human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Women with polycystic ovary syndrome ( PCOS ) have symptoms of depression and anxiety and impaired health related quality of life ( HRQoL ) . Here we test the post-hoc hypothesis that acupuncture and exercise improve depression and anxiety symptoms and HRQoL in PCOS women . Methods Seventy-two PCOS women were r and omly assigned to 16 weeks of 1 ) acupuncture ( n = 28 ) ; 2 ) exercise ( n = 29 ) ; or 3 ) no intervention ( control ) ( n = 15 ) . Outcome measures included : change in Montgomery Åsberg Depression Rating Scale ( MADRS-S ) , Brief Scale for Anxiety ( BSA-S ) , Swedish Short-Form 36 ( SF-36 ) , and PCOS Question naire ( PCOSQ ) scores from baseline to after 16-week intervention , and to 16-week post-intervention follow-up . Results A reduction in MADRS-S and BSA-S from baseline to 16-weeks post-intervention follow-up was observed for the acupuncture group . The SF-36 domains role physical , energy/vitality , general health perception and the mental component of summary scores improved in the acupuncture group after intervention and at follow-up . Within the exercise group the role physical decreased after treatment , while physical functioning and general health perception scores increased at follow-up . The emotion domain in the PCOSQ improved after 16-weeks of intervention within all three groups , and at follow-up in acupuncture and exercise groups . At follow-up , improvement in the infertility domain was observed within the exercise group . Conclusion There was a modest improvement in depression and anxiety scores  in women treated with  acupuncture  , and improved HRQoL scores were noted in both intervention groups . While not a primary focus of the trial , these data suggest continued investigation of mental health outcomes in women treated for PCOS.Trial registration number Clinical Trials.gov Identifier : Acupuncture has been demonstrated to improve menstrual frequency and to decrease circulating testosterone in women with polycystic ovary syndrome ( PCOS ) . Our aim was to investigate whether acupuncture affects ovulation frequency and to underst and the underlying mechanisms of any such effect by analyzing LH and sex steroid secretion in women with PCOS . This prospect i ve , r and omized , controlled clinical trial was conducted between June 2009 and September 2010 . Thirty-two women with PCOS were r and omized to receive either acupuncture with manual and low-frequency electrical stimulation or to meetings with a physical therapist twice a week for 10 - 13 wk . Main outcome measures were changes in LH secretion patterns from baseline to after 10 - 13 wk of treatment and ovulation frequency during the treatment period . Secondary outcomes were changes in the secretion of sex steroids , anti-Müllerian hormone , inhibin B , and serum cortisol . Ovulation frequency during treatment was higher in the acupuncture group than in the control group . After 10 - 13 wk of intervention , circulating levels of estrone , estrone sulfate , estradiol , dehydroepi and rosterone , dehydroepi and rosterone sulfate , and rostenedione , testosterone , free testosterone , dihydrotestosterone , and rosterone glucuronide , and rostane-3α,17β-diol-3-glucuronide , and and rostane-3α,17β-diol-17-glucuronide decreased within the acupuncture group and were significantly lower than in the control group for all of these except and rostenedione . We conclude that repeated acupuncture treatments result ed in higher ovulation frequency in lean/overweight women with PCOS and were more effective than just meeting with the therapist . Ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion BACKGROUND Some evidence has suggested that a diet with a higher ratio of protein to carbohydrates has metabolic advantages in the treatment of polycystic ovary syndrome ( PCOS ) . OBJECTIVE The objective of this study was to compare the effect of a high-protein ( HP ) diet to a st and ard-protein ( SP ) diet in women with PCOS . DESIGN A controlled , 6-mo trial was conducted in 57 PCOS women . The women were assigned through rank minimization to one of the following 2 diets without caloric restriction : an HP diet ( > 40 % of energy from protein and 30 % of energy from fat ) or an SP diet ( < 15 % of energy from protein and 30 % of energy from fat ) . The women received monthly dietary counseling . At baseline and 3 and 6 mo , anthropometric measurements were performed , and blood sample s were collected . RESULTS Seven women dropped out because of pregnancy , 23 women dropped out because of other reasons , and 27 women completed the study . The HP diet produced a greater weight loss ( mean : 4.4 kg ; 95 % CI : 0.3 , 8.6 kg ) and body fat loss ( mean : 4.3 kg ; 95 % CI : 0.9 , 7.6 kg ) than the SP diet