生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响

doi:10.3969/j.issn.1006-7795.2021.06.019

首都医科大学学报 ›› 2021, Vol. 42 ›› Issue (6): 1021-1025.doi: 10.3969/j.issn.1006-7795.2021.06.019

生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响

李健¹, 白文佩^1*, 江波^2*, 白栎然³, 吴凤云¹

1.首都医科大学附属北京世纪坛医院妇产科,北京 100038;
2.首都医科大学附属北京天坛医院肿瘤综合治疗中心,北京 100070;
3.航空总医院健康管理中心,北京100012

收稿日期:2021-08-28 出版日期:2021-12-21 发布日期:2021-12-17
基金资助:
北京市医院管理中心“登峰”计划专项经费资助项目(DFL20190701)。

Effects of ketogenic diet on menstruation and fertility in overweight/obese women with polycystic ovary syndrome

Li Jian¹, Bai Wenpei^1*, Jiang Bo^2*, Bai Liran³, Wu Fengyun¹

1. Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;
2. Department of Comprehensive Tumor Treatment Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China;
3. Department of Health Management Center, Aviation General Hospital, Beijing 100012, China

Received:2021-08-28 Online:2021-12-21 Published:2021-12-17
Contact: * E-mail: baiwp@bjsjth.cn, jiangboprof@163.com
Supported by:
Beijing Hospitals Authority “Ascent” Plan(DFL20190701).

摘要/Abstract

摘要： 目的评估生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响。方法选择2019年1月至2020年1月就诊于首都医科大学附属北京世纪坛医院妇科门诊的超重/肥胖多囊卵巢综合征患者,给予生酮饮食干预12周,随访1年,比较患者干预前后体质量、月经周期、妊娠情况的差异。结果共纳入52例患者,中位年龄29(23~39)岁,诊断多囊卵巢综合征中位时间5(1~8)年。生酮饮食干预后,体质量明显下降[(75.40±9.74) kg vs (65.48±8.30) kg,P＜0.001],月经周期明显缩短[(74.71±45.36) d vs (31.44±4.48) d,P＜0.001],月经紊乱率由71.15%降至21.15%。生酮饮食前有生育要求但不孕患者29例,干预后妊娠15例,其中1例胚胎停育,另14例均妊娠至足月,妊娠率为51.72%,活产率为48.28%。妊娠者怀孕时间距离干预结束平均2.4(0.5~10.0)个月,分娩孕周平均(39±1.13)周,分娩方式:阴道分娩占85.71%,剖宫产占21.43%,新生儿出生平均体质量(3.26±0.48) kg,孕期仅有2例合并妊娠期糖尿病,1例合并妊娠期高血压。结论超重/肥胖多囊卵巢综合征女性经过生酮饮食治疗,可以降低体质量,缩短月经周期,改善不孕症,同时减少孕期合并症。

关键词: 生酮饮食, 多囊卵巢综合征, 肥胖, 月经周期, 生育力

Abstract: Objective To evaluated the effect of ketogenic diet on fertility in overweight/obese women with polycystic ovary syndrome. Methods Overweight/obese patients with polycystic ovary syndrome who visited the gynecological clinic from January 2019 to January 2020 were given ketogenic diet intervention for 12 weeks and followed up for 1 year. The differences of weight, menstrual cycle and pregnancy before and after the intervention were compared. Results A total of 52 patients were included. The median age was 29 years (23-39 years). The median time for diagnosis of polycystic ovary syndrome was 5 years (1-8 years). After ketogenic diet intervention, body weight decreased significantly (75.40±9.74 vs 65.48±8.30 kg, P＜0.001), menstrual cycle shortened significantly [(74.71±45.36) d vs (31.44±4.48) d, P＜0.001], and menstrual disorder rate decreased from 71.15% to 21.15%. There were 29 infertile patients who had fertility requirements before ketogenic diet, and 15 patients were pregnant after intervention, including 1 case of embryo suspension, and the other 14 cases were pregnant to full term. The pregnancy rate was 51.72% and the live birth rate was 48.28%. The average time of pregnancy was 2.4 months from the end of intervention (0.5-10.0 months). The average gestational age of delivery was (39.00±1.13) weeks. The mode of delivery: vaginal delivery accounted for 85.71%, cesarean section 21.43%, neonatal birth weight averaged (3.26±0.48) kg, only 2 cases had gestational diabetes during pregnancy, and 1 cases had gestational hypertension. Conclusion Ketogenic diet can reduce weight, shorten menstrual cycle, improve infertility and reduce pregnancy complications in overweight/obese women with polycystic ovary syndrome.

Key words: ketogenic diet, polycystic ovary syndrome, obesity, menstrual cycle, fertility

中图分类号:

R711

李健, 白文佩, 江波, 白栎然, 吴凤云. 生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响[J]. 首都医科大学学报, 2021, 42(6): 1021-1025.

Li Jian, Bai Wenpei, Jiang Bo, Bai Liran, Wu Fengyun. Effects of ketogenic diet on menstruation and fertility in overweight/obese women with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2021, 42(6): 1021-1025.

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生酮饮食对超重/肥胖多囊卵巢综合征女性月经及生育力的影响

Effects of ketogenic diet on menstruation and fertility in overweight/obese women with polycystic ovary syndrome

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