Polikistik Over Sendromlu Bireylerde Diyet Müdahalesinin Serum İleri Glikasyon Son Ürünleri ve Metabolik Profil Üzerine Etkisi

Abstract

This study was planned and conducted to investigate the effects of energy-restricted diet containing low advanced glycation end products (AGEs) versus energy-restricted diet containing standard AGEs on serum advanced glycation end products, hormonal profile, and anthropometric measurements in individuals with polycystic ovary syndrome (PCOS) phenotype A. A total of 30 participants with PCOS aged 19-35 years who applied to Hacettepe University Faculty of Medicine, Gynecology and Obstetrics Outpatient Clinic were included in the study. Participants were assigned to either a 12-week energy-restricted low AGE diet or an energy-restricted standard AGE diet by stratified randomization. A questionnaire including sociodemographic information, food consumption habits, and cooking methods was administered to the individuals at baseline, and anthropometric measurements, blood pressure measurements, and 3-day food consumption records were taken at baseline and after the 12-week intervention. In addition, biochemical data on fasting blood glucose and fasting insulin values, lipid profile, and sex hormone profile were recorded as part of routine examinations at baseline and 12 weeks. Serum N∊(Carboxymethyl)lysine (CML), soluble receptor for advanced glycation end product (sRAGE), hs-CRP, and tnf-a levels were analyzed by ELISA method in serum samples collected from individuals at the beginning of the study and 12 weeks after the intervention. In addition, serum antioxidant and oxidant capacity levels were analyzed. Individuals' daily energy and nutrient intake and intake of AGEs from food consumption records were evaluated. When the study results were analyzed, both the low AGE (n=14) and standard AGE (n=16) groups showed similar weight loss compared to their baseline weight [-8.4 (-10.3 to -5.8) vs. -5.2 (-8.8 to -4.6) kg, respectively, p=0.183]. However, fasting glucose levels decreased significantly more in the low AGE group compared to the standard AGE group [-8.5 (-11.5 to -3.5) vs. -0.5 (-3.7 to 0.7) mg/dL, respectively, p=0.027). In the low AGE group, waist-to-hip circumference ratio (p=0,009), LDL cholesterol (p=0,046), TNF-α (0,004), total testosterone (TT) (p=0,009), free-androgen index (FAI) (p=0,028), and anti-Müllerian hormone (AMH) (p=0,041) levels decreased significantly from baseline, whereas sex hormone-binding globulin (SHBG) levels increased after dietary intervention (p=0,042). In contrast, there was no statistically significant change in these parameters in the standard AGE group. In conclusion, both diet groups experienced similar body weight loss with the energy-restricted diet and energy-restricted diet with reduced dietary AGE intake. However, patients with PCOS phenotype-A in the low AGE group, who reduced their dietary AGE intake, showed a significantly greater improvement in metabolic and hormonal profiles.