effects of daily administration of 200μg selenium or placebo on serum glucose, total testosterone (tT), sex hormone binding globulin (SHBG) and free androgen index (FAI) in fasting state were evaluated.
RESULTS: At the end of the study, insulin resistance was significantly increased in selenium recipients when compared with the placebo group (2.05±0.39 when compared with 1.81±0.25, p=0.017). Also, selenium supplementation resulted in marginally significant increase (p=0.056) in insulin level when compared with the placebo group. There were no statistically significant changes in other study endpoints, when comparing the two groups.
CONCLUSION: This study showed that selenium supplementation in PCOS patients may worsen insulin resistance in them. Until the results of larger studies become available, indiscriminate consumption of selenium supplements in PCOS patients will warrant caution.
Be well!
JP
April 7th, 2016 at 7:52 pm
Updated 04/07/16:
http://www.ncbi.nlm.nih.gov/pubmed/27050252
Horm Metab Res. 2016 Apr 6.
The Effects of Vitamin D-K-Calcium Co-Supplementation on Endocrine, Inflammation, and Oxidative Stress Biomarkers in Vitamin D-Deficient Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
The current study was conducted to assess the effects of vitamin D-K-calcium co-supplementation on endocrine, inflammation, and oxidative stress biomarkers in vitamin D-deficient women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 60 vitamin D-deficient women diagnosed with PCOS aged 18-40 years old. Participants were randomly allocated into 2 groups to intake either 200 IU vitamin D, 90 μg vitamin K plus, 500 mg calcium supplements (n=30), or placebo (n=30) twice a day for 8 weeks. Endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning and the end of the study. After 8 weeks of intervention, compared with the placebo, vitamin D-K-calcium co-supplementation resulted in a significant reduction in serum-free testosterone (- 2.1±1.6 vs.+0.1±1.0 pg/ml, p<0.001) and dehydroepiandrosterone sulfate (DHEAS) levels (- 0.8±1.0 vs.-0.1±0.5 μg/ml, p=0.006). In addition, a significant increase in plasma total antioxidant capacity (TAC) (+ 75.7±126.1 vs.-80.4±242.8 mmol/l, p=0.005) and a significant difference in plasma malondialdehyde (MDA) concentrations (+ 0.03±0.6 vs.+1.4±2.4 μmol/l, p=0.005) was observed following the supplementation with vitamin D-K-calcium compared with the placebo. A trend toward a greater decrease in luteinizing hormone was observed in vitamin D-K-calcium co-supplement group compared to placebo group (- 7.0 vs.-1.2 IU/l, p=0.09). We did not find any significant effect of vitamin D-K-calcium co-supplementation on prolactin, follicle-stimulating hormone, 17-OH progesterone, inflammatory markers, and glutathione levels. Overall, vitamin D-K-calcium co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on serum DHEAS, free testosterone, plasma TAC, and MDA levels.
Be well!
JP
August 5th, 2016 at 9:17 pm
Updated 08/05/16:
http://press.endocrine.org/doi/pdf/10.1210/jc.2016-1762
J Clin Endocrinol Metab. 2016 Aug 4:jc20161762.
The Effects of Soy Isoflavones on Metabolic Status of Patients With Polycystic Ovary Syndrome.
CONTEXT: Limited data are available evaluating the effects of soy isoflavones on metabolic status of patients with polycystic ovary syndrome (PCOS).
OBJECTIVE: The current study was performed to determine the effects of soy isoflavones on metabolic status of patients with PCOS.
METHODS: This randomized, double-blind, placebo-controlled trial was performed on 70 women diagnosed with PCOS according to the Rotterdam criteria who were 18-40 years old. Participants were randomly allocated into two groups to take either 50 mg/d soy isoflavones (n = 35) or placebo (n = 35) for 12 weeks. Metabolic, endocrine, inflammation, and oxidative stress biomarkers were quantified at the beginning of the study and after the 12-week intervention.
RESULTS: After 12 weeks of intervention, compared to the placebo group, soy isoflavone administration significantly decreased circulating serum levels of insulin (-1.2 ± 4.0 vs +2.8 ± 4.7 μ IU/mL; P < .001) and homeostasis model of assessment-estimated insulin resistance (-0.3 ± 1.0 vs +0.6 ± 1.1; P < .001) and increased the quantitative insulin sensitivity check index (+0.0009 ± 0.01 vs -0.01 ± 0.03; P = .01). Supplementation with soy isoflavones resulted in significant reductions in free androgen index (-0.03 ± 0.04 vs +0.02 ± 0.03; P < .001) and serum triglycerides (-13.3 ± 62.2 vs +10.3 ± 24.5 mg/dL; P = .04) compared to the placebo group. There was a significant increase in plasma total glutathione (+96.0 ± 102.2 vs +22.7 ± 157.8 μ mol/L; P = .04) and a significant decrease in malondialdehyde levels (-0.7 ± 0.8 vs +0.8 ± 2.3 μ mol/L; P = .001) by soy isoflavone intake compared with the placebo group. We did not observe any significant effect of soy isoflavone intake on other lipid profiles and inflammatory and oxidative stress markers. CONCLUSION: Soy isoflavone administration for 12 weeks in women with PCOS significantly improved markers of insulin resistance, hormonal status, triglycerides, and biomarkers of oxidative stress. Be well! JP
September 14th, 2016 at 9:31 pm
Updated 09/14/16:
http://www.sciencedirect.com/science/article/pii/S0303720716303732
Mol Cell Endocrinol. 2016 Sep 9.
The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome.
This study was conducted to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein(a) (Lp[a]) and oxidized low-density lipoprotein (Ox-LDL), lipid profiles and biomarkers of oxidative stress in women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly assigned into two groups to receive either 1000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-Linolenic acid plus 400 IU vitamin E supplements (n = 34) or placebo (n = 34) for 12 weeks. Lp(a) and Ox-LDL mRNA levels were quantified in peripheral blood mononuclear cells of PCOS women with RT-PCR method. Lipid profiles and biomarkers of oxidative stress were quantified at the beginning of the study and after 12-week intervention. Quantitative results of RT-PCR demonstrated that compared with the placebo, omega-3 fatty acids and vitamin E co-supplementation downregulated expressed levels of Lp(a) mRNA (P < 0.001) and Ox-LDL mRNA (P < 0.001) in peripheral blood mononuclear cells of women with PCOS. In addition, compared to the placebo group, omega-3 fatty acids and vitamin E co-supplementation resulted in a significant decrease in serum triglycerides (-22.1 ± 22.3 vs. +7.7 ± 23.6 mg/dL, P < 0.001), VLDL- (-4.4 ± 4.5 vs. +1.5 ± 4.7 mg/dL, P < 0.001), total- (-20.3 ± 16.6 vs. +12.2 ± 26.1 mg/dL, P < 0.001), LDL- (-16.7 ± 15.3 vs. +11.9 ± 26.1 mg/dL, P < 0.001) and total-/HDL-cholesterol (-0.5 ± 0.6 vs. +0.4 ± 0.8, P < 0.001). There were a significant increase in plasma total antioxidant capacity (+89.4 ± 108.9 vs. +5.9 ± 116.2 mmol/L, P = 0.003) and a significant decrease in malondialdehyde levels (-0.3 ± 0.4 vs. -0.008 ± 0.6 μmol/L, P = 0.01) by combined omega-3 fatty acids and vitamin E intake compared with the placebo group. Overall, omega-3 fatty acids and vitamin E co-supplementation for 12 weeks in PCOS women significantly improved gene expression of Lp(a) and Ox-LDL, lipid profiles and biomarkers of oxidative stress.
