Objectives: The aim of this study was to evaluate the effects of a hypo caloric (1500 Kcal) and hypo glycidic diet (43% of the daily Kcal intake) on the ultrasonographic picture of PCOS.Weight loss, with an insulin resistance reduction, would seem to be successful in treating metabolic, hormone and ultrasonographic alterations seen in PCOS. Materials: 40 women with PCOS, non diabetic and not being treated with hormones (oral contraceptives) or insulin sensitizers for at least two months. Women suffering from eating disorders were excluded from the study. PCOS was diagnosed on the basis of the criteria established by the Consensus Conference in Rotterdam 2993 ESHRE/ASRM. The average age of the patients was 28 (from 17 to 41 years of age) . Only 32 % of patients were of normal weight, 21 % were overweight and 42 % were slightly or moderately obese, while 5 % were seriously obese. The average BMI was 27 Kg/m2 (range from 23 to 48 Kg/m2). In the group examined, menstruation was regular for 9 patients (22,5% of cases) before the diet. Of the remaining 77,5% of cases, 76% were oligomenorrhoeal and 24% were amenorrhoeal. Increased ovary volume (>10,8 ml) was observed in 65% of the total number of cases and 90% of these occurred in concomitance with the increased number of follicles >10 (75% ) and/or with an increased stroma (77,5% ). Results: after 6 months of dieting a reduction in weight was observed varying between 4.7% and 7% with a subsequent decrease of insulinaemia while fasting (range of reduction 60-18%), systolic and diastolic artery pressure , with a greater load reduction of this latter, glycaemia reduced to 12% or less, FAI by 39%, and triaglyceridaemia by 18%. It is possible that the benefits observed in this study can be attributed to the fact that the diet is hyper glycidic Conclusions : The first therapeutic approach for PCOS should always be a hyper caloric and hyper glycidic diet for its elevated clinical efficiency, thanks to the significant regularization of the menstruation cycle, which can be verified ultrasonographically, seen in 70% of the cases (28 patients) during a follow up after 6 months. An improved ultrasonic picture of the PCOS gradually appeared for the stromal component and the thickening of the ovary cortical while, in 60% of cases during the follow up after only 3months, the number of ovary follicles had already increased in compliance with a revival of menstrual regularity.
Obiettivi dello studio: scopo del nostro studio è stato quello di valutare gli effetti di un regime dietetico ipocalorico (1500 Kcal) ed ipoglicidico (43% dell’apporto Kcal giornaliero) sul quadro ecografico della PCOS. La perdita di peso, accompagnata alla riduzione dell’insulino-resistenza, sembrerebbe aver successo nel trattamento delle alterazioni metaboliche, ormonali ed ultrasonografiche caratteristiche della PCOS. Materiali: Abbiamo arruolato 40 donne con PCOS, non diabetiche e non in trattamento insulino-sensibilizzante né ormonale (contraccezione orale) da almeno 2 mesi. Abbiamo escluso dallo studio anche le donne con storie di disturbi alimentari. La diagnosi di PCOS è stata posta sulla base dei criteri revisionati dalla Consensus Conference di Rotterdam 2003 ESHRE/ASRM. L’età media delle pazienti è stata di 28 anni (da 17 a 41 anni). Solo il 32% delle pazienti è risultata normopeso, il 21% è sovrappeso, il 42% è affetto da obesità lieve o moderata, il 5% da un’obesità severa. Il BMI medio è stato 27 Kg/m2 (range da 23 a 48 Kg/m2). Nella popolazione in esame le mestruazioni erano regolari in 9 pazienti (22,5% dei casi) prima della dieta. Del restante 77,5% dei casi, il 76% era olimenorroico ed il 24% era amenorroico. Aumentato volume ovarico (>10,8 ml) si riscontra nel 65% del totale dei casi e nel 90% di questi si verifica in concomitanza con l’aumentato numero dei follicoli >10 (75% dei casi) e/o con l’aumento dello stroma (77,5% dei casi). Risultati: dopo 6 mesi di dieta si è registrata una riduzione del peso variabile tra il 4,7% ed il 7% con conseguente diminuzione dell’insulinemia a digiuno (range di riduzione 60-18%), della pressione arteriosa sistolica e diastolica, con maggiori decrementi a carico di quest’ultima, della gilcemia fino al 12% in meno, del FAI del 39%, della trigliceridemia fino al 18%. E’ possibile che i benefici osservati in questo studio siano attribuibili al fatto che la dieta è ipoglucidica. Conclusioni: il primo approccio terapeutico nella PCOS dovrebbe essere una dita ipocalorica ed ipoglucidica per la sua elevata efficacia clinica, grazie alla significativa regolarizzazione dei cicli mestruali, documentabile ecograficamente nel 70% dei casi (28 casi) al follow-up a 6 mesi. Il miglioramento del quadro ecografico della PCOS si è dimostrato lentamente progressivo per quanto riguarda la componente stromale e l’ispessimento della corticale ovarica mentre è già evidente nel 60% dei casi nel follow-up a 3 mesi per quanto riguarda il numero dei follicoli ovarici in conformità con il ripristino della regolarità metruale.
