Skip to main content
Log in

Dieta chetogenica, fertilità femminile e sindrome dell’ovaio policistico

  • RASSEGNA
  • Published:
L'Endocrinologo Aims and scope

Sommario

La Sindrome dell’Ovaio Policistico (PCOS), disordine endocrino-metabolico tra i più comuni nelle donne in età fertile, determina un impatto negativo sull’intero stato di salute, riproduttivo e metabolico della donna e molto spesso coesiste con uno stato di obesità che sembra essere sia un fattore di rischio sia un fattore aggravante di questa sindrome. L’intervento dietetico e la successiva perdita di peso rappresentano la linea di intervento principale migliorando significativamente il decorso della patologia; tuttavia, non è ancora chiaro quale sia il miglior approccio nutrizionale da adottare nella PCOS. In particolare, un elevato apporto di carboidrati e l’infiammazione cronica di basso grado cooperano con l’insulino-resistenza e l’iperandrogenismo sull’espressione fisiopatologica della PCOS. L’insulina regola l’attività degli enzimi ovarici ed epatici coinvolti nella produzione di androgeni e innesca l’infiammazione cronica di basso grado associata a insulino-resistenza, dislipidemia e malattie cardio-metaboliche. Una dieta sbilanciata, associata tali alterazioni, è una componente chiave in questo “quartetto mortale” di fattori di rischio associati alla fisiopatologia della PCOS. Approcci dietetici nutrizionalmente equilibrati sono uno strumento primario sia preventivo che terapeutico nelle donne con PCOS, riducendo l’insulino-resistenza e promuovendo miglioramenti ormonali e metabolici e, di conseguenza, riproduttivi, conferendo al nutrizionista un ruolo chiave. In questo contesto, la dieta chetogenica è stata proposta come un’attraente strategia nutrizionale sia per la gestione dell’obesità che delle comorbidità della PCOS, metaboliche, endocrine e riproduttive. Nella presente rassegna, riportiamo le ultime e più recenti evidenze disponibili in letteratura scientifica sull’uso della dieta chetogenica nella PCOS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Bibliografia

  1. Azziz R (2018) Polycystic ovary syndrome. Obstet Gynecol 132(2):321–336

    Article  Google Scholar 

  2. Rotterdam EA-SPcwg (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19(1):41–47

    Article  Google Scholar 

  3. Gonzalez F (2012) Inflammation in polycystic ovary syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids 77(4):300–305

    Article  CAS  Google Scholar 

  4. Mehrabani HH, Salehpour S, Amiri Z et al. (2012) Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: a randomized controlled intervention study. J Am Coll Nutr 31(2):117–125

    Article  CAS  Google Scholar 

  5. Deswal R, Yadav A, Dang AS (2018) Sex hormone binding globulin – an important biomarker for predicting PCOS risk: a systematic review and meta-analysis. Syst Biol Reprod Med 64(1):12–24

    Article  CAS  Google Scholar 

  6. Moghetti P, Tosi F, Castello R et al. (1996) The insulin resistance in women with hyperandrogenism is partially reversed by antiandrogen treatment: evidence that androgens impair insulin action in women. J Clin Endocrinol Metab 81(3):952–960

    CAS  PubMed  Google Scholar 

  7. Teede HJ, Misso ML, Costello MF et al. (2018) Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod 33(9):1602–1618

    Article  Google Scholar 

  8. Moran L, Norman RJ (2004) Understanding and managing disturbances in insulin metabolism and body weight in women with polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 18(5):719–736

    Article  CAS  Google Scholar 

  9. Jaacks LM, Vandevijvere S, Pan A et al. (2019) The obesity transition: stages of the global epidemic. Lancet Diabetes Endocrinol 7(3):231–240

    Article  Google Scholar 

  10. Barber TM, Hanson P, Weickert MO, Franks S (2019) Obesity and polycystic ovary syndrome: implications for pathogenesis and novel management strategies. Clin Med Insights Reprod Health 13:1179558119874042

    Article  Google Scholar 

  11. Barber TM, McCarthy MI, Franks S, Wass JA (2007) Metabolic syndrome in polycystic ovary syndrome. Endokrynol Pol 58(1):34–41

    PubMed  Google Scholar 

  12. Barber TM, Franks S (2013) Genetics of polycystic ovary syndrome. Front Horm Res 40:28–39

    Article  CAS  Google Scholar 

  13. Lim SS, Davies MJ, Norman RJ, Moran LJ (2012) Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Updat 18(6):618–637

    Article  CAS  Google Scholar 

  14. Day F, Karaderi T, Jones MR et al. (2018) Large-scale genome-wide meta-analysis of polycystic ovary syndrome suggests shared genetic architecture for different diagnosis criteria. PLoS Genet 14(12):e1007813

