IJPR.2018.128

Type of Article:  Original Research

Volume 6; Issue 3 (May 2018)

Page No.: 2740-2747

DOI: https://dx.doi.org/10.16965/ijpr.2018.128

EFFECT OF DIET CONTROL THERAPY ON THE DERMATOLOGICAL SYMPTOMS OF OBESE POLYCYSTIC OVARIAN SYNDROME WOMEN: REPEATED MEASURE DESIGN

Noha F. Mahmoud *.

* Department of Physical Therapy for Surgery, Faculty of Physical Therapy, October 6 University.

* Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University.

Corresponding author: Noha Fekry Mahmoud, Department of Physical Therapy for Surgery, Faculty of Physical Therapy, October 6 University. Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University.

E-Mail: nfmahmoud@pnu.edu.sa; nohfek@gmail.com

ABSTRACT

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrinal disorder in female causing metabolic, cutaneous, and reproductive disorders.

Purpose:  This repeated measure study was designed to investigate the effect of diet control therapy on hyperandrogen symptoms (Acne & Hirsutism) in obese PCOS women.

Subjects and Methods: Thirty PCOS obese women were recruited, their age ranged from 20 to 30 years and their BMI ranged from 30 to 34.9 kg/m2. All of them received diet control therapy, and were evaluated before, after 12 weeks and after 24 weeks of therapy through measuring their weight, C-reactive protein, luteinizing hormone (LH) / follicular stimulating hormone (FSH) ratio, androgen excess symptoms (modified Ferryman–Gallwey (mFG) scoring system & global acne grading system (GAGS).

Results: Repeated Measure MANOVA showed a statistically significant difference (P < 0.05) between the pre-treatment compared to after therapy (in both 12 and 24 weeks) in LH/FSH ratio, CRP, mFG and GAGS, however no significance difference was found between 12 weeks and 24 weeks for all the dependent variables. As well as, Pearson’s product-moment correlation revealed a weak positive correlation between C-reactive protein and androgen excess symptoms (Acne & Hirsutism).

Conclusion: Three months following the recommended diet control therapy is an effective therapy for improving the cutaneous symptoms and fertility through the hormonal variables of PCOS patients. Diet control therapy for another consequent three months is also recommended to keeping this improvement.

Key words: Polycystic ovarian syndrome, Diet therapy, Hyperandrogen, hirsutism, Acne.

