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D Jakubowicz, M Barnea, J Wainstein and O Froy
Abstract
In PCOS women, hyperinsulinemia stimulates ovarian cytochrome P450c17α activity that, in turn, stimulates ovarian androgen production. Our objective was to compare whether timed caloric intake differentially influences insulin resistance and hyperandrogenism in lean PCOS women. Sixty lean PCOS women (BMI 23.7±0.2kg/m2) were randomized into two isocaloric (~1800kcal) maintenance diets with different meal timing distribution: a breakfast diet (BF) (980kcal breakfast, 640kcal lunch, 190kcal dinner) or a dinner diet (D) group (190kcal breakfast, 640kcal lunch, 980kcal dinner) for 90 days. In the BF group, a significant decrease was observed in both AUCglucose and AUCinsulin, by 7 and 54%, respectively. In the BF group, free testosterone decreased by 50% and SHBG increased by 105%. GnRH-stimulated peak serum 17α hydroxyprogesterone decreased by 39%. No change in these parameters was observed in the D group. In addition, women in the BF group presented increased ovulation rate. In lean PCOS women, a high caloric intake at breakfast with reduced intake at dinner results in improved insulin sensitivity indices and reduced cytochrome P450c17α activity, which ameliorates hyperandrogenism and improves ovulation rate. Meal timing and distribution should be considered as a therapeutic option for women with PCOS.
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Concepts
Estrogen, Metformin, Luteinizing hormone, Polycystic ovary syndrome
MeSH headings
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