after 6 mo . Waist circumference was reduced more by the HP diet than by the SP diet . The HP diet produced greater decreases in glucose than did the SP diet , which persisted after adjustment for weight changes . There were no differences in testosterone , sex hormone-binding globulin , and blood lipids between the groups after 6 mo . However , adjustment for weight changes led to significantly lower testosterone concentrations in the SP-diet group than in the HP-diet group . CONCLUSION Replacement of carbohydrates with protein in ad libitum diets improves weight loss and improves glucose metabolism by an effect that seems to be independent of the weight loss and , thus , seems to offer an improved dietary treatment of PCOS women Background / Objectives : The aim of the study was to compare the effect of two-meal patterns ( three vs six meals per day ) on glucose and insulin levels in women with polycystic ovary syndrome (PCOS).Subjects/ Methods : In a r and omised , crossover , 24-week study , 40 women with PCOS , aged 27±6 years , body mass index 27±6 kg/m2 , followed a weight maintenance diet ( % carbohydrates : protein : fat , 40:25:35 ) , consumed either as a three- or a six-meal pattern , with each intervention lasting for 12 weeks . Anthropometric measurements , diet compliance and subjective hunger , satiety and desire to eat were assessed biweekly . All women underwent an oral glucose tolerance test ( OGTT ) with 75 g glucose for measurement of plasma glucose  and insulin at the beginning and end of each intervention . HaemoglobinA1c ( HbA1c ) , blood lipids and hepatic enzymes were measured at the beginning and end of each intervention . Results : Body weight remained stable throughout the study . Six meals  decreased significantly fasting insulin ( P=0.014 ) and post-OGTT insulin sensitivity ( Matsuda index , P=0.039 ) vs three meals . After incorporation of individual changes over time , with adjustment for potential confounders , the only variable that remained significant was the Matsuda index , which was then used in multivariate analysis and general linear models . Six meals  improved post-OGTT insulin sensitivity independently of age and body weight vs three meals ( P=0.012 ) . No significant differences were found between six and three meals for glucose , HbA1c , blood lipids , hepatic enzymes , subjective desire to eat and satiety . Conclusions : Six meals had a more favourable effect on post-OGTT insulin sensitivity in women with PCOS compared with isocaloric three meals Objective : The recommended composition of a hypocaloric diet for obese women with polycystic ovary syndrome ( PCOS ) is unclear . The aim of this study was to investigate the effects of a high-protein , low-glycemic-load diet compared with a conventional hypocaloric diet on reproductive hormones , inflammatory markers , lipids , glucose , and insulin levels in obese women with PCOS . Methods : A total of 60 overweight and obese women with PCOS who did not use insulin-sensitizing agents were recruited and r and omly assigned to 1 of the 2 hypocaloric diet groups for a single-blind clinical trial . The groups included a conventional hypocaloric diet ( CHCD ) ( 15 % of daily energy from protein ) and a modified hypocaloric diet ( MHCD ) with a high-protein , low-glycemic load ( 30 % of daily energy from protein plus low-glycemic-load foods selected from a list ) that was prescribed via counseling visits weekly during 12 weeks of study . Anthropometric assessment s and biochemical measurements including reproductive hormones , inflammatory factors , lipids , glucose , and insulin were performed on fasting blood sample s at baseline and after 12 weeks of dietary intervention . Results : Weight loss was significant and similar in the 2 groups . Mean of testosterone in the MHCD and CHCD groups decreased from 1.78 ± 0.32 to 1.31 ± 0.26 ng/ml and from 1.51 ± 0.12 to 1.15 ± 0.11 ng/ml , respectively ( p < 0.001 ) . Follicle sensitizing hormone ( FSH ) , luteinizing hormone ( LH ) , and blood lipids concentrations were not changed except low-density lipoprotein cholesterol ( LDL-C ) was reduced by 24.5 % ± 12.3 % ( p < 0.001 for both ) after 12 weeks of intervention . MHCD result ed in a significant reduction in insulin level , homeostatic model assessment for insulin resistance ( HOMA ) , and high-sensitivity C- reactive protein ( hsCRP ) concentration ( p < 0.001 ) . Conclusions : In this study both hypocaloric diets significantly led to reduced body weight and and rogen levels in these two groups of women with PCOS . The combination of high-protein and low-glycemic-load foods in a modified diet caused a significant increase in insulin sensitivity and a decrease in hsCRP level when compared with a conventional diet BACKGROUND Women with polycystic