《1. 引言》

1. 引言

《2. 材料与方法》

2. 材料与方法

《2.1. 背景》

2.1. 背景

《2.2. 研究人群》

2.2. 研究人群

《2.3. 干预》

2.3. 干预

《2.4. 变量》

2.4. 变量

《2.5. 数据分析》

2.5. 数据分析

《2.6. 伦理》

2.6. 伦理

《3. 结果》

3. 结果

1000名受试者的基线数据和临床特征见表1。患者的平均年龄为28岁，平均BMI为24.2。多毛症和痤疮的发生率分别为26.6%和32.4%。18.5%的女性有黑棘皮症，22.2%的女性月经失调严重（闭经），91.7%的女性有卵巢多囊样改变（PCOM）。男性伴侣的平均年龄为 30岁，平均精子浓度为9.74 × 107 mL–1

《表1》

The values in parentheses are total numbers or percentages.

WHR: waist-to-hip ratio; PCOM: polycystic ovary morphology; SBP: systolic blood pressure; DBP: diastolic blood pressure; CC: clomiphene citrate.

《表2》

The values in parentheses are total numbers or percentages.

MAP: mean arterial pressure.

SI conversion factors: To convert LH and FSH to IU∙L–1 , multiply by 1.0; P to nmol∙L–1 , multiply by 3.18; E2 to pmol∙L–1 , multiply by 3.671; total T to nmol∙ L–1 , multiply by 0.0347; SHBG to nmol∙L–1 , multiply by 8.896; free T to nmol∙L–1 , multiply by 0.0000347; glucose to mmol∙L–1 , multiply by 0.0555; insulin to pmol∙L–1 , multiply by 6.945; triglycerides to mmol∙L–1 , multiply by 0.0113; and total cholesterol, HDL-C, and LDL-C to mmol∙L–1 , multiply by 0.0259.

a The Kruskal–Wallis test was used to compare the differences between the three groups.

《表3》

Abs. diff.: absolute difference; CI: confidence interval.

a Live birth was defined as the delivery of a live-born infant ≥ 20 weeks’ gestation. Conception was defined as any positive serum level of human chorionic gonadotropin. Pregnancy was defined as an intrauterine pregnancy with fetal heart motion as determined by ultrasonography. Ovulation was defined as a serum progesterone level according to the standard of the local site laboratory (minimum value of luteal phase). Biochemical factor was defined as a positive urine or serum human chorionic gonadotropin test, but no fetus or gestational sac was visible on ultrasound.

b The chi-square test was used to compare the difference between three groups.

《表4》

The values in parentheses are total numbers or percentages.

a The Kruskal–Wallis test was used to compare the differences between two groups.

《表5》

a Live birth was defined as the delivery of a live-born infant ≥ 20 weeks’ gestation. Conception was defined as any positive serum level of human chorionic gonadotropin. Pregnancy was defined as an intrauterine pregnancy with fetal heart motion as determined by ultrasonography. Ovulation was defined as a serum progesterone level according to the standard of the local site laboratory (minimum value of luteal phase). Biochemical factor was defined as a positive urine or serum human chorionic gonadotropin test, but no fetus or gestational sac was visible on ultrasound.

b The chi-square test was used to compare the differences between three groups.

《4. 讨论》

4. 讨论

《4.1. BMI 增加加重 PCOS 表型》

4.1. BMI 增加加重 PCOS 表型

《4.2. BMI 增加导致干预效果减弱》

4.2. BMI 增加导致干预效果减弱

PCOSAct试验发现，BMI是临床结局的重要因素。随着BMI增加，排卵率、受孕率、妊娠率和活产率均降低。这与美国239 127个IVF周期的鲜胚IVF队列研究一致，该研究表明，BMI增加组的妊娠结局出现进展性恶化且具有统计学意义[23]。最近，对PCOS女性而言，在不孕治疗前通过改变生活方式减重很有好处[24]。因此，如果BMI较高的PCOS女性想要怀孕，则建议减重。

《4.3. 不同生活方式导致不同的 BMI 和表型》

4.3. 不同生活方式导致不同的 BMI 和表型

《致谢》

《Compliance with ethics guidelines》

Compliance with ethics guidelines

Jingshu Gao, Hongli Ma, Yu Wang, Xinming Yang, Yijuan Cao, Bei Zhang, Conghui Han, and Xiaoke Wu declare that they have no conflict of interest or financial conflicts to disclose.