Be well!
JP
November 10th, 2016 at 3:07 pm
Update 11/10/16:
http://www.sciencedirect.com/science/article/pii/S019566631630705X
Appetite. 2016 Nov 4.
Binge eating behaviours and food cravings in women with Polycystic Ovary Syndrome.
Polycystic Ovary Syndrome (PCOS), the most common endocrine condition in women, is often anecdotally associated with binge eating behaviours and food cravings; however there is a paucity of research. This study aimed to report the prevalence of binge eating and food cravings and their relation to obesity risk in women with PCOS. Participants completed an online survey including the Bulimia Investigatory Test, Edinburgh, Food Cravings-Trait Questionnaire and the Three Factor Eating Questionnaire revised-18. The study included obese (n = 340), overweight (n = 70) and lean (n = 45) women with PCOS and lean healthy women (n = 40). Sixty percent of obese women with PCOS were categorised with binge-eating behaviour, with 39% presenting with clinically significant behaviour. Obese women with PCOS presented with high mean food cravings-trait scores (131.6 ± 28.9) that were significantly greater compared with lean (114.0 ± 34.9) and overweight women with PCOS (120.1 ± 29.5; p < 0.001). Multiple regression exploring relations between eating styles and adiposity explained 59% of the variance in binge eating symptom scores in women with PCOS (F = 173.8; p < 0.001, n = 463): significant predictors were food cravings total score (beta = 0.52; p < 0.001), emotional eating score (beta = 0.16; p < 0.001), BMI (beta = 0.13; p < 0.001) and uncontrolled eating score (beta = 0.10; p < 0.01). Compared with lean healthy women, lean women with PCOS exhibited significantly higher binge eating symptom scores (10.9 ± 7.8 versus 7.4 ± 6.0; p < 0.05), though similar total food craving scores (114.0 ± 34.9 versus 105.6 ± 26.6: NS). This study is the largest, to date, to robustly report that a high proportion of women with PCOS exhibit binge eating behaviours. We recommend screening women with PCOS for binge eating behaviours to help inform the choice of weight management approach for this clinical population. Be well! JP
November 22nd, 2016 at 12:26 am
Updated 11/21/16:
http://press.endocrine.org/doi/full/10.1210/jc.2016-1858
J Clin Endocrinol Metab. 2016 Nov;101(11):4322-4328.
Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial.
CONTEXT: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age. Hyperandrogenism is the central feature of PCOS. Studies on isolated ovarian theca-interstitial cells suggest that resveratrol, a natural polyphenol, reduces androgen production.
OBJECTIVE: This study was designed to evaluate endocrine and metabolic effects of resveratrol on PCOS.
DESIGN AND SETTING: This was a randomized (1:1) double-blind, placebo-controlled trial that evaluated the effects of resveratrol over a period of 3 months in an academic hospital.
PATIENTS AND OTHER PARTICIPANTS: Subjects with PCOS were identified according to the Rotterdam criteria. Thirty-four subjects were enrolled and 30 subjects completed the trial. Evaluations were performed at baseline and repeated after 3 months of treatment.
INTERVENTION: Resveratrol (1,500 mg p.o.) or placebo were administered daily.
MAIN OUTCOME MEASURE: Primary outcome was the change in the serum total T.
RESULTS: Resveratrol treatment led to a significant decrease of total T by 23.1% (P = .01). In parallel, resveratrol induced a 22.2% decrease of dehydroepiandrosterone sulfate (P = .01), a decrease of fasting insulin level by 31.8% (P = .007) and an increase of the Insulin Sensitivity Index (Matsuda and DeFronzo) by 66.3% (P = .04). Levels of gonadotropins, the lipid profile as well as markers of inflammation and endothelial function were not significantly altered.
CONCLUSIONS: Resveratrol significantly reduced ovarian and adrenal androgens. This effect may be, at least in part, related to an improvement of insulin sensitivity and a decline of insulin level.
Be well!
JP
December 7th, 2016 at 12:45 am
Updated 12/06/16:
http://www.tandfonline.com/doi/abs/10.1080/09513590.2016.1259407?journalCode=igye20
Gynecol Endocrinol. 2016 Dec 2:1-4.
Substituting poly- and mono-unsaturated fat for dietary carbohydrate reduces hyperinsulinemia in women with polycystic ovary syndrome.
OBJECTIVE: Hyperinsulinemia is a prevalent feature of polycystic ovary syndrome (PCOS), contributing to metabolic and reproductive manifestations of the syndrome. Weight loss reduces hyperinsulinemia but weight regain is the norm, thus preventing long-term benefits. In the absence of weight loss, replacement of dietary carbohydrate (CHO) with mono/polyunsaturated fat reduces ambient insulin concentrations in non-PCOS subjects. The current study evaluated whether this dietary intervention could ameliorate hyperinsulinemia in women with PCOS.
DESIGN/SETTING/PATIENTS: Obese women with PCOS (BMI 39 ± 7 kg/m2) and insulin resistance completed a crossover study (Stanford University Clinical Research Center) comparing two isocaloric diets, prepared by research dietitians, containing 60% CHO/25% fat versus 40% CHO/45% fat (both 15% protein and ≤7% saturated fat). After 3 weeks on each diet, daylong glucose, insulin, and fasting lipid/lipoproteins were measured.
RESULTS: Daylong glucose did not differ according to diet. Daylong insulin concentrations were substantially (30%) and significantly lower on the low CHO/higher fat diet. Beneficial changes in lipid profile were also observed.
CONCLUSIONS: Replacement of dietary CHO with mono/polyunsaturated fat yields clinically important reductions in daylong insulin concentrations, without adversely affecting lipid profile in obese, insulin-resistant women with PCOS. This simple and safe dietary intervention may constitute an important treatment for PCOS.
Be well!
JP
March 25th, 2017 at 6:49 pm
Updated 03/25/17:
https://www.thieme-connect.com/DOI/DOI?10.1055/s-0042-118705
Horm Metab Res. 2017 Feb;49(2):115-121.
Effects of Quercetin on Adiponectin-Mediated Insulin Sensitivity in Polycystic Ovary Syndrome: A Randomized Placebo-Controlled Double-Blind Clinical Trial.
