Prevalence of Sarcopenic obesity in patients with Polycystic ovary syndrome and efficacy of individualised lifestyle modifications for treatment of Sarcopenic obesity: A Matched Case Control and pre-post intervention study.

·       Rationale/ gaps in existing knowledge

Sarcopenic obesity (SO) is a clinical and functional condition characterized by the coexistence of obesity, characterized by excess fat mass (FM), and sarcopenia (low skeletal muscle mass and function). Sarcopenic obesity is thought to be the consequence of dieting and the cause of weight management problems. SO research in low- and middle- income countries (LMICs) is very limited and comprehensive data on diagnosis and prevalence of SO in India are lacking therefore SO remains largely unsuspected and undiagnosed.

 Â·       Novelty

Despite several common risk factors for sarcopenic obesity and PCOS, the prevalence of SO in women with PCOS is currently not known. Present study is the first study nationally and internationally estimating prevalence of SO in women with PCOS, followed by development of individualised lifestyle modifications modules for  treatment of Sarcopenic obesity.

·       Objectives

To compare the proportion of sarcopenic obesity between an age-BMI matched women with PCOS diagnosed using Rotterdam criteria and healthy controls, assessing efficacy of individualised lifestyle modifications for treatment of Sarcopenic obesity. Furthermore, we want to compare the metabolic parameters, markers of inflammation and insulin resistance between SO and non-SO patients.

·       Methods

Seventy 18 to 35 years age women diagnosed with PCOS as cases and 70 age and BMI matched healthy controls will be recruited in the study. Body composition will be assessed once at the time of recruitment using dual-energy X-ray absorptiometry. At baseline metabolic parameters relevant to the study will be done. Nutritional status will be assessed using 24-hour recall method and food frequency questionnaire. After DEXA who come out to be sarcopenic obese will be given individualised lifestyle modifications (low glycaemic index diet with adequate protein as per RDA and resistant exercise training) for treatment of Sarcopenic obesity along with standard treatment.

 Â·       Expected outcome

o   Present study will estimate the prevalence of SO in PCOS patients. It will help in developing primary preventive measures and a screening strategy for SO.

o   Development of dietary and exercise modules specific for management of sarcopenic obesity.

o   Early detection of SO in PCOS, may help in tackling the long term adverse outcomes of SO like NCDs and may guide the healthcare professionals  in the management of PCOS having associated SO, as the treatment regime for SO is quite different as Obesity management strategies should cut fat, not muscle.