Effetti di un regime dietetico ipocalorico ed ipoglicidico sugli aspetti ecografici dell’ovaio nella PCOS
CARBONARO, Antonio;CIANCI, Antonio
2008-01-01
Abstract
Objectives: The aim of this study was to evaluate the effects of a hypo caloric (1500 Kcal) and hypo glycidic diet (43% of the daily Kcal intake) on the ultrasonographic picture of PCOS.Weight loss, with an insulin resistance reduction, would seem to be successful in treating metabolic, hormone and ultrasonographic alterations seen in PCOS. Materials: 40 women with PCOS, non diabetic and not being treated with hormones (oral contraceptives) or insulin sensitizers for at least two months. Women suffering from eating disorders were excluded from the study. PCOS was diagnosed on the basis of the criteria established by the Consensus Conference in Rotterdam 2993 ESHRE/ASRM. The average age of the patients was 28 (from 17 to 41 years of age) . Only 32 % of patients were of normal weight, 21 % were overweight and 42 % were slightly or moderately obese, while 5 % were seriously obese. The average BMI was 27 Kg/m2 (range from 23 to 48 Kg/m2). In the group examined, menstruation was regular for 9 patients (22,5% of cases) before the diet. Of the remaining 77,5% of cases, 76% were oligomenorrhoeal and 24% were amenorrhoeal. Increased ovary volume (>10,8 ml) was observed in 65% of the total number of cases and 90% of these occurred in concomitance with the increased number of follicles >10 (75% ) and/or with an increased stroma (77,5% ). Results: after 6 months of dieting a reduction in weight was observed varying between 4.7% and 7% with a subsequent decrease of insulinaemia while fasting (range of reduction 60-18%), systolic and diastolic artery pressure , with a greater load reduction of this latter, glycaemia reduced to 12% or less, FAI by 39%, and triaglyceridaemia by 18%. It is possible that the benefits observed in this study can be attributed to the fact that the diet is hyper glycidic Conclusions : The first therapeutic approach for PCOS should always be a hyper caloric and hyper glycidic diet for its elevated clinical efficiency, thanks to the significant regularization of the menstruation cycle, which can be verified ultrasonographically, seen in 70% of the cases (28 patients) during a follow up after 6 months. An improved ultrasonic picture of the PCOS gradually appeared for the stromal component and the thickening of the ovary cortical while, in 60% of cases during the follow up after only 3months, the number of ovary follicles had already increased in compliance with a revival of menstrual regularity.File | Dimensione | Formato | |
---|---|---|---|
Effetti di un regime dietetico ipocalorico ed ipoglicidico sugli aspetti ecografici dell’ovaio nella PCOS..pdf
solo gestori archivio
Licenza:
Non specificato
Dimensione
2.2 MB
Formato
Adobe PDF
|
2.2 MB | Adobe PDF | Visualizza/Apri |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.