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Zhang H, Ye Y, Zhao Y, Li S, Jiao P, Yang Y, Jin Y, Zeng L, Zhang H, Chen M, Jiang H, Zhou L, Li J, Li D, Li R. Obesity is associated with lower levels of negative emotions in polycystic ovary syndrome in clinical and animal studies. Ann Med 2024; 56:2373199. [PMID: 38956857 PMCID: PMC11225633 DOI: 10.1080/07853890.2024.2373199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in women of reproductive age. It is frequently comorbid with obesity and negative emotions. Currently, there are few reports on the relationship between obesity and negative emotions in patients with PCOS. Here we performed both basic and clinical studies to study the relationship between obesity and negative emotions in PCOS. METHODS We performed a cross-sectional study including 608 patients with PCOS and 184 healthy participants to assess the mental health status of people with different body mass indices (BMI). Self-rated anxiety, depression, and perceived stress scales were used for subjective mood evaluations. Rat PCOS models fed 45 and 60% high-fat diets were used to confirm the results of the clinical study. Elevated plus maze and open field tests were used to assess anxiety- and depression-like behaviors in rats. RESULTS We observed overweight/obesity, increased depression, anxiety, and perceived stress in women with PCOS, and found that anxiety and depression were negatively correlated with BMI in patients with severe obesity and PCOS. Similar results were confirmed in the animal study; the elevated plus maze test and open field test demonstrated that only 60% of high fat diet-induced obesity partly reversed anxiety- and depression-like behaviors in PCOS rats. A high-fat diet also modulated rat hypothalamic and hippocampal luteinizing hormone and testosterone levels. CONCLUSION These results reveal a potential relationship between obesity and negative emotions in PCOS and prompt further investigation. The interactions between various symptoms of PCOS may be targeted to improve the overall well-being of patients.
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Affiliation(s)
- Haolin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yang Ye
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yue Zhao
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Shi Li
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Peijie Jiao
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Yang Yang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yuxin Jin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Meishuang Chen
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Hong Jiang
- Department of Neurobiology, School of Basic Medical Sciences, Neuroscience Research Institute, Peking University, Beijing, China
| | - Lifei Zhou
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Jiayi Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Dong Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Rong Li
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
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Kataoka J, Stener‐Victorin E, Schmidt J, Larsson I. A prospective 12-month structured weight loss intervention in women with severe obesity and polycystic ovary syndrome: Impact of weight loss on eating behaviors. Acta Obstet Gynecol Scand 2024; 103:1615-1624. [PMID: 38717931 PMCID: PMC11266713 DOI: 10.1111/aogs.14867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION The knowledge regarding eating behavior and disorders in women with polycystic ovary syndrome (PCOS) and severe obesity is limited. This study aimed to assess eating behavior and lifestyle factors in women with severe obesity (BMI ≥35 kg/m2), with and without PCOS, and the effect of weight loss on these behaviors. MATERIAL AND METHODS A prospective clinical trial with participants screened for PCOS using National Institutes of Health criteria. Participants completed the Food Frequency Questionnaire, International Physical Activity Questionnaire, Three-Factor Eating Questionnaire, and Questionnaire of Eating and Weight Patterns-revised, and were evaluated regarding binge eating disorder using DSM-5 criteria before and after a 12-month weight loss intervention. CLINICALTRIALS gov: NCT01319162. RESULTS 246 women were included (PCOS n = 63, age 33.0 ± 8.4, BMI 39.9 ± 4.7; non-PCOS n = 183, age 37.7 ± 8.7, BMI 39.6 ± 4.3). Women with PCOS showed elevated baseline scores in cognitive restraint eating (50.0 [33.3-63.2]) compared to women without PCOS (38.9 [27.8-55.6]; p = 0.012). No differences were observed between groups in emotional and uncontrolled eating. In both groups, cognitive restraint eating was negatively correlated with energy intake (PCOS: r = -0.315, p < 0.05; non-PCOS: r = -0.214, p < 0.001), while uncontrolled eating displayed a positive correlation with energy intake (PCOS: r = 0.263, p = 0.05; non-PCOS: r = 0.402, p < 0.001). A positive correlation was found between emotional eating and energy intake only in women without PCOS (r = 0.400, p < 0.001). Baseline self-reported energy intake and physical activity did not differ between groups. At 12-month follow-up, women with PCOS reported reduced fat intake. Women without PCOS reported reduced energy intake, carbohydrates and sugar, increased protein, reduced scores for emotional and uncontrolled eating, and heightened scores for cognitive restraint eating. Comparing changes from baseline to follow-up, differences were found between groups in cognitive restraint, intake of fat, carbohydrates, and sugar. The mean weight loss was 12-14 kg, with no between-group difference (p = 0.616). CONCLUSIONS Women with severe obesity and PCOS showed elevated cognitive restraint eating behaviors compared to women without PCOS. Although significant weight loss was seen in both groups, alterations in eating behavior more favorable for weight loss were only seen in women without PCOS.
