Abstract
This study aims to investigate the effects of a low-advanced glycation end products(AGEs) diet versus a standard AGE-containing weight-loss diet on metabolic and hormonal profiles of overweight phenotype-A polycystic ovary syndrome(PCOS) patients.A randomized controlled interventional study.A total of 44 Rotterdam phenotype-A PCOS patients aged 19-35 were enrolled between January 2022 and May 2023. They were randomly assigned to 12-weeks of an energy-restricted Standard-AGEs diet(S-AGEs) or an energy-restricted Low-AGEs diet(L-AGEs). At baseline and after 12-weeks of intervention, weight loss, oligo-amenorrhea, hormonal profiles, plasma lipid profiles, and inflammation markers were evaluated. During the intervention, 8 participants from the L-AGEs group and 6 from the S-AGEs group dropped out. Completers had similar baseline characteristics to dropouts. In the per-protocol analysis, similar weight loss was observed in the L-AGEs(n = 14) and S-AGEs(n = 16) groups compared to baseline weight [-8.4 [-10.3 to -5.8] vs. -5.2 [-8.8 to -4.6] kg, respectively, p = 0.183]. However, in the L-AGEs group, fasting glucose levels decreased significantly more compared to the S-AGEs group (-8.5 [-11.5 to -3.5] vs. -0.5 [-3.7 to 0.7] mmol/L, respectively, p = 0.027). Following the diet intervention in the L-AGEs group, the waist-to-hip circumference ratio, LDL-cholesterol, TNF-α, total testosterone (TT), free-androgen index (FAI), and anti-Müllerian hormone (AMH) levels significantly decreased compared to baseline levels, while sex hormone-binding globulin (SHBG) levels increased. In contrast, there was no statistically significant change in these parameters in the S-AGEs group.In addition to weight-loss, reducing dietary AGEs intake resulted in significantly greater improvements in metabolic and hormonal profiles among phenotype-A PCOS patients. Clinicaltrials.gov registration no. NCT05830487.