TY - JOUR
T1 - The effect of lifestyle intervention on systemic oxidative stress in women with obesity and infertility
T2 - A post-hoc analysis of a randomized controlled trial
AU - Wang, Zheng
AU - Bourgonje, Arno R.
AU - Groen, Henk
AU - Abdulle, Amaal E.
AU - Cantineau, Astrid E. P.
AU - van Oers, Anne M.
AU - van Dammen, Lotte
AU - Bulthuis, Marian L. C.
AU - Wekker, Vincent
AU - Mol, Ben W. J.
AU - the LIFEstyle study group
AU - Roseboom, Tessa J.
AU - van Goor, Harry
AU - Hoek, Annemieke
N1 - Funding Information: This trial was funded by ZonMw (Prevention Program-Health Care Efficiency Research; Project Number 50-50110-96-518). ZonMw had no role in data collection, analysis, interpretation of data or writing the report. We would like to thank the women who participated in this study. We would like to acknowledge Mrs. A. Bolster (University Medical Center Groningen) as senior trainer of the intervention coaches. We thank all lifestyle coaches, research nurses, research midwives and office members of the Dutch Consortium 2.0 (www.studies-obsgyn.nl) for their hard work and dedication. We also thank Marjan Reinders for her excellent technical assistance. Group Authorship of The LIFEstyle Study Group: In addition to the listed authors, W.K.H. Kuchenbecker (Isala, Zwolle), D.A.M. Perquin (Medisch Centrum Leeuwarden, Leeuwarden), C.A.M. Koks (Maxima Medisch Centrum, Veldhoven), R. van Golde (Maastricht Universitair Medisch Centrum, Maastricht), E.M. Kaaijk (OLVG, Amsterdam), G.J.E. Oosterhuis (St. Antonius Ziekenhuis, Nieuwegein), F.J. Broekmans (Universitair Medisch Centrum Utrecht, Utrecht), N.E.A. Vogel (Martini Ziekenhuis, Groningen), J.A. Land (Univerisiteit Groningen, Groningen), C.B. Lambalk (VU medisch centrum, Amsterdam), N.F. Klijn (Leiden Universitair Medisch Centrum, Leiden), P.E.A.M. Mercelina (Atrium Medisch Centrum, Heerlen), Y.M. van Kasteren (Noordwest Ziekenhuisgroep, Alkmaar), A.W. Nap (Rijnstate Ziekenhuis, Arnhem), E.T.C.M. Gondrie (Zuyderland Medisch Centrum, Sittard) and J.P. de Bruin (Jeroen Bosch Ziekenhuis, Den Bosch) are members of the LIFEstyle study group and collaborated on this study. Publisher Copyright: © 2021, MDPI. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - We aimed to study whether lifestyle intervention could reduce systemic oxidative stress (OS) and the association between OS and cardiometabolic outcomes in women with obesity and infertility. From 2009 to 2012, infertile women with a BMI ≥ 29 kg/m2 were randomly assigned to a six-month lifestyle intervention followed by infertility treatment (N = 289) or to prompt infertility treatment (N = 285). Fasting serum free thiols (FT) concentrations were determined by colorimetry at baseline, at three and six months after randomization. Generalized estimating equations and restricted cubic spline regressions were used to estimate mean differences in serum FT levels between groups and to explore associations between serum FT levels and cardiometabolic outcomes. Baseline serum FT levels did not differ between the two groups (N = 203 in the intervention group vs. N = 226 in the control group, 222.1 ± 48.0 µM vs. 229.9 ± 47.8 µM, p = 0.09). Body weight decreased by 3.70 kg in the intervention group compared with the control group at six months (95% confidence interval [CI]: -7.61 to 0.21, p = 0.06). No differences in serum FT levels were observed between groups at either three months (N = 142 vs. N = 150, mean differences: -1.03 µM, 95% CI: -8.37 to 6.32, p = 0.78) or six months (N = 104 vs. N = 96, mean differences: 2.19 µM, 95% CI: -5.90 to 10.28, p = 0.60). In a pooled analysis of all available measurements, triglycerides (crude B: 5.29, 95% CI: 1.08 to 9.50, p = 0.01), insulin (crude B: 0.62, 95% CI: 0.26 to 0.98, p = 0.001), and homeostasis model assessment of insulin resistance (crude B: 2.50, 95% CI: 1.16 to 3.38, p < 0.001) were positively associated with serum FT levels. High-sensitivity C-reactive protein (hs-CRP) was negatively associated with serum FT levels (crude B: -0.60, 95% CI: -1.11 to -0.10, p = 0.02). The change in hs-CRP during the lifestyle intervention was strongly and inversely associated with serum FT levels (crude B: -0.41, 95% CI: -0.70 to -0.13, p = 0.005). No significant deviations from linear associations were observed between serum FT and hs-CRP. We do not observe an improvement in systemic OS in women with obesity and infertility with modest weight loss. There were potential associations between OS and biomarkers of cardiometabolic health. Trial registration: This trial was registered on 16 November 2008 at the Dutch trial register (NTR1530).