Polycystic ovary syndrome (PCOS) is a heterogeneous, multi-causal, and genetically complex disorder, which is related to the failure in endocrine glands. Adiponectin has been reported to be low in PCOS, even in the absence of adiposity. Quercetin reduces serum glucose, insulin, triglycerides, and cholesterol levels and increases the expression and secretion of adiponectin. The aim of this study was to determine the effect of quercetin on the adiponectin-mediated insulin sensitivity in PCOS patients. Eighty-four women with PCOS were selected and randomly assigned to 2 groups of treatment and control. The treatment group received 1 g quercetin (two 500 mg capsules) daily for 12 weeks, and the control group received placebo. In addition to anthropometric assessments, fasting serum levels of total adiponectin, high-molecular-weight (HMW) adiponectin, glucose, insulin, testosterone, LH, and SHBG were also measured at the baseline and at the end of the trial. Quercetin could slightly increase the level of adiponectin by 5.56% as compared to placebo (adjusted p-value=0.001) and HMW adiponectin by 3.9% as compared to placebo (adjusted p-value=0.017), while it reduced the level of testosterone (0.71 ng/dl in quercetin vs. 0.77 ng/dl in placebo; p<0.001) and LH (8.42 IU/l in quercetin vs. 8.68 IU/l in placebo; p=0.009). HOMA-IR levels were also significantly (p<0.001) lower in quercetin (1.84) group compared to placebo group (2.21). Oral quercetin supplementation was effective in improving the adiponectin-mediated insulin resistance and hormonal profile of women with PCOS.
Be well!
JP
March 31st, 2017 at 12:23 am
Updated 03/30/17:
http://www.mdpi.com/2072-6643/9/4/334/htm
Nutrients 2017, 9(4), 334
Vitamin D Decreases Serum VEGF Correlating with Clinical Improvement in Vitamin D-Deficient Women with PCOS: A Randomized Placebo-Controlled Trial
Vascular endothelial growth factor (VEGF) has been suggested to play a role in the pathophysiology of polycystic ovary syndrome (PCOS) and may contribute to increased risk of ovarian hyperstimulation syndrome (OHSS) in affected individuals. Vitamin D (VitD) supplementation improves multiple clinical parameters in VitD-deficient women with PCOS and decreases VEGF levels in several other pathologic conditions. Unveiling the basic mechanisms underlying the beneficial effects of vitamin D on PCOS may enhance our understanding of the pathophysiology of this syndrome. It may also suggest a new treatment for PCOS that can improve it through the same mechanism as vitamin D and can be given regardless of vitamin D levels. Therefore, we aimed to explore the effect of VitD supplementation on serum VEGF levels and assess whether changes in VEGF correlate with an improvement in characteristic clinical abnormalities of PCOS. This is a randomized placebo-controlled trial conducted between October 2013 and March 2015. Sixty-eight VitD-deficient women with PCOS were recruited. Women received either 50,000 IU of oral VitD3 or placebo once weekly for 8 weeks. There was a significant decrease in serum VEGF levels (1106.4 ± 36.5 to 965.3 ± 42.7 pg·mL–1; p < 0.001) in the VitD group. Previously reported findings of this trial demonstrated a significant decrease in the intermenstrual intervals, Ferriman-Gallwey hirsutism score, and triglycerides following VitD supplementation. Interestingly, ∆VEGF was positively correlated with ∆triglycerides (R2 = 0.22; p = 0.02) following VitD supplementation. In conclusion, VitD replacement significantly decreases serum VEGF levels correlating with a decrease in triglycerides in women with PCOS. This is a novel molecular explanation for the beneficial effects of VitD treatment. It also suggests the need to investigate a potential role of VitD treatment in reducing the incidence or severity of OHSS in VitD-deficient women with PCOS. Be well! JP
April 14th, 2017 at 11:43 pm
Updated 04/14/17:
https://www.thieme-connect.com/DOI/DOI?10.1055/s-0043-104530
Exp Clin Endocrinol Diabetes. 2017 Apr 13.
The Effects of Calcium, Vitamins D and K co-Supplementation on Markers of Insulin Metabolism and Lipid Profiles in Vitamin D-Deficient Women with Polycystic Ovary Syndrome.
Data on the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles among vitamin D-deficient women with polycystic ovary syndrome (PCOS) are scarce. This study was done to determine the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles in vitamin D-deficient women with PCOS. This randomized double-blind, placebo-controlled trial was conducted among 55 vitamin D-deficient women diagnosed with PCOS aged 18-40 years old. Subjects were randomly assigned into 2 groups to intake either 500 mg calcium, 200 IU vitamin D and 90 µg vitamin K supplements (n=28) or placebo (n=27) twice a day for 8 weeks. After the 8-week intervention, compared with the placebo, joint calcium, vitamins D and K supplementation resulted in significant decreases in serum insulin concentrations (-1.9±3.5 vs. +1.8±6.6 µIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (-0.4±0.7 vs. +0.4±1.4, P=0.01), homeostasis model of assessment-estimated b cell function (-7.9±14.7 vs. +7.0±30.3, P=0.02) and a significant increase in quantitative insulin sensitivity check index (+0.01±0.01 vs. -0.008±0.03, P=0.01). In addition, significant decreases in serum triglycerides (-23.4±71.3 vs. +9.9±39.5 mg/dL, P=0.03) and VLDL-cholesterol levels (-4.7±14.3 vs. +2.0±7.9 mg/dL, P=0.03) was observed following supplementation with combined calcium, vitamins D and K compared with the placebo. Overall, calcium, vitamins D and K co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on markers of insulin metabolism, serum triglycerides and VLDL-cholesterol levels.
Be well!
JP
May 2nd, 2017 at 6:13 pm
Updated 05/02/17:
https://www.thieme-connect.com/DOI/DOI?10.1055/s-0042-117773
Exp Clin Endocrinol Diabetes. 2017 Apr 13.
The Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Indices of Insulin Resistance and Hormonal Parameters in Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
This study was conducted to determine the effects of omega-3 fatty acids and vitamin E co-supplementation on indices of insulin resistance and hormonal parameters in women with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was done on 68 women diagnosed with PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly assigned into 2 groups to receive either 1 000 mg omega-3 fatty acids from flaxseed oil containing 400 mg α-Linolenic acid plus 400 IU vitamin E supplements (n=34) or placebo (n=34) for 12 weeks. Hormonal parameters were quantified at the beginning of the study and after 12-week intervention. After 12 weeks of intervention, compared to the placebo, omega-3 fatty acids and vitamin E co-supplementation resulted in a significant decrease in insulin (-1.0±3.5 vs. +2.7±6.6 µIU/mL, P=0.004), homeostasis model of assessment-estimated insulin resistance (-0.2±0.8 vs. +0.6±1.5, P=0.005), homeostasis model of assessment-estimated B cell function (-4.3±14.3 vs. +10.5±24.5, P=0.004) and a significant increase in quantitative insulin sensitivity check index (+0.006±0.02 vs. -0.01±0.04, P=0.008). Supplementation with omega-3 fatty acids plus vitamin E led to significant reductions in serum total testosterone (-0.5±0.7 vs. -0.1±0.5 ng/mL, P=0.008) and free testosterone (-1.2±2.1 vs. -0.2±1.7, P=0.04) compared to the placebo group. We did not observe any significant effect of omega-3 fatty acids and vitamin E co-supplementation on fasting plasma glucose and other hormonal profiles. Omega-3 fatty acids and vitamin E co-supplementation for 12 weeks in PCOS women significantly improved indices of insulin resistance, total and free testosterone.