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Affiliation(s)
- Josefin Kataoka
- Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Obstetrics and GynaecologySahlgrenska University HospitalGothenburgSweden
| | | | - Johanna Schmidt
- Institute of Clinical Sciences, Sahlgrenska academyUniversity of GothenburgGothenburgSweden
- Göteborgs IVF‐klinikGothenburgSweden
| | - Ingrid Larsson
- Department of MedicineSahlgrenska University HospitalGothenburgSweden
- Institute of Medicine, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Ji S, Yang H, Ji Y, Wu W, Dong Y, Fu H, Tang N, Hou Z, Wang F. Liraglutide Improves PCOS Symptoms in Rats by Targeting FDX1. Reprod Sci 2024; 31:2049-2058. [PMID: 38441776 DOI: 10.1007/s43032-024-01503-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/22/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder characterized by ovulatory disorders, hyperandrogenemia, and polycystic changes in the ovaries. FDX1 is a ferredoxin-reducing protein on human mitochondria that plays an important role in steroid anabolism. Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has recently emerged as a potential therapeutic agent for PCOS. Recent studies have suggested that FDX1 may be associated with the development of PCOS. This study aims to explore the pivotal role of FDX1 in the amelioration of PCOS through liraglutide intervention. MATERIALS AND METHODS A PCOS rat model was induced via subcutaneous DHEA injections. Following successful model establishment, the rats were treated with liraglutide combined with metformin, or with each drug individually, over a six-week period. After 6 weeks of treatment, we assessed changes in body weight, fasting blood glucose, sex hormone levels, estrous cycle regularity, ovarian morphology, FDX1 expression in ovarian tissue, and ovarian ROS levels. RESULTS PCOS rats exhibited significant increases in body weight and fasting blood glucose levels, disrupted estrous cycles, and polycystic ovarian morphology. FDX1 expression was notably reduced in the ovarian tissues of PCOS rats. Treatment with liraglutide, both alone and in combination with metformin, led to improvements in body weight, fasting blood glucose, sex hormone balance, estrous cycle regularity, ovarian morphology, and ovarian ROS levels. Notably, FDX1 expression was significantly restored in all treatment groups, with the most substantial increase observed in the liraglutide-treated group. CONCLUSION This study suggests that FDX1 could serve as a potential biomarker for elucidating the underlying mechanisms of liraglutide's therapeutic effects in PCOS management.
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Affiliation(s)
- Shuqing Ji
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China
| | - Hua Yang
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China
| | - Yuqing Ji
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China
| | - Weifan Wu
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China
| | - Yaping Dong
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China
| | - Hongxia Fu
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China
| | - Na Tang
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Institute of Endocrinology, Chu Hsien-I Memorial Hospital, Tianjin Medical University, 300134, Tianjin, China
| | - Zhimin Hou
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Institute of Endocrinology, Chu Hsien-I Memorial Hospital, Tianjin Medical University, 300134, Tianjin, China.
| | - Fang Wang
- Department of Gynaecology, the Second Hospital of Tianjin Medical University, 300211, Tianjin, China.
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Kujanpää L, Arffman RK, Pesonen P, Hurskainen E, Järvelin MR, Franks S, Tapanainen JS, Morin-Papunen L, Piltonen TT. Polycystic ovary syndrome presents as a multimorbid condition by age 50: birth cohort linkage to national register data. Eur J Endocrinol 2024; 190:409-420. [PMID: 38781435 DOI: 10.1093/ejendo/lvae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/03/2024] [Accepted: 05/22/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE This population-based follow-up study investigated register-based disease diagnoses and medication use up till age of 50 years among women with polycystic ovary syndrome (PCOS) that were identified from a population-based birth cohort. DESIGN Population-based longitudinal cohort study. PATIENTS Women reporting oligo/amenorrhea and hirsutism at age 31 and/or who were diagnosed with PCOS by a physician by age 46 (n = 244) and women without PCOS symptoms or diagnosis (n = 1556) in the Northern Finland Birth Cohort 1966. MAIN OUTCOME MEASURES National register data on diagnosed diseases (International Statistical Classification of Diseases [ICD]-8-10) and medication use (Anatomical Therapeutic Chemical) until the age of 50. RESULTS Women with PCOS had a 26% higher risk for any registered diagnosis (risk ratio [RR]: 1.26 [1.09-1.46]) and a 24% higher risk for medication use (RR: 1.24 [1.05-1.46]) compared with non-PCOS women, even after adjusting for several confounders. Several main ICD categories were more prevalent among women with PCOS versus non-PCOS controls, eg, endocrine, metabolic, nervous system, musculoskeletal, and genitourinary diseases in addition with different symptoms and injuries. Surprisingly, even though the overall morbidity was only increased in women with PCOS with a body mass index (BMI) ≥ 25 kg/m2, there were several ICD main categories that showed higher comorbidity risk especially in women with PCOS with a BMI < 25 kg/m2. Several medications were prescribed more often to women with PCOS versus non-PCOS controls, eg, medications related to the alimentary tract and metabolism, the cardiovascular system, genitourinary system drugs and sex hormones, dermatologic and hormonal preparations, and medications to treat the musculoskeletal, nervous, and respiratory systems. CONCLUSION Women with PCOS are burdened with multimorbidity and higher medication use, independent of BMI and other confounders. Accordingly, preventive strategies are needed to alleviate the disease burden and improve the health outcomes of women with PCOS.
