مجله زنان، مامایی و  نازایی ایران

مجله زنان، مامایی و نازایی ایران

تأثیر رژیم‌های با شاخص گلیسمی پایین بر وضعیت آندروژن در زنان مبتلا به سندرم تخمدان پلی‌کیستیک: یک مطالعه مرور سیستماتیک و متاآنالیز

نوع مقاله : مروری

نویسندگان
1 استادیار گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.
2 دانشجوی دکتری تخصصی بهداشت باروری، کمیته تحقیقات و فناوری دانشجویی، مرکز تحقیقات مامایی و بهداشت باروری، گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.
10.22038/ijogi.2026.90886.6540
چکیده
مقدمه: با وجود انجام مطالعات متعدد در زمینه اثر رژیم‌های غذایی با شاخص گلیسمی پایین در زنان مبتلا به سندرم تخمدان پلی‌کیستیک، تاکنون مرور سیستماتیک و متاآنالیز جامعی با تمرکز بر وضعیت آندروژن‌ها انجام نشده است. ازاین‌رو، مطالعه حاضر با هدف بررسی اثر رژیم‌های غذایی با شاخص گلیسمی پایین بر وضعیت آندروژن در زنان مبتلا به سندرم تخمدان پلی‌کیستیک انجام شد.
روشکار: این مطالعه به‌صورت مرور سیستماتیک و متاآنالیز و مطابق با دستورالعمل‌های کاکرین و چک‌لیست PRISMA انجام شد. جستجوی مقالات تا 30 اردیبهشت 1404 در پایگاه‌های اطلاعاتی بین‌المللی و فارسی صورت گرفت. کیفیت مطالعات با استفاده از ابزار ارزیابی خطر سوگیری کاکرین بررسی شد. تحلیل داده‌ها با نرم‌افزارهای STATA و SPSS و با استفاده از مدل اثرات تصادفی انجام شد. ناهمگنی مطالعات با شاخصو آزمون Q ارزیابی گردید. همچنین تحلیل زیرگروهی، تحلیل حساسیت و بررسی سوگیری انتشار با آزمون‌های Begg و Egger انجام شد.
یافته­ ها: در مجموع 9 کارآزمایی بالینی تصادفی‌سازی‌شده شامل 482 شرکت‌کننده وارد مطالعه شدند. نتایج متاآنالیز نشان داد که رژیم‌های غذایی با شاخص گلیسمی پایین در مقایسه با رژیم‌های با شاخص گلیسمی بالا، موجب کاهش معنی‌دار شاخص مقاومت به انسولین (اختلاف میانگین وزنی: 14/1- و 29/1- تا 75/0- : 95CI؛ 001/0˂p) و کاهش معنی‌دار غلظت تستوسترون (اختلاف میانگین وزنی: 25/0- و 35/0- تا 11/0-: 95CI و 001/0˂p) شدند؛ با اینحال، تأثیر معنی‌داری بر شاخص آندروژن آزاد مشاهده نشد (اختلاف میانگین وزنی: 59/0- و 59/1- تا 36/0: 95CI؛ 233/0=p).
نتیجه­ گیری: رژیم‌های غذایی با شاخص گلیسمی پایین، به‌ویژه در صورت همراهی با محدودیت کالری، می‌توانند موجب بهبود شاخص‌های متابولیک و برخی شاخص‌های هورمونی در زنان مبتلا به سندرم تخمدان پلی‌کیستیک شوند. با این حال، شواهد کافی برای تأیید تأثیر این رژیم‌ها بر شاخص آندروژن آزاد وجود ندارد و انجام مطالعات بیشتر در این زمینه ضروری است.
کلیدواژه‌ها
موضوعات

عنوان مقاله English

The Effect of Low Glycemic Index Diets on Androgen Status in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

نویسندگان English

Seideh Hanieh Alamolhoda 1
Roghayeh Salmani 2
Sanaz Safarzadeh 2
Fatemeh Shabani 2
1 Assistant Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 PhD Student in Reproductive Health, Department of Midwifery and Reproductive Health, Student Research Committee, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده English

Introduction: Despite numerous studies on the effects of low-glycemic-index diets in women with polycystic ovary syndrome (PCOS), no comprehensive systematic review and meta-analysis focusing on androgen status has been conducted to date. Therefore, the present study was pconducted with aim to investigate the effect of low-glycemic-index diets on androgen status in women with PCOS.
Methods: This systematic review and meta-analysis study was conducted according to Cochrane guidelines and the PRISMA checklist. A literature search was conducted up to May 20, 2025, in international and Persian databases. The quality of studies was assessed using the Cochrane risk of bias assessment tool. Data analysis was performed using STATA and SPSS software applying random-effects models. Study heterogeneity was assessed using the I² index and the Q test. Subgroup analysis, sensitivity, and publication bias were evaluated using Begg’s and Egger’s tests.
Results: A total of 9 randomized clinical trial articles involving 482 participants were included; meta-analysis results showed that low glycemic index )GI( diets compared to high GI diets significantly reduced the insulin resistance index (Weighted Mean Difference [WMD]: -1.14; 95% CI: -0.75 to -1.29; P < 0.001), and total testosterone concentration (WMD: -0.25; 95% CI: -0.11 to -0.35; P < 0.001), whereas they did not produce a significant reduction in the free androgen index (WMD: -0.59; 95% CI: 0.36 to -1.59; P = 0.233).
Conclusion: Low glycemic index diets, especially along with calorie restriction, can help improve metabolic and some hormonal indices in PCOS women to polycystic ovary syndrome. However, there is insufficient evidence to confirm the effect of these diets on the free androgen index, and further studies in this area are necessary.

کلیدواژه‌ها English

Androgen
Calorie Restriction
Insulin Resistance
Low Glycemic Index
Polycystic Ovary Syndrome
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