AB - We aimed to study whether lifestyle intervention could reduce systemic oxidative stress (OS) and the association between OS and cardiometabolic outcomes in women with obesity and infertility. From 2009 to 2012, infertile women with a BMI ≥ 29 kg/m2 were randomly assigned to a six-month lifestyle intervention followed by infertility treatment (N = 289) or to prompt infertility treatment (N = 285). Fasting serum free thiols (FT) concentrations were determined by colorimetry at baseline, at three and six months after randomization. Generalized estimating equations and restricted cubic spline regressions were used to estimate mean differences in serum FT levels between groups and to explore associations between serum FT levels and cardiometabolic outcomes. Baseline serum FT levels did not differ between the two groups (N = 203 in the intervention group vs. N = 226 in the control group, 222.1 ± 48.0 µM vs. 229.9 ± 47.8 µM, p = 0.09). Body weight decreased by 3.70 kg in the intervention group compared with the control group at six months (95% confidence interval [CI]: -7.61 to 0.21, p = 0.06). No differences in serum FT levels were observed between groups at either three months (N = 142 vs. N = 150, mean differences: -1.03 µM, 95% CI: -8.37 to 6.32, p = 0.78) or six months (N = 104 vs. N = 96, mean differences: 2.19 µM, 95% CI: -5.90 to 10.28, p = 0.60). In a pooled analysis of all available measurements, triglycerides (crude B: 5.29, 95% CI: 1.08 to 9.50, p = 0.01), insulin (crude B: 0.62, 95% CI: 0.26 to 0.98, p = 0.001), and homeostasis model assessment of insulin resistance (crude B: 2.50, 95% CI: 1.16 to 3.38, p < 0.001) were positively associated with serum FT levels. High-sensitivity C-reactive protein (hs-CRP) was negatively associated with serum FT levels (crude B: -0.60, 95% CI: -1.11 to -0.10, p = 0.02). The change in hs-CRP during the lifestyle intervention was strongly and inversely associated with serum FT levels (crude B: -0.41, 95% CI: -0.70 to -0.13, p = 0.005). No significant deviations from linear associations were observed between serum FT and hs-CRP. We do not observe an improvement in systemic OS in women with obesity and infertility with modest weight loss. There were potential associations between OS and biomarkers of cardiometabolic health. Trial registration: This trial was registered on 16 November 2008 at the Dutch trial register (NTR1530).
KW - Cardiometabolic health
KW - High-sensitivity C-reactive protein
KW - Infertility
KW - Lifestyle intervention
KW - Obesity
KW - Oxidative stress
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=85115992475&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/jcm10184243
DO - https://doi.org/10.3390/jcm10184243
M3 - Article
C2 - 34575354
SN - 2077-0383
VL - 10
JO - Journal of clinical medicine
JF - Journal of clinical medicine
IS - 18
M1 - 4243
ER -