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Affiliation(s)
- Linda Kujanpää
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, 90220 Oulu, Finland
| | - Riikka K Arffman
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, 90220 Oulu, Finland
| | - Paula Pesonen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
| | - Elisa Hurskainen
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, 90220 Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life-Course Epidemiology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, SW7 2BT London, United Kingdom
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, Oulu University Hospital, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, 00014 Helsinki, Finland
- Department of Obstetrics and Gynecology, HFR-Cantonal Hospital of Fribourg, University of Fribourg, 79085 Fribourg, Switzerland
| | - Laure Morin-Papunen
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, 90220 Oulu, Finland
| | - Terhi T Piltonen
- Research Unit of Clinical Medicine, University of Oulu, 90220 Oulu, Finland
- Medical Research Center Oulu (MRC Oulu), University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, 90220 Oulu, Finland
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Huddleston HG, Milani A, Blank R. Productivity loss due to polycystic ovary syndrome and its relationship to race, mental health and healthcare delivery indices. F S Rep 2024; 5:157-163. [PMID: 38983727 PMCID: PMC11228788 DOI: 10.1016/j.xfre.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 07/11/2024] Open
Abstract
Objective To study the impact of polycystic ovary syndrome (PCOS) on work-related impairments and explore relationships with race, mental health, and healthcare delivery indices. Design A cross-sectional internet-based survey. Setting North American women with PCOS between August 2022 and October 2022. Patients Individuals with a self-reported diagnosis of PCOS. Interventions Not applicable. Main Outcome Measures The primary outcome was missed work because of PCOS. The secondary outcomes included leave from work, impacts on the quality of work, and feelings of being held back at work because of PCOS. Results Of 1,105 respondents, 1,058 reported having PCOS diagnosed by a physician. Of this group, 50.4% reported missing work because of PCOS, 72% felt that PCOS impacted the quality of their work, and 51.5% felt held back at work by PCOS. Multivariate analyses revealed that missing work because of PCOS was independently associated with black race, lack of insurance, requiring multiple doctors for a PCOS diagnosis, needing ≥3 doctors for current care, decreased satisfaction with care, and symptoms of anxiety and depression. Conclusions Polycystic ovary syndrome significantly impacts employment-related productivity. Factors such as race, mental health, and healthcare delivery appear to play a crucial role in the extent of this impact.
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Affiliation(s)
- Heather Gibson Huddleston
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, San Francisco, California
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Guan M, Li R, Wang B, He T, Luo L, Zhao J, Lei J. Healthcare professionals' perspectives on the challenges with managing polycystic ovary syndrome: A systematic review and meta-synthesis. PATIENT EDUCATION AND COUNSELING 2024; 123:108197. [PMID: 38377709 DOI: 10.1016/j.pec.2024.108197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/06/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To provide an overview of healthcare professionals' experience of PCOS management and identify the relevant facilitators and barriers. METHODS A systematic search was conducted in MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL database from the earliest available date to April 2023. Qualitative and mixed methods studies that described healthcare professionals' experiences of PCOS management were included. RESULTS A total of 74 findings were extracted from the 8 included studies, which were categorized into facilitators and barriers. The barriers were meta-aggregated into four themes: the weakness of clinical evidence; women's low adherence to PCOS management; various obstacles that healthcare professionals face, and the influence of social environment and culture. The facilitators were meta-aggregated into three themes: chronic disease healthcare plan, communication techniques and healthcare professionals' ability and awareness. CONCLUSION The findings of this study have the potential to improve the care provided to women with PCOS. However, it is important for national health professionals and policy markers to consider the cultural context of their own country when implementing these findings. PRACTICAL IMPLICATIONS This study illustrated several challenges in managing the heterogeneous condition of PCOS and provide insights for the development of medical policies and future research directions.
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Affiliation(s)
- Minhui Guan
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Rong Li
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Binglu Wang
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Tan He
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Lan Luo
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China
| | - Jinxin Zhao
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China; Xiang Ya Nursing School of Central South University, 172 Tongzipo Road, Yuelu District, Changsha 410013, Hunan, China.
| | - Jun Lei
- Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University,138 Tongzipo Road, Yuelu District, Changsha 410013, Hunan,China.
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Cao Y, Wang W, Song X, Wen Q, Xie J, Zhang D. Identification of Key Genes and Imbalanced SNAREs Assembly in the Comorbidity of Polycystic Ovary Syndrome and Depression. Genes (Basel) 2024; 15:494. [PMID: 38674428 PMCID: PMC11049873 DOI: 10.3390/genes15040494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/02/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Women with polycystic ovary syndrome (PCOS) have increased odds of concurrent depression, indicating that the relationship between PCOS and depression is more likely to be comorbid. However, the underlying mechanism remains unclear. Here, we aimed to use bioinformatic analysis to screen for the genetic elements shared between PCOS and depression. METHODS Differentially expressed genes (DEGs) were screened out through GEO2R using the PCOS and depression datasets in NCBI. Protein-protein interaction (PPI) network analysis and enrichment analysis were performed to identify the potential hub genes. After verification using other PCOS and depression datasets, the associations between key gene polymorphism and comorbidity were further studied using data from the UK biobank (UKB) database. RESULTS In this study, three key genes, namely, SNAP23, VTI1A, and PRKAR1A, and their related SNARE interactions in the vesicular transport pathway were identified in the comorbidity of PCOS and depression. The rs112568544 at SNAP23, rs11077579 and rs4458066 at PRKAR1A, and rs10885349 at VTI1A might be the genetic basis of this comorbidity. CONCLUSIONS Our study suggests that the SNAP23, PRKAR1A, and VTI1A genes can directly or indirectly participate in the imbalanced assembly of SNAREs in the pathogenesis of the comorbidity of PCOS and depression. These findings may provide new strategies in diagnosis and therapy for this comorbidity.
