| dc.description.abstract | Background and aim: Polycystic ovary syndrome (PCOS), as the most common endocrinopathy in reproductive-aged women, is a multisystem disorder and a heterogeneous condition with a wide range of signs and symptoms which decreases the quality of life and is closely associated with obesity, insulin resistance, and inflammation. Lifestyle modifications including, diet therapy and nutritional interventions have been considered as a first-line evidence-based treatment. Therefore, this study was designed to investigate the effect of spinach-derived thylakoids supplementation combined with a hypocaloric diet on metabolic, hormonal, and inflammatory status in obese women with PCOS.
Materials and methods: In this double-blind clinical trial, forty-eight obese females with PCOS were randomly assigned into thylakoid (hypocaloric diet + 5g of thylakoid daily) or placebo group (hypocaloric diet + placebo daily) for 12 weeks. Anthropometric measures, dietary intakes, physical activity, and blood pressure were assessed before, at the middle, and after the intervention. After 12 h overnight fasting, venous blood samples of the participants were taken at baseline and endpoint of the study to measure fasting serum levels of blood sugar (FBS), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile, omentin, chemerin, inflammatory biomarkers (neopterin and high sensitivity C-reactive protein; hs-CRP), and sex hormones. Food intake was analyzed using Nutritionist IV. Data were analyzed by Paired t-test, Independent samples t-test, Chi-square, Repeated measures ANOVA, and ANCOVA.
Results: Forty-four participants completed the trial (thylakoid group (n)=21; placebo group (n)=23). Energy and macronutrient intakes except for protein decreased significantly in both study groups at the end of the study (P<0.001). The physical activity of the participants did not change significantly in either of the groups, throughout the study (P>0.05). Thylakoid supplementation resulted in greater decreases in body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), fat mass, HOMA-IR, serum levels of insulin, hs-CRP, and testosterone compared to the placebo (P< 0.001 for all ). The between-group differences in the mean changes of the total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), FBS, non-esterified fatty acid (NEFA), and systolic blood pressure were non-significant post-intervention (P>0.05). Significant increase in serum level of omentin and significant decreases in levels of free androgen index (FAI), lipid accumulation product (LAP), diastolic blood pressure, serum levels of triglyceride (TG), chemerin, and neopterin in the thylakoid group compared with the placebo group, were affected by weight changes during the trial.
Conclusion:The present study, for the first time, revealed that supplementation with 5g/day thylakoid along with a calorie-restricted diet for 12 weeks could significantly improve anthropometrics and some PCOS-related metabolic parameters. However, except for a decrease in testosterone level, other hormonal parameters did not significantly change. Taken together, these data suggest that thylakoid may be a promising adjunct to treatment for obese females with PCOS. However, further investigations with longer durations and larger sample sizes are warranted to more vividly elucidate the probable beneficial effects of thylakoid supKey words: Polycystic ovary syndrome (PCOS), Obesity, Thylakoid, Calorie-restriction, Inflammation, Adipokines | en_US |