Be well!
JP
June 8th, 2017 at 10:32 pm
Updated 06/08/17:
https://www.ncbi.nlm.nih.gov/pubmed/28584836
J Educ Health Promot. 2017 May 5;6:36.
Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: A clinical trial.
BACKGROUND AND OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the common cause of Oligo-ovulation. This syndrome causes long-term metabolic issues as well as increase the risk of diabetes type 2, hypertension, dyslipidemia, and cardiovascular disease. The current research aimed to study the effect of green tea on weight and hormonal changes of women suffering from PCOS.
METHODS: This two group, double-blind, randomized clinical trial was conducted in Isfahan city. Overweight women suffering from PCOS (n = 60) were randomly divided into two groups. Green tea was prescribed to the experimental group, and placebo was prescribed to the control group. Free testosterone hormones and fasting insulin were compared in both groups at the beginning and 12 weeks after the study commencement. The weight of participants of both groups was also measured before and after the study. The statistical data were analyzed by SPSS software and paired t-test.
RESULTS: The paired t-test showed that there was no significant difference in the mean weight of both groups before the intervention (P = 0.812), but the difference was significant after the intervention (P = 0.031). There was no significant difference in the mean fasting insulin of both groups before the intervention (P = 0.352), but the difference was significant after the intervention (P < 0.0001). Moreover, there was no significant difference in the mean free testosterone level of both groups before the intervention (P = 0.638), but the difference was significant after the intervention (P < 0.0001). CONCLUSION: The consumption of green tea by overweight and obese women suffering from PCOS leads to weight loss, a decrease in fasting insulin, and a decrease in the level of free testosterone. Be well! JP
July 3rd, 2017 at 2:12 pm
Updated 07/03/17:
https://www.ncbi.nlm.nih.gov/pubmed/28668998
Biol Trace Elem Res. 2017 Jul 1.
Magnesium-Zinc-Calcium-Vitamin D Co-supplementation Improves Hormonal Profiles, Biomarkers of Inflammation and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial.
Data on the effects of magnesium-zinc-calcium-vitamin D co-supplementation on hormonal profiles, biomarkers of inflammation, and oxidative stress among women with polycystic ovary syndrome (PCOS) are scarce. The objective of this study was to assess the effects of magnesium-zinc-calcium-vitamin D co-supplementation on hormonal profiles, biomarkers of inflammation, and oxidative stress in women with PCOS. Sixty PCOS women were randomized into two groups and treated with 100 mg magnesium, 4 mg zinc, 400 mg calcium plus 200 IU vitamin D supplements (n = 30), or placebo (n = 30) twice a day for 12 weeks. Hormonal profiles, biomarkers of inflammation, and oxidative stress were assessed at baseline and at end-of-treatment. After the 12-week intervention, compared with the placebo, magnesium-zinc-calcium-vitamin D co-supplementation resulted in significant reductions in hirsutism (-2.4 ± 1.2 vs. -0.1 ± 0.4, P < 0.001), serum high sensitivity C-reactive protein (-0.7 ± 0.8 vs. +0.2 ± 1.8 mg/L, P < 0.001), and plasma malondialdehyde (-0.4 ± 0.3 vs. +0.2 ± 1.0 μmol/L, P = 0.01), and a significant increase in plasma total antioxidant capacity concentrations (+46.6 ± 66.5 vs. -7.7 ± 130.1 mmol/L, P = 0.04). We failed to find any significant effect of magnesium-zinc-calcium-vitamin D co-supplementation on free androgen index, and other biomarkers of inflammation and oxidative stress. Overall, magnesium-zinc-calcium-vitamin D co-supplementation for 12 weeks among PCOS women had beneficial effects on hormonal profiles, biomarkers of inflammation, and oxidative stress. Be well! JP
July 6th, 2017 at 12:14 pm
Updated 07/05/17:
J Res Med Sci. 2017 May 30;22:64.
Omega-3 supplementation effects on polycystic ovary syndrome symptoms and metabolic syndrome.
BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder with unknown etiology and with different complications. The aim of this study was to evaluate the effect of omega-3 supplementation on PCOS symptoms and metabolic syndrome.
MATERIALS AND METHODS: This double-blind clinical trial was performed in 2015 in Alzahra and Shahid Beheshti Hospitals, Isfahan, Iran, on 88 patients with PCOS. Intervention group took omega-3 supplements with dose of 2 g/day for 6 months (two capsules), but control group received two olive oil capsules. Finally, ultrasound and laboratory findings and the recovery rate of menstrual disorders in both groups were compared.
RESULTS: After 6 months’ intervention, waist circumference (WC) was significantly lower in omega-3 as compared to control (81.18 ± 2.87 vs. 84.22 ± 2.61 cm, respectively, P < 0.0001). High-density lipoprotein was increased (47.2 ± 1.37 vs. 41.56 ± 1.34 mg/dl, respectively, P < 0.0001) while low-density lipoprotein (107.79 ± 1.68 vs. 117.4 ± 1.57 mg/dl, respectively), triglyceride (116.02 ± 3.13 vs. 125.06 ± 2.91 mg/dl, respectively), and cholesterol (180.34 ± 6.34 vs. 189.56 ± 5.93 mg/dl, respectively) in omega-3 were significantly lower than control (P < 0.0001). The interval between periods in omega-3 was significantly shorter than control (29.83 ± 4.68 vs. 47.11 ± 8.72 days, respectively, P < 0.001).
CONCLUSION: Omega-3 decrease lipid profiles, WC, and interval between periods while weight, hip circumference, fasting blood sugar, number of ovarian follicle, size of ovary, bleeding volume, menstrual bleeding, and hirsutism score did not change by administration of omega-3.
Be well!
JP
July 6th, 2017 at 3:06 pm
Updated 07/06/17:
https://www.ncbi.nlm.nih.gov/pubmed/28679142
Horm Metab Res. 2017 Jul 5.
Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
The current study was conducted to evaluate the effects of 2 different doses of vitamin D supplementation on metabolic profiles of insulin-resistant patients with polycystic ovary syndrome (PCOS). This randomized double-blind, placebo-controlled trial was performed on 90 insulin-resistant patients with PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly allocated into 3 groups to receive either 4 000 IU of vitamin D (n=30) or 1 000 IU of vitamin D (n=30) or placebo (n=30) per day for 12 weeks. Vitamin D supplementation (4 000 IU), compared with vitamin D (1 000 IU) and placebo, led to reduced fasting plasma glucose (-4.3±8.6 vs. -4.7±7.1 and +0.1±6.7 mg/dl, respectively, p=0.02), serum insulin concentrations (-2.7±2.7 vs. -1.4±4.2 and -0.1±4.1 μIU/ml, respectively, p=0.02), and HOMA-IR (-0.6±0.6 vs. -0.4±1.0 and -0.1±0.9, respectively, p=0.02). In addition, we found significant decreases in mean change of serum triglycerides (-10.3±7.3 vs. -3.6±14.5 and +6.9±23.8 mg/dl, respectively, p=0.001), VLDL- (-2.0±1.5 vs. -0.7±2.9 and +1.4±4.8 mg/dl, respectively, p=0.001), total- (-14.0±9.5 vs. -6.2±24.0 and +7.1±29.7 mg/dl, respectively, p=0.002), LDL- (-10.8±8.3 vs. -5.7±21.9 and +6.8±28.2 mg/dl, respectively, p=0.005), and total-/HDL-cholesterol ratio (-0.2±0.3 vs. -0.1±0.6 and +0.2±0.7 mg/dl, respectively, p=0.003) in the high-dose vitamin D group compared with low-dose vitamin D and placebo groups. Overall, vitamin D supplementation at a dosage of 4 000 IU/day for 12 weeks in insulin-resistant patients with PCOS had beneficial effects of glucose metabolism and lipid profiles compared with 1 000 IU/day of vitamin D and placebo groups.