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Affiliation(s)
- Yi Cao
- Biomedical Center, Qingdao University, No. 308 Ningxia Road, Qingdao 266021, China; (Y.C.); (X.S.); (Q.W.)
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, Qingdao 266021, China;
| | - Xuxia Song
- Biomedical Center, Qingdao University, No. 308 Ningxia Road, Qingdao 266021, China; (Y.C.); (X.S.); (Q.W.)
| | - Qian Wen
- Biomedical Center, Qingdao University, No. 308 Ningxia Road, Qingdao 266021, China; (Y.C.); (X.S.); (Q.W.)
| | - Jing Xie
- Biomedical Center, Qingdao University, No. 308 Ningxia Road, Qingdao 266021, China; (Y.C.); (X.S.); (Q.W.)
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, No. 308 Ningxia Road, Qingdao 266021, China;
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Hsu TW, Kao YC, Tsai SJ, Bai YM, Su TP, Chen TJ, Liang CS, Chen MH. Suicide Attempts After a Diagnosis of Polycystic Ovary Syndrome : A Cohort Study. Ann Intern Med 2024; 177:335-342. [PMID: 38315996 DOI: 10.7326/m23-2240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Limited evidence exists about suicide risk in persons with polycystic ovary syndrome (PCOS). OBJECTIVE To assess suicide risk in persons with PCOS, accounting for psychiatric comorbid conditions and age group. DESIGN Cohort study. SETTING Data from the Taiwanese nationwide database from 1997 to 2012. PATIENTS A cohort of 18 960 patients diagnosed with PCOS, each matched with control participants in a 1:10 ratio on the basis of age, psychiatric comorbid conditions, urbanization level, and income. Suicide attempts were evaluated using Cox regression models. MEASUREMENTS Suicide risk with hazard ratios (HRs). RESULTS Participants with PCOS had a notable 8.47-fold increase in risk for suicide attempt compared with the control group (HR, 8.47 [95% CI, 7.54 to 9.51]), after adjustment for demographic characteristics, psychiatric comorbid conditions, Charlson Comorbidity Index scores, and frequency of all-cause clinical visits. The elevated risk was evident across the adolescent (HR, 5.38 [CI, 3.93 to 7.37]), young adult (<40 years; HR, 9.15 [CI, 8.03 to 10.42]), and older adult (HR, 3.75 [CI, 2.23 to 6.28]) groups. Sensitivity analyses involving the exclusion of data from the first year or the first 3 years of observation yielded consistent results. LIMITATION Potential underestimation of PCOS and mental disorder prevalence due to use of administrative claims data; lack of clinical data, such as body mass index and depressive symptoms; and no assessment of a confounding effect of valproic acid exposure. CONCLUSION This study underscores the heightened risk for suicide attempt that persons with PCOS face, even after adjustment for demographics, psychiatric comorbid conditions, physical conditions, and all-cause clinical visits. This suggests the importance of routine monitoring of mental health and suicide risk in persons diagnosed with PCOS. PRIMARY FUNDING SOURCE Taipei Veterans General Hospital, Yen Tjing Ling Medical Foundation, and Ministry of Science and Technology of Taiwan.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, E-DA Dachang Hospital, and Department of Psychiatry, E-DA Hospital, Kaohsiung, Taiwan (T.-W.H.)
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, and Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Y.-C.K., C.-S.L.)
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (S.-J.T., Y.-M.B., M.-H.C.)
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (S.-J.T., Y.-M.B., M.-H.C.)
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University; and Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan (T.-P.S.)
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, and Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan, and Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan (T.-J.C.)
| | - Chih-Sung Liang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, and Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Y.-C.K., C.-S.L.)
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (S.-J.T., Y.-M.B., M.-H.C.)
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Alur-Gupta S, Dokras A, Cooney LG. Management of polycystic ovary syndrome must include assessment and treatment of mental health symptoms. Fertil Steril 2024; 121:384-399. [PMID: 38244713 DOI: 10.1016/j.fertnstert.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder with reproductive and metabolic manifestations affecting millions of women worldwide. The health risks associated with PCOS, however, go beyond physical health. Over the past decade, data have emerged demonstrating a high risk of concurrent mental health conditions, specifically depression and anxiety, but extending into other aspects of psychological health, including body image distress, eating disorders, and sexual dysfunction. International surveys suggest physician knowledge about the mental health associations with PCOS is poor and that patients are often dissatisfied regarding counseling-related psychological issues. We performed a review of mental health comorbidities in individuals with PCOS, including depression, anxiety, body image distress, eating disorders, psychosexual dysfunction, and decreased quality of life, as well as evaluated the impact of common PCOS treatments on these conditions. Most meta-analyses in reproductive age women demonstrate increased risks of these conditions, although data are more limited in adolescents and older adults. In addition, the impact of PCOS treatments on these conditions as well as data on first-line treatments in the PCOS population is limited. All providers involved in the multidimensional care of individuals with PCOS should be aware of these mental health risks to provide appropriate screening, counseling and referral options. Future studies should be designed to evaluate targeted treatment for individuals with PCOS.