ovary syndrome ( PCOS ) present with vascular abnormalities , including elevated markers of endothelial dysfunction . There is limited evidence for the effect of lifestyle modification and weight loss on these markers . The aim of this study was to determine if 20 weeks of a high-protein energy-restricted diet with or without exercise in women with PCOS could improve endothelial function . METHODS This is a secondary analysis of a subset of 50 overweight/obese women with PCOS ( age : 30.3 ± 6.3 years ; BMI : 36.5 ± 5.7 kg/m(2 ) ) from a previous study . Participants were r and omly assigned by computer generation to one of three 20-week interventions : diet only ( DO ; n = 14 , ≈ 6000 kJ/day ) , diet and aerobic exercise ( DA ; n = 16 , ≈ 6000 kJ/day and five walking sessions/week ) and diet and combined aerobic-resistance exercise ( DC ; n = 20 , ≈ 6000 kJ/day , three walking and two strength sessions/week ) . At Weeks 0 and 20 , weight , markers of endothelial function [ vascular cell adhesion molecule-1 ( sVCAM-1 ) , inter-cellular adhesion molecule-1 ( sICAM-1 ) , plasminogen activator inhibitor-1 ( PAI-1 ) and asymmetric dimethylarginine ( ADMA ) ] , insulin resistance and hormonal profile were assessed . RESULTS All three treatments result ed in significant weight loss ( DO 7.9 ± 1.2 % , DA 11.0 ± 1.6 % , DC 8.8 ± 1.1 ; P < 0.001 for time ; P = 0.6 time × treatment ) . sVCAM-1 , sICAM-1 and PAI-1 levels decreased with weight loss ( P≤ 0.01 ) , with no differences between treatments ( P ≥ 0.4 ) . ADMA levels did not change significantly ( P = 0.06 ) . Testosterone , sex hormone-binding globulin and the free and rogen index ( FAI ) and insulin resistance also improved ( P < 0.001 ) with no differences between treatments ( P ≥ 0.2 ) . Reductions in sVCAM-1 were correlated to reductions in testosterone ( r = 0.32 , P = 0.03 ) and FAI ( r = 0.33 , P = 0.02 ) as well as weight loss ( r= 0.44 , P = 0.002 ) . Weight loss was also associated with reductions in sICAM-1 ( r= 0.37 , P = 0.008 ) . CONCLUSIONS Exercise training provided no additional benefit to following a high-protein , hypocaloric diet on markers of endothelial function in overweight/obese women with PCOS Polycystic ovary syndrome ( PCOS ) , the most common endocrine disorder in women of reproductive age , is characterized by hyper and rogenism , oligo/amenorrhea , and polycystic ovaries 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Women with polycystic ovary syndrome ( PCOS ) have symptoms of depression and anxiety and impaired health related quality of life ( HRQoL ) . Here we test the post-hoc hypothesis that acupuncture and exercise improve depression and anxiety symptoms and HRQoL in PCOS women . Methods Seventy-two PCOS women were r and omly assigned to 16 weeks of 1 ) acupuncture ( n = 28 ) ; 2 ) exercise ( n = 29 ) ; or 3 ) no intervention ( control ) ( n = 15 ) . Outcome measures included : change in Montgomery Åsberg Depression Rating Scale ( MADRS-S ) , Brief Scale for Anxiety ( BSA-S ) , Swedish Short-Form 36 ( SF-36 ) , and PCOS Question naire ( PCOSQ ) scores from baseline to after 16-week intervention , and to 16-week post-intervention follow-up . Results A reduction in MADRS-S and BSA-S from baseline to 16-weeks post-intervention follow-up was observed for the acupuncture group . The SF-36 domains role physical , energy/vitality , general health perception and the mental component of summary scores improved in the acupuncture group after intervention and at follow-up . Within the exercise group the role physical decreased after treatment , while physical functioning and general health perception scores increased at follow-up . The emotion domain in the PCOSQ improved after 16-weeks of intervention within all three groups , and at follow-up in acupuncture and exercise groups . At follow-up , improvement in the infertility domain was observed within the exercise group . Conclusion There was a modest improvement in depression and anxiety scores  in women treated with  acupuncture  , and improved HRQoL scores were noted in both intervention groups . While not a primary focus of the trial , these data suggest continued investigation of mental health outcomes in women treated for PCOS.Trial registration number Clinical Trials.gov Identifier : Acupuncture has been demonstrated to improve menstrual frequency and to decrease circulating testosterone in women with polycystic ovary syndrome ( PCOS ) . Our aim was to investigate whether acupuncture affects ovulation frequency and to underst and the underlying mechanisms of any such effect by analyzing LH and sex steroid secretion in women with PCOS . This prospect i ve , r and omized , controlled clinical trial was conducted between June 2009 and September 2010 . Thirty-two women with PCOS were r and omized to