超重/肥胖PCOS患者低碳水化合物饮食与限制能量平衡膳食干预的减重比较研究  

Comparative study of weight loss between low carbohydrate diets and calorie restrict diet in overweight/obese patients with PCOS

作　　者：金莉娅[1] 游丽娟 李静[1] 王燕炯 李慧敏[2] Jin Li-ya;You Li-juan;Li jing;Wang Yan-jiong;Li Hui-min(Health Management Center,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;Woman Health Care,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院健康管理中心,甘肃兰州730050 [2]甘肃省妇幼保健院妇女保健科,甘肃兰州730050

出　　处：《兰州大学学报（医学版）》2022年第5期51-56,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省自然科学基金资助项目(20JR10RA425);兰州市科技发展指导性计划资助项目(2020-ZD-4)。

摘　　要：目的 探讨低碳水化合物饮食(LCD)与限制能量平衡膳食(CRD)干预对超重/肥胖多囊卵巢综合征(PCOS)患者的体成分、代谢指标、生殖内分泌指标及妊娠的影响。方法 选择就诊于甘肃省妇幼保健院的PCOS患者285例,将患者分为LCD组、CRD组和对照组,每组95例。分别观察各组干预10周前后和干预结束4周后的体成分变化情况,以及干预前后的内分泌代谢指标变化,并随访1年后的妊娠结局。结果 LCD组和CRD组减重后的体质量指数、体重、体脂率、腰围、腰臀比和内脏脂肪等级均明显低于减重前,差异有统计学意义(P<0.05),对照组体重、体质量指数值较减重前降低,差异有统计学意义(P<0.05);LCD组和CRD组减重后的甘油三酯、空腹胰岛素、谷草转氨酶、谷丙转氨酶和尿酸均明显低于减重前,差异有统计学意义(P<0.05);随访观察1年内失访情况LCD组和CRD组明显低于对照组,LCD组和CRD组PCOS患者干预后临床妊娠率明显高于对照组。结论 LCD和CRD均能有效减重,改善PCOS患者的体成分和内分泌等代谢指标,并能提高妊娠率,但CRD更适合长期减重。Objective To investigate the effects of low carbohydrate diet(LCD)and calorie restrict diet(CRD)intervention on body composition,metabolic indicators,reproductive endocrine in overweight/obese polycystic ovary syndrome(PCOS)patients'indicators and also on pregnancy.Methods 285 PCOS patients who were treated in Gansu Provincial Maternity and Child-care Hospital were selected,and were divided into a LCD group,CRD group and control group,with 95 patients in each group.The changes in body composition before and after 10 weeks of intervention and 4 weeks after the intervention,as well as the changes in endocrine and metabolic indexes before and after intervention in each group were observed,and the pregnancy outcomes followed up for 1 year.Results The body mass index,body weight,body fat percentage,waist circumference,waist-to-hip ratio and visceral fat area after weight loss in the LCD group and the CRD group were significantly lower than those before weight loss,and the difference was statistically significant(P<0.05).The weight and body mass index of the control group were lower than those before weight loss,and the difference was statistically significant(P<0.05).The triglyceride,fasting insulin,aspartate aminotransferase,alanine aminotransferase and uric acid after weight loss in the LCD group and CRD group were significantly lower than those before weight loss,and the difference was statistically significant(P<0.05).As for the loss to follow-up and pregnancy,the situation of loss to follow-up within 1 year was observed,the LCD group and the CRD group were significantly lower than the control group.For pregnancy,the clinical pregnancy rate of PCOS patients in the LCD group and the CRD group was significantly higher than that in the control group.Conclusion Both LCD and CRD can effectively lose weight,improve metabolic indicators such as body composition and endocrine in PCOS patients,and increase the pregnancy rate,but CRD is more suitable for long-term weight loss.

关 键 词：多囊卵巢综合征 限制能量平衡膳食 低碳水化合物饮食 减重 

分 类 号：R151.1[医药卫生—营养与食品卫生学]