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Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura G Cooney
- Department of Obstetrics and Gynecology, University of Wisconsin, Middleton, Wisconsin
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Huddleston HG, Jaswa EG, Casaletto KB, Neuhaus J, Kim C, Wellons M, Launer LJ, Yaffe K. Associations of Polycystic Ovary Syndrome With Indicators of Brain Health at Midlife in the CARDIA Cohort. Neurology 2024; 102:e208104. [PMID: 38295344 DOI: 10.1212/wnl.0000000000208104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Polycystic ovary syndrome (PCOS) is a common reproductive disorder associated with an adverse cardiometabolic profile early in life. Increasing evidence links cardiovascular risk factors, such as diabetes and hypertension, to accelerated cognitive aging. However, less is known about PCOS and its relationship to brain health, particularly at midlife. Our goal was to investigate possible associations between PCOS and midlife cognitive function and brain MRI findings in an ongoing prospective study. METHODS We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a geographically diverse prospective cohort study of individuals who were 18-30 years at baseline (1985-1986) and followed for 30 years. We identified women with PCOS from an ancillary study (CARDIA Women's study (CWS); n = 1,163) as those with elevated androgen levels and/or hirsutism in conjunction with symptoms of oligomenorrhea. At year 30, participants completed cognitive testing, including the Montreal Cognitive Assessment, Rey Auditory Verbal Learning Test (RAVLT) (verbal learning and memory), Digit Symbol Substitution Test (processing speed and executive function), Stroop test (attention and cognitive control), and category and letter fluency tests (semantics and attention). A subset completed brain MRI to assess brain structure and white matter integrity. Multivariable linear regression models estimated the association between PCOS and outcomes, adjusting for age, race, education, and study center. RESULTS Of the 1163 women in CWS, 907 completed cognitive testing, and of these, 66 (7.1%) met criteria for PCOS (age 54.7 years). Women with and without PCOS were similar for age, BMI, smoking/drinking status, and income. At year 30, participants with PCOS performed lower (mean z score; 95% CI) on Stroop (-0.323 (-0.69 to -7.37); p = 0.008), RAVLT (-0.254 (-0.473 to -0.034); p = 0.002), and category fluency (-0.267 (-0.480 to -0.040); p = 0.02) tests. Of the 291 participants with MRI, 25 (8.5%) met PCOS criteria and demonstrated lower total white matter fractional anisotropy, a measure of white matter integrity (coefficient (95% CI) -0.013 (-0.021 to -0.005); p = 0.002), though not abnormal white matter. DISCUSSION Our results suggest that women with PCOS have lower cognitive performance and lower white matter integrity at midlife. Additional research is needed to confirm these findings and to determine potential mechanistic pathways including potential modifiable factors.
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Affiliation(s)
- Heather G Huddleston
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Eleni G Jaswa
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Kaitlin B Casaletto
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - John Neuhaus
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Catherine Kim
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Melissa Wellons
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Lenore J Launer
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
| | - Kristine Yaffe
- From the Department of Obstetrics, Gynecology and Reproductive Sciences (H.G.H., E.G.J.), Memory and Aging Center (K.B.C.), and Departments of Epidemiology and Biostatistics (J.N.) and Psychiatry (K.Y.), University of California, San Francisco; Department of Medicine (C.K.), University of Michigan, Ann Arbor; Department of Medicine (M.W.), Vanderbilt University, Nashville, TN; and Laboratory of Epidemiology and Population Sciences (L.J.L.), Intramural Research Program, National Institute on Aging, Gaithersburg, MD
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11
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He J, Deng R, Wei Y, Zhang S, Su M, Tang M, Wang J, Nong W, Lei X. Efficacy of antioxidant supplementation in improving endocrine, hormonal, inflammatory, and metabolic statuses of PCOS: a meta-analysis and systematic review. Food Funct 2024; 15:1779-1802. [PMID: 38251706 DOI: 10.1039/d3fo02824k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Background and aim: A large number of recent studies have reported on the use of antioxidants in patients with polycystic ovary syndrome (PCOS). This study aimed to evaluate the antioxidant effects on PCOS. Methods: We searched PubMed, Embase, Web of Science, and The Cochrane Library to identify randomized controlled trials investigating the use of antioxidants in treating PCOS. Statistical analysis was performed using Review Manager 5.4. Stata17.0 software was used to conduct sensitivity analyses. Results: This meta-analysis included 49 articles and 62 studies. The sample comprised 1657 patients with PCOS from the antioxidant group and 1619 with PCOS from the placebo group. The meta-analysis revealed that the fasting blood glucose levels [standardized mean difference (SMD): -0.31, 95% confidence interval (CI): -0.39 to -0.22, P < 0.00001], the homeostatic model assessment of insulin resistance (SMD: -0.68, 95% CI: -0.87 to -0.50], P < 0.00001), and insulin levels (SMD: -0.68, 95% CI: -0.79 to -0.58, P < 0.00001) were significantly lower in patients with PCOS taking antioxidants than those in the placebo group. Further, total cholesterol levels (SMD: -0.38, 95% CI: -0.56 to -0.20, P < 0.001), low-density lipoprotein cholesterol levels (SMD: -0.24, 95% CI: -0.37 to -0.10, P = 0.0008), and very low-density lipoprotein levels (SMD: -0.53, 95% CI: -0.65 to -0.41, P < 0.00001) were lower in patients with PCOS taking antioxidant supplements compared with the placebo group. Total testosterone (TT) level (SMD: -0.78, 95% CI: -1.15 to -0.42, P < 0.0001), dehydroepiandrosterone level (SMD: -0.42, 95% CI: -0.58 to -0.25, P < 0.00001), and mean standard deviation modified Ferriman-Gallway (MF-G scores) (SMD: -0.63, 95% CI: -0.98 to -0.28, P = 0.0004) were lower in patients taking antioxidant supplements. C-reactive protein (CRP) levels (SMD: -0.48, 95% CI: -0.63 to -0.34, P < 0.000001), body mass index [mean difference (MD): -0.27, 95% CI: -0.50 to -0.03, P = 0.03], weight (MD: -0.73, 95% CI: -1.35 to -0.11, P = 0.02), and diastolic blood pressure (MD: -3.78, 95% CI: -6.30 to -1.26, P = 0.003) were significantly lower. Moreover, the levels of sex hormone-binding protein (SMD: 0.23, 95% CI: 0.07-0.38, P = 0.004), high-density lipoprotein cholesterol (SMD: 0.11, 95% CI: 0.01-0.20, P = 0.03), total antioxidant capacity (SMD: 0.59, 95% CI: 0.31-0.87, P < 0.0001), and quantitative insulin sensitivity index (SMD: 0.01, 95% CI: 0.01-0.02, P < 0.00001) were higher in patients with PCOS who took antioxidant supplements compared with the placebo group. Antioxidant supplements did not affect other analyzed parameters in these patients, including follicle-stimulating hormone, free androgen index, nitric oxide, glutathione, malondialdehyde, and diastolic blood pressure. Conclusions: Antioxidants are beneficial in treating PCOS. Our study might provide a new treatment strategy for patients with clinical PCOS. We hope that more high-quality studies evaluating the effects of antioxidants on patients with PCOS will be conducted in the future. Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023448088.
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Affiliation(s)
- Junhui He
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
- Department of Obstetrics and Gynecology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, 533300, China.
| | - Renhe Deng
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Yanhong Wei
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
- Department of Obstetrics and Gynecology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, 533300, China.
| | - Shun Zhang
- Department of Reproductive Medical Center, The Affiliated Hospital of Guilin Medical University, Guilin 541001, China
| | - Mingxuan Su
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Masong Tang
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Jinyuan Wang
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | - Weihua Nong
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
- Department of Obstetrics and Gynecology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, 533300, China.
| | - Xiaocan Lei
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
- Department of Obstetrics and Gynecology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, 533300, China.
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Hu R, Geng Y, Huang Y, Liu Z, Li F, Dong H, Ma W, Song K, Zhang M, Zhang Z, Song Y. New insights into the interaction between polycystic ovary syndrome and psychiatric disorders: A narrative review. Int J Gynaecol Obstet 2024; 164:387-420. [PMID: 37458179 DOI: 10.1002/ijgo.14988] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 01/15/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent endocrine disease characterized by hyperandrogenism, ovulatory dysfunction, and ovarian polycystic changes, which combines with reproductive problems, metabolic disorders, and psychological disorders to exhibit a far-reaching impact on the physical and mental health of women. We reviewed previous research and discovered that psychiatric disorders are more common in PCOS patients and their children, potentially exacerbating the condition and creating a vicious loop. To understand the reasons, relevant articles were collected following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines from PubMed, Web of Science, and Cochrane Library, through December 2022. Evidence suggested that PCOS-related clinical manifestations, hyperandrogenism, insulin resistance, obesity, gut dysbiosis, and other variables may increase the risk of psychiatric disorders in patients. In turn, psychiatric disorders may aggravate the pathologic process of PCOS and increase the difficulty of the treatment. We systematically reported the mechanisms underlying the psychiatric disorders-PCOS interactions, intending to provide potential ways to break the vicious cycle and lay the groundwork for future research. However, research on PCOS and psychiatric disorders were still in initial stages, which limited the scope of this review. More studies are needed to further verify our findings.
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Affiliation(s)
- Runan Hu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuli Geng
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanjing Huang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Liu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Li
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haoxu Dong
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenwen Ma
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kunkun Song
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingmin Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Zhang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yufan Song
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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13
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Syed S, Gragnoli C. The glucocorticoid receptor gene (NR3C1) is linked to and associated with polycystic ovarian syndrome in Italian families. J Ovarian Res 2024; 17:13. [PMID: 38217051 PMCID: PMC10785542 DOI: 10.1186/s13048-023-01329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES Components of the hypothalamic-pituitary axis (HPA) pathway are potential mediators of the genetic risk of polycystic ovarian syndrome (PCOS). Impaired glucocorticoid receptor (NR3C1) expression and function may underlie impaired HPA-axis cortisol activity, thereby also contributing to the increased adrenal cortisol and androgen production present in women with PCOS. In this study, we aimed to identify whether NR3C1 is linked or in linkage disequilibrium (LD), that is, linkage joint to association, with PCOS in Italian peninsular families. METHOD In 212 Italian families with type 2 diabetes (T2D) from the Italian peninsula, previously recruited for a T2D study and phenotyped for PCOS, we used microarray to genotype 25 variants in the NR3C1 gene. We analyzed the 25 NR3C1 variants by Pseudomarker parametric linkage and LD analysis. RESULTS We found the novel implication in PCOS risk of two intronic variants located within the NR3C1 gene (rs10482672 and rs11749561), thereby extending the phenotypic implication related to impaired glucocorticoid receptor. CONCLUSIONS To the best of our knowledge, this is the first study to report NR3C1 as a risk gene in PCOS.
