Table 1 Characteristics of studies included
Author (year) setting | Study design | Sample size | Groups (mean age and bmi) | PCOS diagnosis criteria | Life style modification | Follow up duration | outcome | Main result |
|---|---|---|---|---|---|---|---|---|
Wong et al., 2016 USA | RCT | 19 | Group 1: patient with diet intervention and Weight loss n = 9 Mean age:16.3 ± 2.2 Mean BMI baseline: 32.80 ± 3.20 Mean BMI after:30.9 ± 3.70 Group 2: patient with diet intervention and non-Weight loss n = 10 Mean age:15.4 ± 1.3 Mean BMI baseline:36.50 ± 4.30 Mean BMI after:36.10 ± 4.70 | Androgen Excess Society | Diet LGL (45% carbohydrate, 35% fat, 20% protein) or LF (55% carbohydrate, 25% fat, 20% protein) diet | 6 months | BMI, BP,FBS FBI,SHBG,TG HDL, LDL,TT FT, BT | ↓BMI |
Lass et al., 2011 German | NRS | 59 | Group 1: patient with lifestyle intervention and Weight loss n = 26 Mean age:14.9 ± 0.8 Mean BMI baseline:32.20 ± 3.70 Mean BMI after:28.30 ± 3.40 Group 2: patient with lifestyle intervention and non-Weight loss n = 33 Mean age:15.1 ± 0.7 Mean BMI baseline:33.90 ± 6.8 Mean BMI after:34.60 ± 6.90 | National Institutes of Health | Diet 30% fat, 15% proteins, and 55% carbohydrates including 5% sugar Exercise dancing, ball games, jogging, trampoline jumping Behavior | 12 months | BMI, BP,FBS FBI, SHBG HOMA, TG HDL, LDL, FSH LH, FT, AFI | ↓BMI, ↓TG, ↓HOMA, ↓testosterone, ↓FAI, ↓LH, ↓systole and ↓diastole blood pressure |
Reinehr et al., 2017 German | NRS | 20 | Group 1: patient with lifestyle intervention and Weight loss n = 10 Mean age:: 14.9 ± 1.4 Mean BMI baseline:32.20 ± 4.10 Mean BMI after: 27.40 ± 2.5 Group 2: patient with lifestyle intervention and non-Weight loss n = 10 Mean age:15 ± 1.2 Mean BMI baseline:31.40 ± 4.90 Mean BMI after:33.30 ± 6.6 | Endocrine Society proposed | Diet 30% fat, 15% proteins, and 55% carbohydrates including 5% sugar Exercise dancing, ball games, jogging, trampoline jumping Behavior | 12 months | BMI, SHBG HOMA, FSH LH, FT, AFI AMH | ↓BMI, ↓LH, ↑SHBG, ↓FAI, ↓HOMA, ↓AMH |
Hoeger et al., 2008 USA | RCT | 18 | Group 1: patient with lifestyle intervention n = 8 Mean age: 15.4 ± 1.2 Mean BMI baseline:36 ± 6.20 Mean BMI after: 34.90 ± 7 Group 2: patient with no intervention (control) n = 10 Mean age: 15.4 ± 1.7 Mean BMI baseline:34.90 ± 6.7 Mean BMI after: 34.90 ± 6.70 | Rotterdam criterion | Diet Hypo caroric diet with 500 kcal/d deficit Exercise:30 min/d of moderate to intense activity | 6 months | BMI, BP,FBS FBI, TG, SHBG HDL, LDL, TT AFI, FG | ↓FAI, ↑SHBG, ↓Diastolic blood pressure |
Ornestein et al., 2011 Chicago | RCT | 16 | Group 1: patient with diet intervention n = 16 Mean age: 15.8 ± 2.2 Mean BMI baseline: 35.70 ± 6 Mean BMI after: 32.90 ± 5.80 | Rotterdam criterion | Diet:Low fat less than 40 g per day of fat, with five servings of starch per day and an ad libitum intake of fat-free dairy foods, fruits, vegetables low carbohydrate: 40 g carbohydrate daily by adding low glycemic index foods, such as nuts, fruits, And whole grains. | 3 months | BMI | ↓BMI |
