Weight-neutral approach and later sleep midpoint in adolescents with “emerging polycystic ovary syndrome phenotype” as vehicles for sustainable weight loss
Year: 2024
Type: article
Abstract: Objective: Incorporate sleep into a novel lifestyle intervention strategy in adolescents with Emerging symptoms of polycystic ovary syndrome (E-PCOS). Design: A single-center cohort study. Setting: University hospital-based clinic for adolescents with PCOS. Patients: Forty-three girls at an age between 10 and 18 years presenting with E-PCOS between March 2015 and September 2017 with clinical signs of androgen excess and/or accelerated weight gain, acanthosis nigricans, irregular periods, or delayed menarche and followed every 6 months for a minimum of 4 visits, to October 2020. Interventions: All patients received nutritional counseling, with a goal of "zero weight gain," daily moderate physical activity goals of 45 minutes per day, and education regarding age-appropriate sleep duration. Three treatment strategies for E-PCOS symptoms were applied depending on the chief clinical complaint: anti-insulin approach with metformin; antiandrogen approach with oral contraceptive and spironolactone; and surveillance. Main Outcome Measures: Body mass index (BMI) Z-score over time. Alanine Transaminase (ALT) levels as a risk factor for nonalcoholic fatty liver. Results: = 0.48). Despite the weight-neutral approach, regression models all demonstrated significant weight loss regardless of menarche status, metformin use, number of visits, and high vs. low ALT groups. Those with the latest sleep midpoint at baseline benefited the most, with BMI Z-score dropping significantly (interaction of time and baseline sleep midpoint from the first visit on school night). Conclusion: A novel approach for adolescent girls with E-PCOS that focuses on metabolic endpoints and includes sleep duration and timing as specific targets, led to significant weight loss irrespective of treatment group.
Source: F&S Reports
Institutions: Michigan Medicine, University of Michigan
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
Awards: Feasibility of app-delivered circadian synchronization therapy with light in a cohort of pregnant women, Improving Negative Stressful Perseverations in Insomnia to Revitalize Expecting Moms (INSPIRE), G4362169119, Wearable Device and Digital Health Platform to Optimize Sleep During Pregnancy, Self-Supporting Nasopharyngeal Airway (ssNPA) Treating Upper Airway Obstruction in Hypotonia, G8439335473
OpenAlex ID: W4402307059