    Article  Google Scholar 

  15. Moghetti P, Tosi F (2021) Insulin resistance and PCOS: chicken or egg? J Endocrinol Invest 44(2):233–244

    Article  CAS  Google Scholar 

  16. Diamanti-Kandarakis E, Dunaif A (2012) Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev 33(6):981–1030

    Article  CAS  Google Scholar 

  17. Toulis KA, Goulis DG, Farmakiotis D et al. (2009) Adiponectin levels in women with polycystic ovary syndrome: a systematic review and a meta-analysis. Hum Reprod Updat 15(3):297–307

    Article  CAS  Google Scholar 

  18. Singh A, Bora P, Krishna A (2018) Systemic adiponectin treatment reverses polycystic ovary syndrome-like features in an animal model. Reprod Fertil Dev 30(4):571–584

    Article  CAS  Google Scholar 

  19. Ludwig DS (2020) The ketogenic diet: evidence for optimism but high-quality research needed. J Nutr 150(6):1354–1359

    Article  Google Scholar 

  20. Trimboli P, Castellana M, Bellido D, Casanueva FF (2020) Confusion in the nomenclature of ketogenic diets blurs evidence. Rev Endocr Metab Disord 21(1):1–3

    Article  Google Scholar 

  21. Muscogiuri G, El Ghoch M, Colao A et al. (2021) European guidelines for obesity management in adults with a very low-calorie ketogenic diet: a systematic review and meta-analysis. Obes Facts 14(2):222–245

    Article  CAS  Google Scholar 

  22. Pavon S, Lazaro E, Martinez O et al. (2021) Ketogenic diet and cognition in neurological diseases: a systematic review. Nutr Rev 79(7):802–813

    Article  CAS  Google Scholar 

  23. Kuchkuntla AR, Shah M, Velapati S et al. (2019) Ketogenic diet: an endocrinologist perspective. Curr Nutr Rep 8(4):402–410

    Article  Google Scholar 

  24. Mavropoulos JC, Yancy WS, Hepburn J, Westman EC (2005) The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond) 2:35

    Article  Google Scholar 

  25. Paoli A, Mancin L, Giacona MC et al. (2020) Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med 18(1):104

    Article  CAS  Google Scholar 

  26. Alwahab U, Pantalone K, Burguera B (2018) A ketogenic diet may restore fertility in women with polycystic ovary syndrome: a case series. AACE Clin Case Rep 4(5):e427–e431

    Article  Google Scholar 

  27. Paschou SA, Polyzos SA, Anagnostis P et al. (2020) Nonalcoholic fatty liver disease in women with polycystic ovary syndrome. Endocrine 67(1):1–8

    Article  CAS  Google Scholar 

  28. Luukkonen PK, Dufour S, Lyu K et al. (2020) Effect of a ketogenic diet on hepatic steatosis and hepatic mitochondrial metabolism in nonalcoholic fatty liver disease. Proc Natl Acad Sci USA 117(13):7347–7354

    Article  CAS  Google Scholar 

  29. Li J, Bai WP, Jiang B et al. (2021) Ketogenic diet in women with polycystic ovary syndrome and liver dysfunction who are obese: a randomized, open-label, parallel-group, controlled pilot trial. J Obstet Gynaecol Res 47(3):1145–1152

    Article  CAS  Google Scholar 

  30. Basciani S, Camajani E, Contini S et al. (2020) Very-low-calorie ketogenic diets with whey, vegetable, or animal protein in patients with obesity: a randomized pilot study. J Clin Endocrinol Metab 105(9):dgaa336

    Article  Google Scholar 

  31. Barrea L, Verde L, Vetrani C et al. (2022) VLCKD: a real time safety study in obesity. J Transl Med 20(1):23

    Article  Google Scholar 

  32. Caprio M, Infante M, Moriconi E et al. (2019) Very-low-calorie ketogenic diet (VLCKD) in the management of metabolic diseases: systematic review and consensus statement from the Italian Society of Endocrinology (SIE). J Endocrinol Invest 42(11):1365–1386

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luigi Barrea.

Ethics declarations

Conflitto di interesse

Gli autori Luigi Barrea, Ludovica Verde, Mariagrazia Tarsitano e Giovanna Muscogiuri dichiarano di non avere conflitti di interesse.

Consenso informato

Lo studio presentato in questo articolo non ha richiesto sperimentazione umana.

Studi sugli animali

Gli autori di questo articolo non hanno eseguito studi sugli animali.

Additional information

Proposto da A. Faggiano.

Nota della casa editrice

Springer Nature rimane neutrale in riguardo alle rivendicazioni giurisdizionali nelle mappe pubblicate e nelle affiliazioni istituzionali.

Informazioni Supplementari

I link al materiale elettronico supplementare sono elencati qui sotto.

(DOC 28 kB)

(DOC 26 kB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barrea, L., Verde, L., Tarsitano, M.G. et al. Dieta chetogenica, fertilità femminile e sindrome dell’ovaio policistico. L'Endocrinologo 23, 364–370 (2022). https://doi.org/10.1007/s40619-022-01120-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40619-022-01120-6

Parole chiave

Navigation