Be well!
JP
July 23rd, 2017 at 1:19 pm
Updated 07/23/17:
http://onlinelibrary.wiley.com/doi/10.1111/cen.13427/abstract
Clin Endocrinol (Oxf). 2017 Jul 20.
Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome – substudy of randomized trial between diet, exercise and diet plus exercise for weight control.
OBJECTIVE: Polycystic ovary syndrome (PCOS) is commonly affected by obesity. PCOS phenotypes are prone to increased waist/hip ratio, insulin resistance and dyslipidaemia. This substudy was undertaken to evaluate the effects of lifestyle interventions on metabolic biomarkers in overweight/obese PCOS women, and the interventional effects of dietary components related to metabolic outcomes.
DESIGN: Randomized three-arm parallel study.
PATIENTS: Fifty-seven PCOS women (BMI >27kg/m2 , age 18-40) were randomly assigned to diet (D, n=19), exercise (E, n=19) or diet plus exercise (DE, n=19) in three-arm fashion over 16 weeks. The D group received nutritional counselling by a dietician to reduce their energy intake by at least 600 kcal/day. The E group received an ambulatory exercise regimen from a physiotherapist. The DE group had both interventions.
MEASUREMENTS: Self-reported food intake over four days, exercise pedometers, BMI, waist/hip ratio, blood pressure, body composition, and oral glucose tolerance test were performed before and at the end of intervention.
RESULTS: BMI, waist circumference and total cholesterol were significantly reduced in the D and DE groups, as well as LDL and HOMA index in the D group. In the E group, exercise was increased along with a decrease in BMI and waist circumference. The strongest predictor of reduced BMI was increased fibre intake (-0.44, p=0.03), while a decrease in trans fatty acid intake predicted reduced insulinogenic index (0.44, p<0.01).
CONCLUSIONS: Nutritional counselling with dieting is clearly effective to improve metabolic disturbances in overweight/obese women with PCOS. Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement and weight control.
Be well!
JP
August 14th, 2017 at 2:01 am
Updated 08/13/17:
http://onlinelibrary.wiley.com/doi/10.1002/ptr.5858/full
Phytother Res. 2017 Jul 7.
Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial.
Polycystic ovary syndrome (PCOS) is a common, complex reproductive endocrinopathy characterized by menstrual irregularities, hyperandrogenism and polycystic ovaries. Lifestyle modification is a first-line intervention; however, there are barriers to success for this form of self-care, and women often seek adjunct therapies including herbal medicines. This pragmatic, randomized controlled trial, delivered in communities of Australia in overweight women with PCOS, compared the effectiveness and safety of a lifestyle intervention plus herbal medicine against lifestyle alone. All participants were helped to construct a personalized lifestyle plan. The herbal intervention consisted of two tablets. Tablet 1 contained Cinnamomum verum, Glycyrrhiza glabra, Hypericum perforatum and Paeonia lactiflora. Tablet 2 contained Tribulus terrestris. The primary outcome was oligomenorrhoea/amenorrhoea. Secondary outcomes were hormones; anthropometry; quality of life; depression, anxiety and stress; pregnancy; birth outcomes; and safety. One hundred and twenty-two women gave their consent. At 3 months, women in the combination group recorded a reduction in oligomenorrhoea of 32.9% (95% confidence interval 23.3-42.6, p < 0.01) compared with controls, estimated as a large effect (ηp2 = 0.11). Other significant improvements were found for body mass index (p < 0.01); insulin (p = 0.02) and luteinizing hormone (p = 0.04); blood pressure (p = 0.01); quality of life (p < 0.01); depression, anxiety and stress (p < 0.01); and pregnancy rates (p = 0.01). This trial provides evidence of improved effectiveness and safety for lifestyle intervention when combined with herbal medicines in women with PCOS. Be well! JP
October 2nd, 2017 at 11:38 pm
Updated 10/02/17:
http://www.tandfonline.com/doi/abs/10.1080/09513590.2017.1381680?journalCode=igye20
Gynecol Endocrinol. 2017 Sep 26:1-6.
The effects of coenzyme Q10 supplementation on gene expression related to insulin, lipid and inflammation in patients with polycystic ovary syndrome.
OBJECTIVE: This research was conducted to assess the effects of coenzyme Q10 (CoQ10) intake on gene expression related to insulin, lipid and inflammation in subjects with polycystic ovary syndrome (PCOS).
METHODS: This randomized double-blind, placebo-controlled trial was conducted on 40 subjects diagnosed with PCOS. Subjects were randomly allocated into two groups to intake either 100 mg CoQ10 (n = 20) or placebo (n = 20) per day for 12 weeks. Gene expression related to insulin, lipid and inflammation were quantified in blood samples of PCOS women with RT-PCR method.
RESULTS: Results of RT-PCR shown that compared with the placebo, CoQ10 intake downregulated gene expression of oxidized low-density lipoprotein receptor 1 (LDLR) (p < 0.001) and upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (p = 0.01) in peripheral blood mononuclear cells of subjects with PCOS. In addition, compared to the placebo group, CoQ10 supplementation downregulated gene expression of interleukin-1 (IL-1) (p = 0.03), interleukin-8 (IL-8) (p = 0.001) and tumor necrosis factor alpha (TNF-α) (p < 0.001) in peripheral blood mononuclear cells of subjects with PCOS. CONCLUSIONS: Overall, CoQ10 intake for 12 weeks in PCOS women significantly improved gene expression of LDLR, PPAR-γ, IL-1, IL-8 and TNF-α. Be well! JP
November 8th, 2017 at 12:23 pm
Updated 11/08/17:
https://www.ncbi.nlm.nih.gov/pubmed/29110281
J Endocrinol Invest. 2017 Nov 6.
The effect of vitamin D supplementation in combination with low-calorie diet on anthropometric indices and androgen hormones in women with polycystic ovary syndrome: a double-blind, randomized, placebo-controlled trial.
PURPOSE: Polycystic ovary syndrome (PCOS) is known as the most common endocrine disorder in reproductive age women. The aim of this studywas to evaluate the effects of vitamin D supplementation in combination with low-calorie diet on anthropometric indices, reproductive hormones and menstrual regularity in overweight and obese PCOS women.
