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Metabolic and Endocrine Effects of a Polyunsaturated Fatty Acid-Rich Diet in Polycystic Ovary Syndrome

Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine (S.E.K.-K., R.U.A., L.G.), Institute of Toxicology and Environmental Health (H.T., B.L.L.), and Department of Statistics (R.W.), University of California, Davis, California 95616

Address all correspondence to: Sidika E. Kasim-Karakas, M.D., Department of Internal Medicine, University of California-Davis, 4150 V Street, PSSB Suite G400, Sacramento, California 95817. E-mail: sekarakas{at}ucdavis.edu. Reprints will not be available.

Effects of a polyunsaturated fatty acid (PUFA)-rich diet were investigated in 17 polycystic ovary syndrome (PCOS) patients. After a 3-month habitual diet period, dietary fats were partly replaced with PUFAs for another 3 months. The PUFA-rich diet increased plasma linoleic acid from 28.36 ± 1.00% to 33.76 ± 1.08% (P < 0.002) and -linolenic acid from 0.52 ± 0.03% to 1.06 ± 0.10% (P < 0.0001). Fasting glucose increased from 76 ± 3 to 95 ± 3 mg/dl (4.2 ± 0.2 to 5.30.2 mmol/liter; P < 0.0001), and the area under the curve for glucose during oral glucose tolerance test increased from 421 ± 34 to 503 ± 31 mg/dl (23.4 ± 1.9 to 27.9 ± 1.7 mmol/liter; P < 0.001). Plasma insulin did not change either at fasting or during oral glucose tolerance test. Fasting plasma free fatty acids decreased from 0.596 ± 0.048 to 0.445 ± 0.058 mg/dl (P = 0.037), and ketone bodies decreased from 9.14 ± 1.57 to 3.63 ± 0.62 mg/dl (895 ± 154 to 356 ± 61 µmol/liter; P < 0.003). Plasma 15-deoxyprostaglandin J₂ tended to decrease (from 239 ± 65 to 171 ± 60 ng/ml; P = 0.053). Plasma testosterone, free testosterone, SHBG, dehydroepiandrosterone sulfate, LH, FSH, and urinary estrogen conjugates did not change. Urinary pregnanediol 3-glucuronide increased from 18.6 ± 2.2 to 31.0 ± 5.7 µg/mg creatinine (P = 0.038). In conclusion, increased dietary PUFA intake can exert significant metabolic and endocrine effects in women with PCOS.

This work was supported by grants (to S.E.K.-K.) from the California Walnut Commission (Sacramento, CA) and ALSAM Foundation (Los Angeles, CA).

Abbreviations: AUC, Area under the curve; BMI, body mass index; cr, creatinine; CV, coefficient of variation; DHEAS, dehydroepiandrosterone sulfate; DM, diabetes mellitus; E1C, estrogen conjugate; HDL, high density lipoprotein; HOMA, homeostasis model assessment for insulin resistance; ISI, insulin sensitivity index; LA, linoleic acid; -LNA, -linolenic acid; 15d-PGDJ₂; 15-deoxyprostaglandin J₂; OGTT, oral glucose tolerance test; PCOS, polycystic ovary syndrome; PdG, pregnanediol 3-glucuronide; PPAR, peroxisomal proliferator-activated receptor; PUFA, polyunsaturated fatty acid; T, testosterone.

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