Impact of short-term ketogenic diet on sex hormones and glucose-lipid metabolism in overweight or obese patients with polycystic ovary syndrome

J Obstet Gynaecol Res. 2025 Jan;51(1):e16178. doi: 10.1111/jog.16178.

Abstract

Aim: This study evaluates the clinical effects of a ketogenic diet (KD) versus a traditional comprehensive intervention, including lifestyle changes and oral contraceptives, in overweight or obese polycystic ovary syndrome (PCOS) patients.

Methods: A retrospective analysis of 70 overweight/obese PCOS patients (body mass index [BMI] ≥24 kg/m2) treated between December 2022 and December 2023 was conducted. The patients were categorized into two groups based on their past treatment modality: Group 1 received a KD treatment (N = 35), and Group 2 underwent comprehensive intervention (N = 35), with both treatments lasting 3 months. Changes in body weight, BMI, sex hormone levels, glucose-lipid metabolism indicators, and liver and kidney function were compared.

Results: Both groups experienced significant reductions in body weight and BMI after treatment (p < 0.05), with the KD group showing a greater reduction (p < 0.05). luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), and total testosterone (TT) levels decreased significantly in both groups (p < 0.05). The KD treatment led to significant reductions in fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride (TG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) (p < 0.05), while the comprehensive intervention resulted in decreased FBG and ALT, and increased high-density lipoprotein-cholesterol (HDL-c) (p < 0.05). Additionally, the KD group had a greater reduction in FBG, and showed decreases in TG and AST, which remained unchanged in the comprehensive intervention group (p < 0.05).

Conclusion: The short-term KD treatment provides significant weight loss and effectively improves hormone regulation and glucose-lipid metabolism in overweight or obese PCOS patients, offering a valuable therapeutic option for managing the condition.

Keywords: glucose metabolism; ketogenic diet; lipid metabolism; polycystic ovary syndrome; sex hormone.

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Body Mass Index
  • Diet, Ketogenic*
  • Female
  • Gonadal Steroid Hormones / blood
  • Humans
  • Lipid Metabolism*
  • Obesity* / diet therapy
  • Obesity* / metabolism
  • Overweight* / diet therapy
  • Overweight* / metabolism
  • Polycystic Ovary Syndrome* / diet therapy
  • Polycystic Ovary Syndrome* / metabolism
  • Retrospective Studies
  • Young Adult

Substances

  • Blood Glucose
  • Gonadal Steroid Hormones