METHODS: In this randomized controlled clinical trial, 60 PCOS women with vitamin D insufficiency were randomly assigned to 12 weeks of either (1) weight-loss intervention + 50,000 IU/week oral vitamin D3 or (2) weight-loss intervention + placebo. At the beginning and end of the study, the anthropometric indices, body composition, 25-hydroxyvitamin D, total testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG) and free androgen index (FAI) were measured and regularity of menses was compared among the two groups.
RESULT: After 12-week intervention, median of serum 25-hydroxyvitamin D3 significantly increased from 18.5 (10.75-20) ng/ml to 42.69 (34-53.25) ng/ml in vitamin D group compared to placebo group (p < 001). Moreover, there was a significant improvement in frequency regular menstrual cycle (p = 0.01). Mean of weight, body mass index, fat mass, waist and hip circumference and waist-to-hip ratio significantly decreased in both groups, but was not different between two groups. Mean of total testosterone insignificantly decreased from 0.7 to 0.5 ng/ml in vitamin D group (p = 0.18). In addition, we did not observe significant differences regarding DHEAS, FAI and SHBG between two groups. CONCLUSIONS: In women with PCOS, androgen profile did not change with vitamin D supplementation when combined with low-calorie diet, but menstrual frequency significantly improved. Be well! JP
November 10th, 2017 at 1:48 pm
Updated 07/10/17:
https://www.thieme-connect.com/DOI/DOI?10.1055/s-0043-119751
Exp Clin Endocrinol Diabetes. 2017 Nov 8.
The Effects of Flaxseed Oil Omega-3 Fatty Acids Supplementation on Metabolic Status of Patients with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
Objective: This study was conducted to evaluate the effects of flaxseed oil omega-3 fatty acids supplementation on metabolic status of patients with polycystic ovary syndrome (PCOS).
Methods: This randomized double-blind, placebo-controlled trial was conducted on 60 women with PCOS according to the Rotterdam criteria aged 18-40 years old. Participants were randomly assigned into two groups to receive either 1,000 mg flaxseed oil omega-3 fatty acids (n=30) or placebo (n=30) twice a day for 12 weeks. Metabolic, endocrine, inflammatory factors were quantified at baseline and after the 12-week intervention.
Results: After the 12-week intervention, compared to the placebo, flaxseed oil omega-3 supplementation significantly decreased insulin values (-2.6±7.7 vs.+1.3±3.9 µIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (-0.7±1.7 vs.+0.3±0.9, P=0.01), mF-G scores (-1.2±1.7 vs. -0.1±0.4, P=0.001), and increased quantitative insulin sensitivity check index (+0.01±0.02 vs. -0.01±0.02, P=0.01). In addition, supplementation with flaxseed oil omega-3 resulted in significant decreases in serum triglycerides (-5.1±20.9 vs.+9.7±26.1 mg/dL, P=0.01), VLDL-cholesterol (-1.0±4.2 vs.+1.9±5.2 mg/dL, P=0.01) and high-sensitivity C-reactive protein (hs-CRP) (-1.6±3.1 vs.+0.2±1.5 mg/L, P=0.004) compared to the placebo. We did not see any significant effect of flaxseed oil omega-3 supplementation on hormonal and other lipid profiles, and plasma nitric oxide levels.
Conclusions: Overall, flaxseed oil omega-3 supplementation for 12 weeks in women with PCOS had beneficial effects on insulin metabolism, mF-G scores, serum triglycerides, VLDL-cholesterol and hs-CRP levels, but did not affect hormonal and other lipid profiles, and plasma nitric oxide levels.
Be well!
JP
December 23rd, 2017 at 9:36 pm
Updated 12/23/17:
https://www.ncbi.nlm.nih.gov/pubmed/29271278
Gynecol Endocrinol. 2017 Dec 22:1-6.
The effect of vitamin D supplementation on insulin resistance, visceral fat and adiponectin in vitamin D deficient women with polycystic ovary syndrome: a randomized placebo-controlled trial.
INTRODUCTION: Low plasma 25-hydroxy-vitamin D (25OHD) is associated with polycystic ovary syndrome (PCOS). Vitamin D deficiency may contribute to the development of insulin resistance, visceral fat and low level of adiponectin which are common feature in PCOS women. This study aimed to evaluate the effect of vitamin D supplementation on insulin resistance, visceral fat, and adiponectin in hypovitaminosis D women with polycystic ovary syndrome.
METHODS: In this randomized, placebo-controlled clinical trial, 44 PCOS women aged 20-38 years with plasma 25OHD <20 ng/mL were randomized in the intervention or placebo groups and followed for 8 weeks. Participants received 50,000 IU of oral vitamin D3 once weekly in the intervention group or placebo. The visceral adipose tissue, Insulin resistance (HOMA-IR), HOMA-B, QUICKI, and circulating adiponectin were compared before and after the intervention within groups using paired tests and the mean changes were analyzed between two groups by independent t-test.
RESULTS: Of 44 eligible participates, 36 patients (81.8%) completed the study. After 8 week intervention, vitamin D supplementation compared to the placebo group significantly decreased fasting plasma glucose (FPG) (7.67 ± 7.66 versus 1.71 ± 7.50 mg/dL, p = .001) and significantly increased homeostasis model of assessment-estimated B cell function (HOMA-B) (129.76 ± 121.02 versus 48.32 ± 128.35, p = .014), Adiponectin (5.17 ± 8.09 versus -5.29 ± 8.64 mg/dL, p = .001), and serum vitamin D level (28.24 ± 6.47 versus 3.55 ± 4.25 ng/mL, p = .001).
CONCLUSION: Vitamin D supplementation in vitamin D deficient women with PCOS, improved the FPG, HOMA-B, Adiponectin, and serum vitamin D level.
Be well!
JP
July 11th, 2018 at 6:50 pm
Updated 07/11/18:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961291/
J Res Med Sci. 2018 Apr 26;23:33.
Effect of chamomile capsule on lipid- and hormonal-related parameters among women of reproductive age with polycystic ovary syndrome.
Background: According to traditional herbal medicine, chamomile has been considered as one of the herbal remedies for patients with polycystic ovary syndrome (PCOS). The study aimed to investigate the effect of chamomile on lipid and hormonal parameters in women of reproductive age with PCOS.
Materials and Methods: This study is a randomized clinical trial which was conducted on 80 women (40 patients in each group) of childbearing age with PCO. The intervention group received 370 mg oral capsules of chamomile three times a day for 3 months. The control group did receive starch capsule (three times a day). Hormonal and lipid parameters were examined before and 3 months after the intervention.
Results: The mean age of the patients was 22.40 ± 5.10 and 24.38 ± 6.14 years in the intervention and control groups, respectively. Decreased level of testosterone was observed in the intervention group (in women with PCOS) who received chamomile capsules (P = 0.017). A significant difference was not seen in low-density lipoprotein cholesterol level (P = 0.249), high-density lipoprotein cholesterol (P = 0.073), triglycerides (P = 0.603), the hormone dehydroepiandrosterone sulfate (P = 0.423), and the ratio of luteinizing hormone/follicle-stimulating hormone (LH/FSH) in the experimental and control groups after the intervention (P = 0.420).