Ladson et al., 2011 USA | RCT | 11 | Group 1: patient with lifestyle intervention n = 11 Mean age: 15.4 ± 1.2 Mean BMI baseline: no reported Mean BMI after: no reporte | National Institutes of Health | Diet: 55% carbohydrate, 30% fat, and 15% protein. Exercise: 35–45 stair stepper, stationary bike, elliptical machine, treadmill, or dancing to music | 6 months | BP, FBS, FBI HOMA, TG SHBG, HDL LDL, FSH LH, BT,AFI | No significant difference in all of measurement outcome |
Nidhi et al., India 2012 | RCT | 71 | Group 1: patient with yoga intervention n = 42 Mean age:16.22 ± 1.13 Mean BMI baseline:20.22 ± 1.65 Mean BMI after:20.11 ± 1.70 Group 2: patient with exercise intervention n = 43 Mean age:16.22 ± 0.93 Mean BMI baseline:21.28 ± 3.05 Mean BMI after: 21.59 ± 2.78 | Rotterdam criterion | Exercise: A yoga suryanamaskara, asanas, pranayama, and meditation | 3 months | BMI, FBS,FBI HOMA, TG HDL, LDL | ↓FBS, ↓HOMA, ↓TG, ↓LDL |
Nidhi et al., India 2013 | RCT | 72 | Group 1: patient with lifestyle intervention n = 45 Mean age: 16.22 ± 1.13 Mean BMI baseline:20.39 ± 2.60 Mean BMI after:20.41 ± 2 Group 2: patient with no intervention (control) n = 45 Mean age:16.22 ± 0.93 Mean BMI baseline:21.39 ± 3.20 Mean BMI after:21.70 ± 2.88 | Rotterdam criterion | Exercise: A yoga suryanamaskara, asanas, pranayama, and meditation | 3 months | BMI, FSH, LH TT, AMH, FG menstrual period | ↓TT, ↓LH, ↓AMH, ↓FG, menstural period improve |
Carolo et al., 2017 Brazil | NRS | 18 | Group 1: patient with lifestyle intervention and Weight loss n = 9 Mean age:16.56 ± 1.33 Mean BMI baseline:88.10 ± 13.3 Mean BMI after:81.40 ± 11.20 Group 2: patient with diet intervention and non-Weight loss n = 9 Mean age:16 ± 1.66 Mean BMI baseline:78.70 ± 17.30 Mean BMI after:84.8 ± 20.7 | Endocrine Society | Diet 55–75% of carbohydrate, 10–15% of Protein and 15–30% of total fat. | 6 months | BMI | Dietary interventions were not beneficial for BMI improve. |
Rofey et al., 2009 USA | NRS | 12 | Group 1: patient with lifestyle intervention n = 12 Mean age: 15.8 Mean BMI baseline:39 ± 9 Mean BMI after:35 ± 6 | National Institutes of Health | Behavior: cognitive–behavioral therapy (CBT) Exercise: (yoga instructor, local swim coach, climbing wall supervisor) | 3 months | BMI | ↓ BMI. |
Marzouk et al., 2015 Egypt | RCT | 60 | Group 1: patient with diet intervention n = 30 Mean age:19.3 ± 1.3 Mean BMI baseline:36.4 ± 4.7 Mean BMI after:33.20 ± 3.8 Group 2: patient with no intervention (control) n = 30 Mean age:20.1 ± 1.8 Mean BMI baseline:35.8 ± 4.8 Mean BMI after:35.7 ± 4.67 | Rotterdam criterion | Diet 15–20% of protein, 30% of fat, 50–55% of carbohydrates | 6 months | BMI, FG menstrual period | ↓ BMI, ↓FG, menstrual period improve. |