Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 21;13(16):4934.
doi: 10.3390/jcm13164934.

The Impact of Diet-Induced Weight Loss on Inflammatory Status and Hyperandrogenism in Women with Polycystic Ovarian Syndrome (PCOS)-A Systematic Review and Meta-Analysis

Salih Atalah Alenezi  1   2 , Nusaiba Elkmeshi  1 , Abdullah Alanazi  3 , Sulaiman T Alanazi  3 , Raheela Khan  1 , Saad Amer  1
Affiliations
Review

The Impact of Diet-Induced Weight Loss on Inflammatory Status and Hyperandrogenism in Women with Polycystic Ovarian Syndrome (PCOS)-A Systematic Review and Meta-Analysis

Salih Atalah Alenezi et al. J Clin Med. .

Abstract

Background: Currently, the primary strategy for addressing polycystic ovarian syndrome (PCOS) involves lifestyle modifications, with a focus on weight loss. The purpose of this meta-analysis was to assess the impact of weight loss through dietary interventions on inflammatory status and hyperandrogenism in PCOS women. Methods: A comprehensive search was conducted to identify randomised controlled trials (RCTs) and cohort studies assessing the impact of diet-induced weight loss on circulating inflammatory markers (CRP, IL-6, IL-1β, TNF-α), androgens (testosterone, androstenedione), SHBG, and luteinising hormone (LH) in PCOS women. The quality and risk of bias of the included studies were assessed using the Cochrane Collaboration's tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. Data were entered into RevMan software v5.9 for the calculation of standard mean difference (SMD) and the 95% confidence interval (95%CI) of circulating inflammatory markers, androgens, and LH between baseline and post-weight loss values. Results: Eleven studies (n = 323) were eligible for the systematic review, of which nine (n = 286) were included in the meta-analysis. Pooled analysis of data revealed a statistically significant decrease in circulating CRP (SMD 0.39, 95%CI 0.22, 0.56; 9 studies, n = 286), IL-6 (SMD 0.37, 95%Cl, 0.12, 0.61; 3 Studies, n = 140), TNF-α (SMD 0.30, 95%Cl, 0.07, 0.53; 4 Studies, n = 162), androstenedione (SMD 0.36, 95%Cl, 0.13, 0.60; 4 studies, n = 147) and LH (SMD 0.30, 95% Cl, 0.09, 0.51; 5 studies, n = 197) after weight loss compared to baseline levels among PCOS women. A meta-analysis of five studies (n = 173) showed a statistically significant increase in circulating SHBG after weight loss compared to baseline levels (SMD -0.43, 95%Cl, -0.65, -0.21). Conclusions: These findings suggest that weight loss induced by dietary interventions seems to improve PCOS-related chronic inflammation and hyperandrogenism. The possible causative relationship between the improvement in inflammation and hyperandrogenism remains to be determined.

Keywords: CRP; PCOS; chronic inflammation; hyperandrogenism; obesity; weight loss.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart.
Figure 2
Figure 2
Risk of bias assessments of individual RCTs [26,31,32,33,34,44,47].
Figure 3
Figure 3
Overall CRP pooled analysis of 9 studies [26,31,32,33,34,44,46,47,49].
Figure 4
Figure 4
CRP pooled analysis for periods of both less than and more than eight weeks [26,31,32,33,34,44,46,47,49].
Figure 5
Figure 5
IL-6 meta-analysis of 3 studies [31,32,48].
Figure 6
Figure 6
TNF-α pooled analysis of 4 studies [31,32,45,48].
Figure 7
Figure 7
Testosterone meta-analysis of 5 studies [32,34,44,45,48].
Figure 8
Figure 8
SHBG pooled analysis of 5 studies [31,32,44,45,48].
Figure 9
Figure 9
Androstenedione pooled analysis of 4 studies [32,44,45,48].
Figure 10
Figure 10
DHEAS data analysis of 6 studies [31,32,34,44,45,48].
Figure 11
Figure 11
LH pooled analysis of 5 studies [32,33,44,45,48].
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Clark N.M., Podolski A.J., Brooks E.D., Chizen D.R., Pierson R.A., Lehotay D.C., Lujan M.E. Prevalence of polycystic ovary syndrome phenotypes using updated criteria for polycystic ovarian morphology: An assessment of over 100 consecutive women self-reporting features of polycystic ovary syndrome. Reprod. Sci. 2014;21:1034–1043. doi: 10.1177/1933719114522525. - DOI - PMC - PubMed
    1. Setji T.L., Brown A.J. Polycystic ovary syndrome: Update on diagnosis and treatment. Am. J. Med. 2014;127:912–919. doi: 10.1016/j.amjmed.2014.04.017. - DOI - PubMed
    1. Lim S.S., Davies M., Norman R.J., Moran L. Overweight, obesity and central obesity in women with polycystic ovary syndrome: A systematic review and meta-analysis. Hum. Reprod. Update. 2012;18:618–637. doi: 10.1093/humupd/dms030. - DOI - PubMed
    1. Diamanti-Kandarakis E., Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: An update on mechanisms and implications. Endocr. Rev. 2012;33:981–1030. doi: 10.1210/er.2011-1034. - DOI - PMC - PubMed
    1. Cho L.W., Randeva H.S., Atkin S.L. Cardiometabolic aspects of polycystic ovarian syndrome. Vasc. Health Risk Manag. 2007;3:55–63. - PMC - PubMed

LinkOut - more resources