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Affiliation(s)
- Shumail Syed
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE, 68124, USA
- Concord Hospital-Laconia, Laconia, NH, 03246, USA
| | - Claudia Gragnoli
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE, 68124, USA.
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, 17033, USA.
- Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, Rome, 00197, Italy.
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14
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Standeven LR, Ho A, Hantsoo L. Bridging the Gap: Integrating Awareness of Polycystic Ovary Syndrome Into Mental Health Practice. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:53-62. [PMID: 38694159 PMCID: PMC11058927 DOI: 10.1176/appi.focus.20230024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. Individuals with PCOS report reduced quality of life compared with those without PCOS, with possible contributing factors including infertility, hirsutism, irregular menses, and weight gain. Recent literature also supports increased associations between PCOS and co-occurring psychiatric conditions, particularly depression, anxiety, bipolar disorder, and eating disorders. It is concerning that a higher prevalence of suicidal ideation has been observed in individuals with PCOS. Given the high rates of psychiatric burden among those with PCOS, psychiatric care providers are well suited to be on the front lines of screening for psychiatric symptoms as well as initiating treatment. Current interventions include lifestyle changes (improving exercise and nutrition), pharmacological treatments (e.g., insulin-sensitizing agents, oral contraceptives, and psychotropic drugs), and psychotherapeutic interventions (e.g., cognitive-behavioral therapy and mindfulness-based therapy). This review provides an overview of recent research on the prevalence of comorbid psychiatric conditions, a foundation in PCOS-specific symptom screening and diagnosis, and an overview of treatments for psychiatric symptoms among individuals with PCOS.
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Affiliation(s)
- Lindsay R Standeven
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore
| | - Annie Ho
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore
| | - Liisa Hantsoo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore
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15
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Sarkisian KI, Ho L, Yang J, Mandelbaum R, Stanczyk FZ. Neuroendocrine, neurotransmitter, and gut microbiota imbalance contributing to potential psychiatric disorder prevalence in polycystic ovarian syndrome. F S Rep 2023; 4:337-342. [PMID: 38204948 PMCID: PMC10774902 DOI: 10.1016/j.xfre.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 01/12/2024] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women, affecting up to 15% of reproductive-aged women. Polycystic ovarian syndrome is a heterogeneous disorder, both in the sense that many different factors may play a role in its manifestation and that multiple systems throughout the body can be affected. Polycystic ovarian syndrome has been linked to an increased prevalence of various psychiatric disorders, including depression and anxiety. Despite the socioeconomic effect that these disorders may have on patients with PCOS and society as a whole, this association is largely lacking in research. There are currently several theories regarding the link between PCOS and mental health. Some suggest that the overactive hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes in PCOS patients may alter the hormonal profile and contribute to the development of psychiatric disorders. Other studies speculate that abnormal levels of neurotransmitters and neuronal signaling may play a role. Recently, more research has begun to focus on the gut-brain axis, addressing the nutritional needs of PCOS patients. Studies show that dietary factors such as probiotics and micronutrient supplementation may significantly improve psychiatric symptoms in PCOS patients while helping regulate neurotransmitter levels in the body. In this review, we examine different theories regarding the association between PCOS and psychiatric disorders and point out different areas of research that are needed to broaden our understanding of this association.
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Affiliation(s)
- Karis I. Sarkisian
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Lananh Ho
- Department of Biomedical Engineering, University of Rochester, Rochester, New York
| | - Jane Yang
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Rachel Mandelbaum
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank Z. Stanczyk
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
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16
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Amin M, Gragnoli C. The prolactin receptor gene (PRLR) is linked and associated with the risk of polycystic ovarian syndrome. J Ovarian Res 2023; 16:222. [PMID: 37993904 PMCID: PMC10664635 DOI: 10.1186/s13048-023-01280-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 09/12/2023] [Indexed: 11/24/2023] Open
Abstract
The prolactin receptor gene (PRLR) may contribute to polycystic ovarian syndrome (PCOS) since it plays important roles in physiological ovarian functions. PRLR-knockout mice have irregular cycles and subfertility and variants in or around the PRLR gene were associated in humans with female testosterone levels and recurrent miscarriage. We tested 40 variants in the PRLR gene in 212 Italian families phenotyped by type 2 diabetes (T2D) and PCOS and found two intronic PRLR-variants (rs13436213 and rs1604428) significantly linked to and/or associated with the risk of PCOS. This is the first study to report PRLR as a novel risk gene in PCOS. Functional studies are needed to confirm these results.
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Affiliation(s)
- Mutaz Amin
- INSERM, US14-Orphanet, Paris, 75014, France
| | - Claudia Gragnoli
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE, 68124, USA.
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, 17033, USA.
- Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, Rome, 00197, Italy.