Conclusion: According to the findings, oral administration of chamomile capsule caused a significant decrease in total testosterone levels in these patients. However, no significant change was reported with lipid parameters, the ratio of LH/FSH, and dehydroepiandrosterone sulfate level.
Be well!
JP
August 1st, 2018 at 12:09 pm
Updated 08/01/18:
https://www.ncbi.nlm.nih.gov/pubmed/30062709
Phytother Res. 2018 Jul 30.
The effects of quercetin supplementation on metabolic and hormonal parameters as well as plasma concentration and gene expression of resistin in overweight or obese women with polycystic ovary syndrome.
The aim of this study was to investigate the effect of quercetin on metabolic and hormonal parameters as well as plasma concentration and gene expression of resistin in overweight or obese women with polycystic ovary syndrome (PCOS). In this randomized, double-blind, placebo-controlled trial, 78 overweight or obese women (25 ≤ BMI ≤ 40 kg/m2 , 20-40 years) with PCOS were recruited. Patients were randomized to receive 1,000 mg/day quercetin or placebo for 12 weeks. Resistin plasma concentration and gene expression in peripheral blood mononuclear cells, parameters of glucose homeostasis, circulatory testosterone, luteinizing hormone (LH), and sex hormone-binding globulin, and anthropometries were assessed at baseline and at the end of the study. Following supplementation, quercetin significantly decreased resistin concentration (2.07 ± 0.23 vs. 2.88 ± 0.40 ng/ml, p < 0.001) and mRNA level (0.64 ± 0.58 vs. 1 ± 0.56 fold change, p = 0.008), compared with placebo group. Moreover, testosterone (0.72 ± 0.15 vs. 0.76 ± 0.12 ng/ml, p = 0.001) and LH (8.05 ± 2.88 vs. 8.77 ± 1.99 mIU/ml, p = 0.035) concentrations were significantly lower in quercetin compared with placebo group. Fasting blood glucose (p < 0.001), insulin (p = 0.02), and homeostatic model assessment of insulin resistance (p = 0.009) decreased within the quercetin group; however, no significant differences were observed compared with the placebo group (p = 0.074, p = 0.226, p = 0.22, respectively). Quercetin supplementation decreased resistin plasma levels and gene expression, and testosterone and LH concentration in overweight or obese women with PCOS. Be well! JP
September 20th, 2018 at 1:48 pm
Updated 09/20/18:
https://www.tandfonline.com/doi/abs/10.1080/0167482X.2018.1508282?journalCode=ipob20
J Psychosom Obstet Gynaecol. 2018 Sep 19:1-9.
The effects of fish oil omega-3 fatty acid supplementation on mental health parameters and metabolic status of patients with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial.
OBJECTIVE: This study was conducted to evaluate the effects of fish oil omega-3 fatty acid supplementation on mental health parameters and metabolic status of women with polycystic ovary syndrome (PCOS).
METHODS: This randomized double-blind, placebo-controlled trial was conducted on 60 women with PCOS, aged 18-40 years old. Participants were randomly assigned into two groups to receive either 2 × 1000 mg/day fish oil omega-3 fatty acid (n = 30) or placebo (n = 30) after lunch for 12 weeks. Metabolic profiles were quantified at baseline and after the 12-week intervention.
RESULTS: Compared with the placebo, omega-3 fatty acid intake led to a significant improvement in Beck Depression Inventory [β (difference in the mean outcomes measures between treatment groups after intervention) -1.05; 95% CI: -1.84, -0.26; p = .01], general health questionnaire (β -1.68; 95% CI: -3.12, -0.24; p = .02) and depression anxiety and stress scale (β -2.03; 95% CI: -3.60, -0.46; p = .01). Omega-3 fatty acid supplementation significantly decreased serum insulin levels (β -2.09 µIU/mL; 95% CI: -3.77, -0.41; p = .01), homeostasis model of assessment-insulin resistance (β -0.74; 95% CI: -1.13, -0.34; p < .001), total testosterone (β -0.23 ng/mL; 95% CI: -0.39, -0.06; p = .03) and hirsutism (β -0.75; 95% CI: -1.17, -0.33; p = .001), and significantly increased the quantitative insulin sensitivity check index (β 0.01; 95% CI: 0.003, 0.02; p = .008) compared with the placebo. Additionally, omega-3 fatty acid intake resulted in a significant decrease in high sensitivity C-reactive protein (β -1.46 mg/L; 95% CI: -2.16, -0.75; p < .001) and malondialdehyde (β -0.28 µmol/L; 95% CI: -0.52, -0.05; p = .03); also significant rises in plasma total glutathione (β 59.09 µmol/L; 95% CI: 7.07, 111.11; p = .02) was observed compared with the placebo. Omega-3 fatty acid supplementation did not change other metabolic parameters. CONCLUSION: Overall, omega-3 fatty acid supplementation for 12 weeks to patients with PCOS had beneficial effects on mental health parameters, insulin metabolism, total testosterone, hirsutism and few inflammatory markers and oxidative stress. Be well! JP
October 11th, 2018 at 1:30 pm
Updated 10/11/18:
https://www.thieme-connect.com/DOI/DOI?10.1055/a-0749-6431
Horm Metab Res. 2018 Oct 4.
The Effect of Magnesium and Vitamin E Co-Supplementation on Glycemic Control and Markers of Cardio-Metabolic Risk in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.
Data on the effects of magnesium and vitamin E co-supplementation on glycemic control and markers of cardio-metabolic risk of patients with polycystic ovary syndrome (PCOS) were collected. This investigation was conducted to evaluate the effects of magnesium and vitamin E co-supplementation on glycemic control and markers of cardio-metabolic risk in women with PCOS. This randomized, double-blind, placebo-controlled trial was carried out on 60 women with PCOS, aged 18-40 years old. Participants were randomly divided into two groups to receive 250 mg/day magnesium plus 400 mg/day vitamin E supplements or placebo (n=30 each group) for 12 weeks. Fasting blood samples were taken at baseline and after the 12-week intervention to quantify related variables. After the 12-week intervention, compared with the placebo, magnesium and vitamin E co-supplementation led to a significant reduction in serum insulin levels (-1.1±3.0 vs. +1.6±3.7 μIU/ml, p=0.003) and homeostatic model of assessment for insulin resistance (-0.2±0.7 vs. +0.4±0.9, p=0.002), and a significant increase in the quantitative insulin sensitivity check index (+0.01±0.01 vs. -0.009±0.02, p=0.003). Furthermore, magnesium plus vitamin E supplementation significantly decreased serum triglycerides (-15.0±24.4 vs. +6.7±22.2 mg/dl, p=0.001) and VLDL-cholesterol concentrations (-3.0±4.9 vs. +0.6±2.4 mg/dl, P=0.01) compared with the placebo. A trend toward a greater decrease in total cholesterol levels was observed in magnesium plus vitamin E group compared to placebo group (-7.0±32.6 vs. +8.1±26.6 mg/dl, p=0.05). In conclusion, magnesium and vitamin E co-supplementation for 12 weeks to PCOS women had beneficial effects on parameters of insulin metabolism and few markers of cardio-metabolic risk.
