Effect Of Lifestyle Intervention On Glucose And Lipid Metabolism And Psychological Status Of Obese Patients With Polycystic Ovary Syndrome

Objective: To examine the effects of lifestyle interventions on the outcomes of weight loss,indexes of glycolipid metabolism,anxiety and depression status,menstrual status and sex hormone levels in obese pat ients with polycystic ovary syndrome(PCOS)and to explore the signifi cance and necessity of weight loss as the first-line treatment for the co mprehensive management of patients with PCOS.Methods: Patients with obese polycystic ovary syndrome who visite d the reproductive medicine outpatient clinic of Cangzhou Central Hospi tal between September 2019 and September 2020 were selected,and a t otal of thirty-eight patients conform to the inclusion and exclusion criter ia.Collected and recorded patients’ age,height,weight,body mass index(BMI),hip circumference,waist circumference,waist to hip ratio(WH R),menstrual status,luteinizing hormone(LH),follicle stimulating horm one(FSH),and testosterone(T),fasting blood glucose,fasting insulin,fasting blood lipid,depression score PHQ9 scale and anxiety score GA D7 scale were filled in at the same time.The patients were subjected to full-range weight management guide d by the triad of behavior,diet,and exercise for three months,and wei ght loss was closely followed with the aid of the wechat platform,and the above indicators were retested at the outpatient clinic three months l ater,do before and after self-control.Results:Among the thirty-eight patients,one patient was referred to the endocrine department due to hyperglycemia,and one patient was re ferred to the psychological clinic due to severe depression.All of them had received specialized treatment,gave up three patients midway(Loss to follow up rate 8%),finally,thirty-three patients were enrolled.All of them lost more than 5% of their original weight,and twenty-two of th em lost up to more than 10% of their own weight.After weight interve ntion,the BMI and WHR of the patients were decreased,and the differ ences were statistically significant(P < 0.01);fasting plasma glucose(F PG),fasting insulin(FINS),insulin resistance index(HOMA-IR,homeos tasis model assessment insulin resistance),total cholesterol(TC),triglyce rides(TG),low density lipoprotein cholesterol(LDL-C)were all decreas ed before weight loss,the difference was statistically significant(P < 0.05),and high density lipoprotein cholesterol(HDL-C)was increased sligh tly,the difference was not significant(P = 0.341);T、LH and LH / FSH were all decreased before weight loss,the difference was statistically si gnificant(P < 0.01),FSH was lower than before weight loss by the t-tes t,there were no significant differences(P = 0.839);menstruation impr oved by the patient’s weight loss compared with before,the difference was statistically significant(P = 0.044);depression and anxiety scores a ll decreased by the patient’s weight loss compared with before,the diffe rence was statistically significant(P < 0.01),and six patients conceived naturally within half a year of the end of the experiment.Conclusions:Lifestyle intervention can help obese PCOS patients los e weight effectively,ameliorate the metabolism of glucose and lipid,im prove depression and anxiety,and help patients recover their spontaneou s menstruation,may help patients conceive naturally to some extent.