Menopause Review
eISSN: 2299-0038
ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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2/2025
vol. 24
 
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abstract:
Original paper

Effect of lifestyle changes on liver enzymes, triglycerides, sex hormones, and daytime sleepiness in polycystic ovarian syndrome women with obstructive sleep apnea and fatty liver – a randomized controlled trial

Ali Mohamed Ali Ismail
1
,
Nehad Mohamed AbdElnabi Mousa
2
,
Sami Kamal Mohamed Elgendy
3
,
Asmaa M. Al-Emrany
4
,
Orchid Saber AbdelFadil Saber
5
,
Sahar Mohamed Adel Elhakk
6, 7
,
Dina Mohamed
8, 9
,
Heba Ahmed Mousa Ghaleb
1, 10

  1. Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  2. Department of Physical Therapy of Musculoskeletal Disorders and it’s Surgeries, Horus University, New Damietta, Egypt
  3. Department of Physical Therapy for Internal Medicine and Elderly, Faculty of Physical Therapy, Modern University for Technology and Information, Cairo, Egypt
  4. Department of Physical Therapy for Internal Medicine and Geriatrics, Faculty of Physical Therapy, October University for Modern Sciences and Arts, 6th October City, Giza, Egypt
  5. Department of Physical Therapy for Surgery and Burns, Faculty of Physical Therapy, Nahda University, Beni Suef, Egypt
  6. Department of Basic Science, Faculty of Physical Therapy, Galala University, Suez, Egypt
  7. Department of Basic Science, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  8. Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Galala University, Suez, Egypt
  9. Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  10. Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
Menopause Rev 2025; 24(2): 94-101
DOI: https://doi.org/10.5114/pm.2025.152991
Online publish date: 2025/07/28
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Introduction:
Lifestyle changes are one of the main therapeutic approaches for women with polycystic ovarian syndrome (PCOS), non-alcoholic fatty liver disease (NAFLD), and obstructive sleep apnea (OSA). This 8-week study aimed to assess the effect of lifestyle modifications on liver enzymes, triglycerides (TG), sex hormones, and daytime sleepiness in PCOS women with NAFLD and mild and moderate OSA.

Material and methods:
This study included 40 women. The included obese PCOS women with OSA and NAFLD were assigned randomly to the study group and control group (n = 20 for each PCOS group). Besides the low-calorie diet (LCD), both PCOS groups received 500 mg of metformin tablets consumed three times daily. The study group additionally received free 30-minute walking exercise daily. Besides aspartate transaminase, alanine transaminase, and TG, the following outcomes were assessed in all PCOS women with OSA and NAFLD: waist circumference, neck circumference, body mass index, waist-hip ratio, serum testosterone, ratio of luteinizing hormone and follicle-stimulating hormone, apnea-hypopnea index, dehydroepiandrosterone, and Epworth sleepiness scale (to assess excessive daytime sleepiness).

Results:
A significant improvement in the value of all outcomes was achieved in both PCOS groups, but the improvements were high in the study group. Also, the designed between-group comparison of post values of PCOS women’s outcomes showed a significant improvement in the study group.

Conclusions:
Adding eight weeks of free-walking exercise to LCD and administration of metformin resulted in significantly greater improvements in PCOS than LCD and administration of metformin alone in women with NAFLD and OSA.

keywords:

weight loss, diet, polycystic ovarian syndrome, non-alcoholic fatty liver, obstructive sleep apnea
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