Be well!
JP
January 23rd, 2019 at 2:32 pm
Updated 01/23/19:
https://www.ncbi.nlm.nih.gov/pubmed/30665436
J Ovarian Res. 2019 Jan 21;12(1):5.
Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome.
OBJECTIVE: The aim of this study was to determine the effect of vitamin D and probiotic co-administration on mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome (PCOS).
METHODS: This randomized, double-blinded, placebo-controlled clinical trial was carried out on 60 subjects, aged 18-40 years old. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 8 × 109 CFU/day probiotic (n = 30) or placebo (n = 30) for 12 weeks.
RESULTS: Vitamin D and probiotic co-supplementation, compared with the placebo, significantly improved beck depression inventory [β (difference in the mean of outcomes measures between treatment groups) - 0.58; 95% CI, - 1.15, - 0.02; P = 0.04], general health questionnaire scores (β - 0.93; 95% CI, - 1.78, - 0.08; P = 0.03) and depression, anxiety and stress scale scores (β - 0.90; 95% CI, - 1.67, - 0.13; P = 0.02). Vitamin D and probiotic co-supplementation was associated with a significant reduction in total testosterone (β - 0.19 ng/mL; 95% CI, - 0.28, - 0.10; P < 0.001), hirsutism (β - 0.95; 95% CI, - 1.39, - 0.51; P < 0.001), high-sensitivity C-reactive protein (hs-CRP) (β - 0.67 mg/L; 95% CI, - 0.97, - 0.38; P < 0.001) and malondialdehyde (MDA) levels (β - 0.25 μmol/L; 95% CI, - 0.40, - 0.10; P = 0.001), and a significant increase in total antioxidant capacity (TAC) (β 82.81 mmol/L; 95% CI, 42.86, 122.75; P < 0.001) and total glutathione (GSH) levels (β 40.42 μmol/L; 95% CI, 4.69, 76.19; P = 0.02), compared with the placebo. CONCLUSIONS: Overall, the co-administration of vitamin D and probiotic for 12 weeks to women with PCOS had beneficial effects on mental health parameters, serum total testosterone, hirsutism, hs-CRP, plasma TAC, GSH and MDA levels. Be well! JP
March 5th, 2019 at 10:44 pm
Updated 03/05/19:
https://www.sciencedirect.com/science/article/pii/S0165032718328210?via%3Dihub
J Affect Disord. 2019 Feb 26;250:51-56.
Effects of melatonin administration on mental health parameters, metabolic and genetic profiles in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial.
OBJECTIVE: The aim of this study was to evaluate the effect of melatonin supplementation on mental health parameters, metabolic and genetic parameters in women suffering from polycystic ovary syndrome (PCOS).
METHODS: This randomized, double-blinded, placebo-controlled clinical trial was performed on 58 subjects, aged 18-40 years old. Subjects were randomly allocated to take either 10 mg melatonin (2 melatonin capsules, 5 mg each) (n = 29) or placebo (n = 29) once a day 1 h before bedtime for 12 weeks. Glycemic control and lipid profiles were measured at baseline and after the 12-week intervention. Using RT-PCR method, gene expression related to insulin and lipid metabolism was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women.
RESULTS: Melatonin supplementation significantly decreased Pittsburgh Sleep Quality Index (β -2.15; 95% CI, -3.62, -0.68; P = 0.005), Beck Depression Inventory index (β -3.62; 95% CI, -5.53, -1.78; P<0.001) and Beck Anxiety Inventory index (β -1.95; 95% CI, -3.41, -0.48; P = 0.01) compared with the placebo. In addition, melatonin administration, compared with the placebo, significantly reduced serum insulin (β -1.20 µIU/mL; 95% CI, -2.14, -0.26; P = 0.01), homeostasis model of assessment-insulin resistance (HOMA-IR) (β -0.28; 95% CI, -0.50, -0.05; P = 0.01), serum total- (β -7.96 mg/dL; 95% CI, -13.75, -2.17; P = 0.008) and LDL-cholesterol levels (β -5.88 mg/dL; 95% CI, -11.42, -0.33; P = 0.03), and significantly increased the quantitative insulin sensitivity check index (QUICKI) (β 0.008; 95% CI, 0.002, 0.014; P = 0.007). Moreover, melatonin supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (P = 0.004) and low-density lipoprotein receptor (LDLR) (P = 0.01) compared with the placebo.
CONCLUSIONS: Overall, melatonin administration for 12 weeks had beneficial effects on mental health parameters, insulin levels, HOMA-IR, QUICKI, total- and LDL-cholesterol levels, and gene expression of PPAR-γ and LDLR among women with PCOS.
Be well!
JP
March 6th, 2019 at 1:14 pm
Updated 03/06/19:
https://www.tandfonline.com/doi/abs/10.1080/0167482X.2018.1557144?journalCode=ipob20
J Psychosom Obstet Gynaecol. 2019 Mar 5:1-9.
Carnitine and chromium co-supplementation affects mental health, hormonal, inflammatory, genetic, and oxidative stress parameters in women with polycystic ovary syndrome.
OBJECTIVE: The aim of this study was to evaluate the effect of the co-administration of carnitine and chromium on mental health, hormonal, inflammatory and genetic parameters in women with PCOS.
METHODS: This randomized, double-blinded, placebo-controlled clinical trial was conducted on 54 subjects, aged 18-40 years old. Subjects were randomly allocated to take either 1000 mg/d carnitine plus 200 µg/d chromium as chromium picolinate (n = 26) or placebo (n = 27) for 12 weeks.
RESULTS: Carnitine and chromium co-supplementation, compared with the placebo, significantly improved beck depression inventory (β - 0.84; 95% CI, -1.51, -0.17; p = 0.01), general health questionnaire scores (β - 1.13; 95% CI, -2.13, -0.14; p = 0.02) and depression anxiety and stress scale scores (β - 0.96; 95% CI, -0.78, -0.14; p = 0.02). Participants who received carnitine plus chromium supplements had significantly lower total testosterone (β - 0.15 ng/mL; 95% CI, -0.24, -0.06; p = 0.002), hirsutism (β - 0.48; 95% CI, -0.91, -0.06; p = 0.02), high-sensitivity C-reactive protein (hs-CRP) (β - 1.02 mg/L; 95% CI, -1.79, -0.25; p = 0.01), and malondialdehyde (MDA) levels (β - 0.38 µmol/L; 95% CI, -0.56, -0.20; p < 0.001), and higher total antioxidant capacity (TAC) levels (β 107.18 mmol/L; 95% CI, 44.24, 170.12; p = 0.001) compared with the placebo. Moreover, carnitine and chromium co-supplementation upregulated gene expression of interleukin-6 (IL-6) (p = 0.02) and tumor necrosis factor alpha (TNF-α) (p = 0.02) compared with the placebo.
CONCLUSION: Overall, the co-administration of carnitine and chromium for 12 weeks to women with PCOS had beneficial effects on mental health parameters, serum total testosterone, mF-G scores, hs-CRP, TAC and MDA levels, and gene expression of IL-6 and TNF-α.
Be well!
JP