The aim of the study was to investigate the changes in the clinical and biochemical parameters of adolescents on a low-carbohydrate diet in relation to their PCOS phenotype in the 3rd trimester.
Polycystic ovary syndrome (PCOS) is an endocrine-metabolic disorder characterized by menstrual irregularities, anovulation, clinical and/or biochemical symptoms of hyperandrogenism (hirsutism and/or acne), micropolycystic ovaries, and metabolic abnormalities. In addition, some clinical and laboratory phenotypic features have been defined that were not previously included in the PCOS definition criteria, but which complement the clinical picture and influence the severity and morbidity of the clinical picture. Phenotype A: HA + OD + PCOM; phenotype B: HA + OD; phenotype C: HA + PCOM and phenotype D: OD + PCOM.For adult patients, internationally recognized diagnostic criteria have been developed based on combinations of otherwise unexplained hyperandrogenism, anovulation and polycystic ovary and are covered by the Rotterdam Consensus Criteria. However, in the adolescent age group, the frequency of anovulatory cycles and associated menstrual irregularities, the frequent symptoms of hyperandrogenism and acne vulgaris in the developmental phase, the problems with testosterone measurement and the prevalence of polycystic ovarian morphology in normal adolescents complicate the diagnosis. PCOS is a serious clinical and psychological problem for adolescent girls. Key interventions include lifestyle modification, including diet, physical activity and weight loss. These measures have been shown to alter the course of the disease in overweight and obese girls. In particular, it is known that high glycemic index carbohydrate intake and glycemic load lead to a rapid rise in blood glucose levels and increased insulin production. It is therefore thought that reducing the amount of insulin could have a more positive effect on PCOS than the usual carbohydrates. A low-carbohydrate diet is an effective, weight-independent approach in the treatment of metabolic disorders in PCOS patients. With this in mind, this study aimed to evaluate the clinical and biochemical outcomes at month 3 after application of the low-carbohydrate diet in adolescents according to their PCOS phenotype.
Study Type
OBSERVATIONAL
Enrollment
60
Each patient will receive a 3-month low-carbohydrate (40% CHO) diet from the same dietitian. Whether the patients adhere to the diet and which components the prescribed diet consists of is recorded in detail. After 3 months of standard application, the patient is examined again by the gynecologist and obstetrician at the PCOS clinic.
Etlik Zübeyde Hanım
Ankara, Turkey (Türkiye)
demographic datas on the study
Age
Time frame: 3 months
Evaluation of demographic data
Smoking
Time frame: 3 months
Demographic data at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
Body mass index Calculation of BMI: Height and body weight of the patients were measured using professionally calibrated devices. BMI was calculated using the formula BMI = weight (kg)/height (m)2.
Time frame: 3 months
Evaluation of clinical results at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
waist circumference(centimeters)
Time frame: 3 months
Evaluation of degree of hirsutism at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
degree of hirsutism (Ferriman-Gallwey Hirsutism Scoring Scale; lowest 8 highest: 24)
Time frame: 3 months
Hormone results at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
prolactin (ng/mL)
Time frame: 3 months
androstenedione at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
androstenedione (mosm/kg)
Time frame: 3 months
dehydroepiandrosterone sulfate at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
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dehydroepiandrosterone sulfate (DHEA-S) (μg/dL)
Time frame: 3 months
TSH at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
thyroid stimulating hormone (TSH) (mIU/mL)
Time frame: 3 months
SHBG at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
Hormone test results : sex hormone-binding globulin (SHBG)
Time frame: 3 months
17-OH progesterone at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
17-OH progesterone (mIU/mL)
Time frame: 3 months
Testosterone at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
free and total testosterone (ng/mL)
Time frame: 3 months
Lipid profile at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
Lipid profile: Total cholesterol (mg/dL), high-density lipoprotein (HDL) cholesterol (mg/dL), low-density lipoprotein (LDL) cholesterol (mg/dL), triglycerides (mg/dL).
Time frame: 3 months
Glucose at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
fasting blood glucose
Time frame: 3 months
Evaluation of insulin resistance at month 3 after application of a low-carbohydrate diet according to PCOS phenotypes in adolescents.
Calculation of insulin resistance: A fasting blood glucose level between 100-125 mg/dl was considered as 'impaired fasting glucose'. A Homeostatic Model Assessment Insulin Resistance (HOMA-IR) value of ≥2.5 was defined as insulin resistance. Insulin resistance was calculated using the formula of the homeostatic model. \[HOMA-IR= fasting glucose (mg/dl)xfasting insulin (mIU/mL)/405\].
Time frame: 3 months