receive either acupuncture with manual and low-frequency electrical stimulation or to meetings with a physical therapist twice a week for 10 - 13 wk . Main outcome measures were changes in LH secretion patterns from baseline to after 10 - 13 wk of treatment and ovulation frequency during the treatment period . Secondary outcomes were changes in the secretion of sex steroids , anti-Müllerian hormone , inhibin B , and serum cortisol . Ovulation frequency during treatment was higher in the acupuncture group than in the control group . After 10 - 13 wk of intervention , circulating levels of estrone , estrone sulfate , estradiol , dehydroepi and rosterone , dehydroepi and rosterone sulfate , and rostenedione , testosterone , free testosterone , dihydrotestosterone , and rosterone glucuronide , and rostane-3α,17β-diol-3-glucuronide , and and rostane-3α,17β-diol-17-glucuronide decreased within the acupuncture group and were significantly lower than in the control group for all of these except and rostenedione . We conclude that repeated acupuncture treatments result ed in higher ovulation frequency in lean/overweight women with PCOS and were more effective than just meeting with the therapist . Ovarian and adrenal sex steroid serum levels were reduced with no effect on LH secretion BACKGROUND Some evidence has suggested that a diet with a higher ratio of protein to carbohydrates has metabolic advantages in the treatment of polycystic ovary syndrome ( PCOS ) . OBJECTIVE The objective of this study was to compare the effect of a high-protein ( HP ) diet to a st and ard-protein ( SP ) diet in women with PCOS . DESIGN A controlled , 6-mo trial was conducted in 57 PCOS women . The women were assigned through rank minimization to one of the following 2 diets without caloric restriction : an HP diet ( > 40 % of energy from protein and 30 % of energy from fat ) or an SP diet ( < 15 % of energy from protein and 30 % of energy from fat ) . The women received monthly dietary counseling . At baseline and 3 and 6 mo , anthropometric measurements were performed , and blood sample s were collected . RESULTS Seven women dropped out because of pregnancy , 23 women dropped out because of other reasons , and 27 women completed the study . The HP diet produced a greater weight loss ( mean : 4.4 kg ; 95 % CI : 0.3 , 8.6 kg ) and body fat loss ( mean : 4.3 kg ; 95 % CI : 0.9 , 7.6 kg ) than the SP diet after 6 mo . Waist circumference was reduced more by the HP diet than by the SP diet . The HP diet produced greater decreases in glucose than did the SP diet , which persisted after adjustment for weight changes . There were no differences in testosterone , sex hormone-binding globulin , and blood lipids between the groups after 6 mo . However , adjustment for weight changes led to significantly lower testosterone concentrations in the SP-diet group than in the HP-diet group . CONCLUSION Replacement of carbohydrates with protein in ad libitum diets improves weight loss and improves glucose metabolism by an effect that seems to be independent of the weight loss and , thus , seems to offer an improved dietary treatment of PCOS women Background / Objectives : The aim of the study was to compare the effect of two-meal patterns ( three vs six meals per day ) on glucose and insulin levels in women with polycystic ovary syndrome (PCOS).Subjects/ Methods : In a r and omised , crossover , 24-week study , 40 women with PCOS , aged 27±6 years , body mass index 27±6 kg/m2 , followed a weight maintenance diet ( % carbohydrates : protein : fat , 40:25:35 ) , consumed either as a three- or a six-meal pattern , with each intervention lasting for 12 weeks . Anthropometric measurements , diet compliance and subjective hunger , satiety and desire to eat were assessed biweekly . All women underwent an oral glucose tolerance test ( OGTT ) with 75 g glucose for measurement of plasma glucose  and insulin at the beginning and end of each intervention . HaemoglobinA1c ( HbA1c ) , blood lipids and hepatic enzymes were measured at the beginning and end of each intervention . Results : Body weight remained stable throughout the study . Six meals  decreased significantly fasting insulin ( P=0.014 ) and post-OGTT insulin sensitivity ( Matsuda index , P=0.039 ) vs three meals . After incorporation of individual changes over time , with adjustment for potential confounders , the only variable that remained significant was the Matsuda index , which was then used in multivariate analysis and general linear models . Six meals  improved post-OGTT insulin sensitivity independently of age and body weight vs three meals ( P=0.012 ) . No significant differences were found between six and three meals for glucose , HbA1c , blood lipids , hepatic enzymes , subjective desire to eat and satiety . Conclusions : Six meals had a more favourable effect on post-OGTT insulin sensitivity in women with PCOS compared with isocaloric three meals Objective : The recommended composition of a hypocaloric diet for obese women with polycystic ovary syndrome ( PCOS ) is unclear . The aim of this study was to investigate the effects of a high-protein , low-glycemic-load diet compared with a conventional hypocaloric diet on reproductive hormones , inflammatory markers , lipids , glucose , and insulin levels in obese women with PCOS . Methods : A total of 60 overweight and obese women with PCOS who did not use insulin-sensitizing agents were recruited and r and omly assigned to 1 of the 2 hypocaloric diet groups for a single-blind clinical trial . The groups included a conventional hypocaloric diet ( CHCD ) ( 15 % of daily energy from protein ) and a modified hypocaloric diet ( MHCD ) with a high-protein , low-glycemic load ( 30 % of daily energy from protein plus low-glycemic-load foods selected from a list ) that was prescribed via counseling visits weekly during 12 weeks of study . Anthropometric assessment s and biochemical measurements including reproductive hormones , inflammatory factors , lipids , glucose , and insulin were performed on fasting blood sample s at baseline and after 12 weeks of dietary intervention . Results : Weight loss was significant and similar in the 2 groups . Mean of testosterone in the MHCD and CHCD groups decreased from 1.78 ± 0.32 to 1.31 ± 0.26 ng/ml and from 1.51 ± 0.12 to 1.15 ± 0.11 ng/ml , respectively ( p < 0.001 ) . Follicle sensitizing hormone ( FSH ) , luteinizing hormone ( LH ) , and blood lipids concentrations were not changed except low-density lipoprotein cholesterol ( LDL-C ) was reduced by 24.5 % ± 12.3 % ( p < 0.001 for both ) after 12 weeks of intervention . MHCD result ed in a significant reduction in insulin level , homeostatic model assessment for insulin resistance ( HOMA ) , and high-sensitivity C- reactive protein ( hsCRP ) concentration ( p < 0.001 ) . Conclusions : In this study both hypocaloric diets significantly led to reduced body weight and and rogen levels in these two groups of women with PCOS . The combination of high-protein and low-glycemic-load foods in a modified diet caused a significant increase in insulin sensitivity and a decrease in hsCRP level when compared with a conventional diet BACKGROUND Women with polycystic ovary syndrome ( PCOS ) present with vascular abnormalities , including elevated markers of endothelial dysfunction . There is limited evidence for the effect of lifestyle modification and weight loss on these markers . The aim of this study was to determine if 20 weeks of a high-protein energy-restricted diet with or without exercise in women with PCOS could improve endothelial function . METHODS This is a secondary analysis of a subset of 50 overweight/obese women with PCOS ( age : 30.3 ± 6.3 years ; BMI : 36.5 ± 5.7 kg/m(2 ) ) from a previous study . Participants were r and omly assigned by computer generation to one of three 20-week interventions : diet only ( DO ; n = 14 , ≈ 6000 kJ/day ) , diet and aerobic exercise ( DA ; n = 16 , ≈ 6000 kJ/day and five walking sessions/week ) and diet and combined aerobic-resistance exercise ( DC ; n = 20 , ≈ 6000 kJ/day , three walking and two strength sessions/week ) . At Weeks 0 and 20 , weight , markers of endothelial function [ vascular cell adhesion molecule-1 ( sVCAM-1 ) , inter-cellular adhesion molecule-1 ( sICAM-1 ) , plasminogen activator inhibitor-1 ( PAI-1 ) and asymmetric dimethylarginine ( ADMA ) ] , insulin resistance and hormonal profile were assessed . RESULTS All three treatments result ed in significant weight loss ( DO 7.9 ± 1.2 % , DA 11.0 ± 1.6 % , DC 8.8 ± 1.1 ; P < 0.001 for time ; P = 0.6 time × treatment ) . sVCAM-1 , sICAM-1 and PAI-1 levels decreased with weight loss ( P≤ 0.01 ) , with no differences between treatments ( P ≥ 0.4 ) . ADMA levels did not change significantly ( P = 0.06 ) . Testosterone , sex hormone-binding globulin and the free and rogen index ( FAI ) and insulin resistance also improved ( P < 0.001 ) with no differences between treatments ( P ≥ 0.2 ) . Reductions in sVCAM-1 were correlated to reductions in testosterone ( r = 0.32 , P = 0.03 ) and FAI ( r = 0.33 , P = 0.02 ) as well as weight loss ( r= 0.44 , P = 0.002 ) . Weight loss was also associated with reductions in sICAM-1 ( r= 0.37 , P = 0.008 ) . CONCLUSIONS Exercise training provided no additional benefit to following a high-protein , hypocaloric diet on markers of endothelial function in overweight/obese women with PCOS Polycystic ovary syndrome ( PCOS ) , the most common endocrine disorder in women of reproductive age , is characterized by hyper and rogenism , oligo/amenorrhea , and polycystic ovaries 
    Output:
    