| ObjectiveTo evaluate the effects of health education intervention,low-carbohydrate diet fortification intervention and low-fat diet fortification intervention on the weight,reproductive endocrine,metabolism and pregnancy outcome of obese women with PCOS.Providing reference basis for non-pharmacological intervention strategies for PCOS patients.Methods101 patients with polycystic ovary syndrome and obesity who were treated at the second Hospital of Jilin University from October 2019 to October 2020 were selected.Subjects meeting the inclusion and exclusion criteria were randomly divided into three groups after obtaining informed consent,including 35 cases in the health education group,34 cases in the low-fat diet fortification intervention group,and 32 cases in the low-carbohydrate diet fortification intervention group.The intervention process includes preparation phase,weight loss phase,ovulation induction phase and pregnancy follow-up.Comparison and analysis of the weight loss effects of three different intervention methods in PCOS obese patients,changes in reproductive hormone levels,changes in glucose and lipid metabolism indicators,and pregnancy outcomes.Results1.Before the intervention,there were no significant differences in the average age,years of infertility,baseline physical examination(BMI,weight,waist circumference,hip circumference),reproductive hormone levels(FSH,LH,E2,P,PRL,T)and various metabolic indicators(TC,TG,LDL-C,HDL-C,FPG,FINS,HOMA-IR)among the three groups(P>0.05).2.Before and after the intervention,there were statistically significant differences in the body weight,BMI,waist and hip circumference of the three groups of intervention patients(P<0.05).After the intervention,compared with the health education group and the low-fat diet intervention group,the body weight,BMI,waist circumference and hip circumference of the low-carbohydrate intervention group were significantly lower,and the differences were statistically significant(P<0.05).3.Before and after intervention,there was no significant difference in serum E2,P,PRL,FSH,LH levels among the three groups(P>0.05).However,serum T level decreased significantly(P<0.001),and the difference was statistically significant.After the intervention,the serum T levels of the three groups were statistically different(P<0.001).Compared with the health education group and the low-fat diet intervention group,the serum T levels of the low-carbohydrate group were significantly lower(P<0.001).After intervention,there were no significant differences in E2,P,PRL,FSH,LH levels among the three groups(P>0.05).4.Comparing within the group before and after intervention,there was no significant difference in FPG,FINS and HOMA-IR levels in the health education group(P>0.05).The level of HOMA-IR in the low-fat diet intervention group was significantly decreased after the intervention(P<0.001),and there was no statistical difference in the levels of FPG and FINS(P>0.05).The levels of FINS and HOMA-IR in the low-carbohydrate diet intervention group were significantly decreased after the intervention(P<0.001),and there was no significant difference in FPG levels(P>0.05).Compared with the three groups after the intervention,the FINS and HOMA-IR levels of the low-carbohydrate intervention group after the intervention were significantly lower(P<0.05),but there was no statistical difference in the FPG level.5.In comparison between before and after the intervention,the serum TG,TC and LDL-C levels of the three groups decreased after the intervention,the difference was statistically significant(P<0.05),while the HDL-C level was not statistically different(P>0.05).Comparing the three groups after the intervention,compared with the health education group and the low-fat diet intervention group,the TG level of the low-carbohydrate intervention group was significantly lower,and the difference was statistically significant(P<0.05).There was no statistical difference in the levels of TC,LDL-C and HDL-C in the three groups after intervention(P>0.05).6.There was no statistically significant difference in the spontaneous pregnancy rate and abortion rate in the health education group,low-fat diet intervention group,and low-carbohydrate diet intervention group(P>0.05),but there was a statistical difference in pregnancy rate after ovulation induction.The clinical pregnancy rate of the low-carbohydrate group was higher than that of the low-fat diet intervention group and the health education group,and the difference was statistically significant(P<0.05).Conclusion1.Health education,low-fat fortified diet intervention and low-carbohydrate diet intervention can reduce the weight,BMI,waist and hip circumference of obese patients with polycystic ovary syndrome.Among them,the weight loss effect of low-carbohydrate diet is more significant after three months of intensive intervention2.Health education,low-fat diet intervention and low-carbohydrate diet intervention can improve reproductive hormone levels and glucose and lipid metabolism indicators in obese patients with polycystic ovary syndrome.After three months of intervention,low-carbohydrate diet can significantly ameliorate high androgen levels,insulin resistance and serum TG levels3.After three months of intensive intervention,the clinical pregnancy rate of obese polycystic ovary syndrome patients with low carbohydrate diet intervention was higher after ovulation induction. |
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