Metabolic health during a randomized controlled lifestyle intervention in women with PCOS

Abstract

Context Women with polycystic ovary syndrome (PCOS) have an increased risk of metabolic syndrome (MetS). Both PCOS and MetS are associated with excess weight. Objective To examine the effect of a three-component lifestyle intervention (LSI) with or without short message service (SMS+ or SMS−, respectively) on the prevalence and severity of MetS and metabolic parameters, compared to care as usual (CAU). Design Randomized controlled trial. Methods Women diagnosed with PCOS and a BMI >25 kg/m2 (n = 183) were either assigned to a 1-year three-component (cognitive behavioural therapy, diet, and exercise) LSI, with or without SMS support, or to CAU which provided weight-loss advice only. Main outcome measures included changes in the prevalence of MetS, the continuous MetS severity z-score (cMetS z-score), metabolic parameters, and the impact of weight loss. Results After 1 year, the decrease in the cMetS z-score was greater in the SMS+ group than the CAU group (−0.39, P  = 0.015). The prevalence of MetS changed with −21.6% (P  = 0.037), −16.5% (P  = 0.190), and +7.0% (P  = 0.509) in both LSI groups and CAU group, respectively. A post hoc analysis for both LSI groups combined vs CAU resulted in a MetS difference of −25.9% (P  = 0.046). Moreover, weight loss per se resulted in significantly favourable effects on all metabolic parameters. Conclusions This three-component LSI was more successful in improving metabolic health compared to CAU. Therefore, we recommend this intervention to women with PCOS and excess weight, provided that a clinically relevant weight loss is being pursued.