Endocrine Abstracts

PCOS is the most common endocrine disorder affecting the women of reproductive age group and weight loss is the mainstay of management of PCOS. We performed an open-label randomised controlled trial to compare the effects of a conventional energy deficit approach (-600 kcal/day of the total energy requirements) vs. a very low-calorie diet (VLCD: 800 kcal/day) on free androgen index (FAI), body weight, and metabolic markers in women with PCOS. Forty-one eligible patients were randomly assigned to a VLCD diet (800 kcal/day provided with gradual food reintroduction over the next 8 weeks) (n = 21) or conventional energy deficit (n = 20) over the same period. Anthropometric characteristics and metabolic markers were assessed at baseline and at 8- and 16-week follow-up. Here, we report the results of the 8-week follow-up. Paired and unpaired t-tests were used to compare differences within- and between-groups, respectively. Nine participants in the VLCD group and 12 participants in the energy deficit arm completed the 8-week follow-up. After 8 weeks both groups experienced weight loss, however, this was significantly higher in the VLCD arm (-11.4 vs -4.2 kg, P < 0.0001). There was also a significant reduction in FAI in the VLCD group as compared to the energy deficit group (-37% vs -7.7%, P = 0 .04). In the VLCD arm, 22% of women (n = 2), but none of the energy deficit arm, had biochemical remission of PCOS (FAI < 4). There was a significant within-group increase in the SHBG (P = 0.01) and reductions in total cholesterol (P = 0.008) and HbA1c (P = 0.04) in the VLCD arm, but not in the energy deficit arm. One serious side effect of abdominal pain and cholecystitis was reported in the same participant. Our findings suggest that VLCD is superior to the energy deficit approach in PCOS and can cause significant weight reduction, improvement in hyperandrogenaemia and biochemical remission of PCOS.