Effect of Lifestyle Intervention on Features of Polycystic Ovarian Syndrome, Metabolic Syndrome, and Intima-Media Thickness in Obese Adolescent Girls
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/m2) 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.
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Intervention trials in adolescents with polycystic ovary syndrome have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance.
“These trials have also shown improvements related to hirsutism, ovulation, quality of life, sleep, lipid profile, adipocytokine levels, and insulin resistance [148-160]”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [148]
A low-carbohydrate diet (20 to 40 g/d) and a hypocaloric diet (<40 g of fat per day) during 12 weeks improved weight and menstrual irregularities with no difference between the diets.
“A low-carbohydrate diet (20 to 40 g/d) and a hypocaloric diet (<40 g of fat per day) during 12 weeks improved weight and menstrual irregularities with no difference between the diets.”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [160]
Family therapy in addition to other lifestyle interventions shows beneficial effects on adolescent PCOS symptoms.
“However, family therapy in addition to other lifestyle interventions show beneficial effects on adolescent PCOS symptoms, and a small open trial shows that cognitive behavior therapy improved depressive symptoms [160, 174].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [160]
Lifestyle interventions in adolescents with PCOS have shown additional improvements in quality of life.
“Lifestyle interventions in adolescents with PCOS have shown additional improvements in quality of life [160, 164, 165].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [160]
Nutrition education in addition to exercise training and behavioral therapy for 12 months resulted in weight loss, as well as improvement of menstrual irregularities and androgen levels in adolescents with obesity and PCOS.
“Nutrition education in addition to exercise training and behavioral therapy for 12 months resulted in weight loss, as well as improvement of menstrual irregularities and androgen levels in adolescents with obesity and PCOS [160].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [160]
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- Authors
- Lass, N., Kleber, M., Winkel, K., Wunsch, R., & Reinehr, T.
- Affiliations
- Witten/Herdecke University (DE)
- Corresponding author
- Reinehr, Thomas
- ORCID
- Reinehr, Thomas
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-11-01
- Volume
- 96
- Issue
- 11
- Pages
- 3533-3540
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2015915222
- Cited by
- 160
- References
- 40
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 10 · 2022: 12 · 2021: 7 · 2020: 10 · 2019: 16 · 2018: 12 · 2017: 12 · 2016: 12 · 2015: 20 · 2014: 9 · 2013: 14 · 2012: 9
- FWCI
- 11.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- START, Global Change System for Analysis, Research, and Training
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- polycystic ovary syndrome, lifestyle intervention, adolescent obesity, intima-media thickness, cardiovascular risk factors, weight loss, hyperandrogenemia, testosterone, sex hormone-binding globulin, menstrual irregularity, oligoamenorrhea, insulin, metabolic syndrome, nutrition education, exercise training, behavior therapy
- MeSH terms
- Adolescent, Body Composition, Child, Exercise Therapy, Female, Follow-Up Studies, Follicle Stimulating Hormone, Humans, Luteinizing Hormone, Life Style, Obesity, Polycystic Ovary Syndrome, Testosterone, Weight Loss, Body Mass Index, Treatment Outcome, Metabolic Syndrome, Waist Circumference, Carotid Intima-Media Thickness
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