REFERENCES

  1. Afifi L, Saeed L, Pasch LA, Huddleston HG, Cedars MI, Zane LT, Shinkai K. Association of ethnicity, Fitzpatrick skin type, and hirsutism: A retrospective cross-sectional study of women with polycystic ovarian syndrome. International journal of women’s dermatology. 2017 Mar 1;3(1):37-43.
  2. Eisenhardt S, Schwarzmann N, Henschel V, Germeyer A, Von Wolff M, Hamann A, Strowitzki T. Early effects of metformin in women with polycystic ovary syndrome: a prospective randomized, double-blind, placebo-controlled trial. The Journal of Clinical Endocrinology & Metabolism. 2006 Mar 1;91(3):946-52.
  3. Foda AA, Foda EA, Abel-Aal I. Serum Irisin levels as a marker in some phenotypes of PCOS. Middle East Fertility Society Journal. 2017 Sep 22.
  4. Mihailidis J, Dermesropian R, Taxel P, Luthra P, Grant-Kels JM. Endocrine evaluation of hirsutism. International journal of women’s dermatology. 2017 Mar 1;3(1):S6-10.
  5. Sachdeva S. Fitzpatrick skin typing: applications in dermatology. Indian Journal of Dermatology, Venereology, and Leprology. 2009 Jan 1;75(1):93.
  6. Schmidt TH, Khanijow K, Cedars MI, Huddleston H, Pasch L, Wang ET, Lee J, Zane LT, Shinkai K. Cutaneous findings and systemic associations in women with polycystic ovary syndrome. JAMA dermatology. 2016 Apr 1;152(4):391-8.
  7. Khomami MB, Tehrani FR, Hashemi S, Farahmand M, Azizi F. Of PCOS symptoms, hirsutism has the most significant impact on the quality of life of Iranian women. PloS one. 2015 Apr 15;10(4):e0123608.
  8. Uysal G, Sahin Y, Unluhizarci K, Ferahbas A, Uludag SZ, Aygen E, Kelestimur F. Is acne a sign of androgen excess disorder or not?. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2017 Apr 1;211:21-5.
  9. Hacivelioglu S, Gungor AN, Gencer M, Uysal A, Hizli D, Koc E, Cosar E. Acne severity and the Global Acne Grading System in polycystic ovary syndrome. International Journal of Gynecology & Obstetrics. 2013 Oct 1;123(1):33-6.
  10. Özdemir S, Özdemir M, Görkemli H, Kiyici A, Bodur S. Specific dermatologic features of the polycystic ovary syndrome and its association with biochemical markers of the metabolic syndrome and hyperandrogenism. Acta obstetricia et gynecologica Scandinavica. 2010 Feb 1;89(2):199-204..
  11. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. The Journal of Clinical Endocrinology & Metabolism. 2004 Jun 1;89(6):2745-9.
  12. Eleftheriadou M, Stefanidis K, Lykeridou K, Iliadis I, Michala L. Dietary habits in adolescent girls with polycystic ovarian syndrome. Gynecological Endocrinology. 2015 Apr 3;31(4):269-71.
  13. Marzouk TM, Ahmed WA. Effect of dietary weight loss on menstrual regularity in obese young adult women with polycystic ovary syndrome. Journal of pediatric and adolescent gynecology. 2015 Dec 1;28(6):457-61.
  14. Moran LJ, Brinkworth GD, Norman RJ. Dietary therapy in polycystic ovary syndrome. InSeminars in reproductive medicine 2008 Jan (Vol. 26, No. 01, pp. 085-092). © Thieme Medical Publishers.
  15. Harris JA, Benedict FG. A biometric study of human basal metabolism. Proceedings of the National Academy of Sciences. 1918 Dec 1;4(12):370-3.
  16. Fauser BC, Tarlatzis B, Chang J, Azziz R, Legro R, Dewailly D, Franks S, Balen AH, Bouchard P, Dahlgren E. The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-7.
  17. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, Boivin J. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertility and sterility. 2012 Jan 1;97(1):28-38.
  18. Hoeger K. Obesity and weight loss in polycystic ovary syndrome. Obstetrics and Gynecology Clinics. 2001 Mar 1;28(1):85-97.
  19. Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. International journal of dermatology. 1997 Jun 1;36(6):416-8.
  20. Lim AJ, Huang Z, Chua SE, Kramer MS, Yong EL. Sleep duration, exercise, shift work and polycystic ovarian syndrome-related outcomes in a healthy population: A cross-sectional study. PloS one. 2016 Nov 21;11(11):e0167048.
  21. Martinez-Bermejo E, Luque-Ramirez M, Escobar-Morreale HF. Obesity and the polycystic ovary syndrome. Minerva endocrinologica. 2007 Sep;32(3):129-40.
  22. Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertility and sterility. 2008 Apr 1;89(4):899-906.
  23. Omar AN, Habib F, Mojaddidi M, El-Bab MF. Body weight reduction and metformin: Roles in polycystic ovary syndrome. Pathophysiology. 2013 Apr 1;20(2):131-7.
  24. Douglas CC, Gower BA, Darnell BE, Ovalle F, Oster RA, Azziz R. Role of diet in the treatment of polycystic ovary syndrome. Fertility and sterility. 2006 Mar 1;85(3):679-88.
  25. Stamets K, Taylor DS, Kunselman A, Demers LM, Pelkman CL, Legro RS. A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. Fertility and sterility. 2004 Mar 1;81(3):630-7.
  26. Moran LJ, Noakes M, Clifton PM, Tomlinson L, Norman RJ. Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2003 Feb 1;88(2):812-9.
  27. Moran LJ, Noakes M, Clifton PM, Wittert GA, Williams G, Norman RJ. Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome–. The American journal of clinical nutrition. 2006 Jun 1;84(1):77-87..
  28. Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome–. The American journal of clinical nutrition. 2010 May 19;92(1):83-92.
  29. Anwar S, Shikalgar N. Prevention of type 2 diabetes mellitus in polycystic ovary syndrome: A review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017 Jul 8.
  30. Bako AU, Morad S, Atiomo WA. Polycystic ovary syndrome:An overview. Reviews in Gynaecological Practice., 2005; 5: 115-122.
  31. Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome-part 1. Endocrine Practice. 2015 Nov;21(11):1291-300.
  32. Rondanelli M, Perna S, Faliva M, Monteferrario F, Repaci E, Allieri F. Focus on metabolic and nutritional correlates of polycystic ovary syndrome and update on nutritional management of these critical phenomena. Archives of gynecology and obstetrics. 2014 Dec 1;290(6):1079-92.
  33. Farrell K, Antoni MH. Insulin resistance, obesity, inflammation, and depression in polycystic ovary syndrome: biobehavioral mechanisms and interventions. Fertility and sterility. 2010 Oct 1;94(5):1565-74.
  34. Kumarapeli VL, Seneviratne RD, Wijeyaratne CN. Health‐related quality of life and psychological distress in polycystic ovary syndrome: a hidden facet in South Asian women. BJOG: An International Journal of Obstetrics & Gynaecology. 2011 Feb 1;118(3):319-28.
  35. Nakanishi N, Shiraishi T, Wada M. Association between C-reactive protein and insulin resistance in a Japanese population: the Minoh Study. Internal medicine. 2005;44(6):542-7.
  36. El-Mesallamy HO, El-Razek RA, El-Refaie TA. Circulating high-sensitivity C-reactive protein and soluble CD40 ligand are inter-related in a cohort of women with polycystic ovary syndrome. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2013 Jun 1;168(2):178-82.
  37. Legro RS, Kunselman AR, Dunaif A. Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. The American journal of medicine. 2001 Dec 1;111(8):607-13.
  38. Heymsfield SB, Segal KR, Hauptman J, Lucas CP, Boldrin MN, Rissanen A, Wilding JP, Sjöström L. Effects of weight loss with orlistat on glucose tolerance and progression to type 2 diabetes in obese adults. Archives of Internal Medicine. 2000 May 8;160(9):1321-6.
  39. Jayagopal V, Kilpatrick ES, Holding S, Jennings PE, Atkin SL. Orlistat is as beneficial as metformin in the treatment of polycystic ovarian syndrome. The Journal of Clinical Endocrinology & Metabolism. 2005 Feb 1;90(2):729-33.

Cite this article: Noha F. Mahmoud. EFFECT OF DIET CONTROL THERAPY ON THE DERMATOLOGICAL SYMPTOMS OF OBESE POLYCYSTIC OVARIAN SYNDROME WOMEN: REPEATED MEASURE DESIGN. Int J Physiother Res 2018;6(3):2740-2747. DOI: 10.16965/ijpr.2018.128