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17
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Seemi T, Sharif H, Sharif S, Naeem H, Naeem FUA, Fatima Z. Anxiety levels among school-going adolescents in peri-urban areas of Karachi, Pakistan. PLoS One 2023; 18:e0289967. [PMID: 37856459 PMCID: PMC10586665 DOI: 10.1371/journal.pone.0289967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/28/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Mental health problems are pervasive nowadays. Adolescents are often expected to balance academic performance with familial obligations and work to support the family financially if they belong to low-socio-economic areas. These pressures can lead to Anxiety, stress, and even depression. OBJECTIVE The study's main objective is to assess the association of gender, parenting style, eating habit, and screen timing with the level of Anxiety among school-going adolescents in three peri-urban areas of Karachi, Pakistan. METHODOLOGY A school-based cross-sectional study was conducted among adolescents of age group 10-19 years using the Generalized Anxiety Disorder-7 (GAD-7) scale in two months in, three populated peri-urban areas of Karachi, Pakistan. Collected Data was analyzed by statistical software SPSS version with 80% response rate. FINDING In our collected data, 544 students participated; 313 (57%) were female, and 231(42%) were male. Among them 173(33%) participants showed moderate to severe level of anxiety out of which 140(26%) were female and 33(7%) were male. As per our study, strict Parenting style plays a significant role in developing moderate to severe 108(20%) levels of Anxiety, shown among adolescents in the studied population. In addition to this, those who do not take tuition 115 (21%), do not use transport to school 91(16%), spend significant time in games on mobile and computer 101 (18%), and have no involvement in physical activities 172 (31%) show more moderate to severe level anxiety than others factors. A significant multivariate association between level of anxiety with gender, school commute, type of lunch Intake, smoker family member at home, physical activity, video game, tuition and strict parent. CONCLUSION This study concluded that there are various factors which have great association with anxiety and can affect adolescents' mental health badly. The factors were parental strictness, video game playing, a sedentary lifestyle, and the smoking habits of family members. Children and adolescents must be evaluated as soon as possible while they are still young to prevent mental health issues.
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Affiliation(s)
- Tooba Seemi
- Research Associates SINA Health and Welfare Education Trust, University of Karachi, Karachi, Pakistan
| | - Hina Sharif
- Assistant Manager Pharmacy and Research, SINA Health and Education Welfare Trust, Karachi, Pakistan
| | - Sana Sharif
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Hira Naeem
- Research Associates SINA Health and Welfare Education Trust, University of Karachi, Karachi, Pakistan
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Hazell P, Balzer BWR, Garden F, Handelsman DJ, Paxton K, Hawke C, Ivers R, Skinner SR, Luscombe G, Steinbeck KS. Association of urinary sex hormones with mood and behavior changes in a community adolescent cohort. PLoS One 2023; 18:e0293040. [PMID: 37844097 PMCID: PMC10578568 DOI: 10.1371/journal.pone.0293040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To examine the contribution of variation in sex hormone excretion to mood and behavioral changes in adolescent females and males. DESIGN Prospective, longitudinal observational cohort study. METHODS Participants were 342 volunteers aged 10-12 years living in rural Australia. Urinary estradiol and testosterone levels measured by liquid chromatography-mass spectrometry were obtained at three-month intervals for three years. Integrated measures (area-under-curve) of urinary steroid excretion summarised as absolute and variability during each 12-month period of the study. Psychosocial data were gathered annually with the primary outcome of depressive symptomatology. Secondary outcomes were the other subscales of the Youth Self-Report, impulsive-aggression, sleep habits, and self-harm. RESULTS 277 (158 male) participants contributed data over the full duration of the study and could be included in the analyses. In females, analyses of absolute urine hormone levels found no relationship between estradiol and any outcome, but higher testosterone was significantly associated with depression and poorer sleep. Greater variability of both urine estradiol and testosterone was associated with lower total psychopathology, anxious/depressed and social problems scores. Greater variability in urine estradiol was associated with lower attention problems and impulsive aggression in females. In males, higher testosterone and estradiol levels were associated with rule-breaking, and poorer sleep, and no associations were found for gonadal hormone variability for males. CONCLUSIONS Longitudinal measurement of both iso-sexual and contra-sexual gonadal hormones contributes to a more nuanced view of the impact of sex steroids on mood and behavior in adolescents. These findings may enlighten the understanding of the impact of sex steroids during normal male and female puberty with implications for hormone replacement therapies as well as management of common mood and behavioral problems.
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Affiliation(s)
- Philip Hazell
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
| | - Ben W. R. Balzer
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
- The University of New South Wales Faculty of Medicine, School of Women’s and Children’s Health, Randwick, NSW, Australia
- Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Frances Garden
- Ingham Institute for Medical Research, The University of New South Wales, Liverpool, NSW, Australia
| | - David J. Handelsman
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
| | - Karen Paxton
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
| | - Catherine Hawke
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
| | - Rebecca Ivers
- The University of New South Wales Faculty of Medicine, School of Public Health and Community Medicine, Kensington, NSW, Australia
| | - S. Rachel Skinner
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
- Specialty of Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Sydney, NSW, Australia
| | - Georgina Luscombe
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
| | - Katharine S. Steinbeck
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Camperdown, NSW, Australia
- Specialty of Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Sydney, NSW, Australia
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19
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Garcia-Beltran C, Malpique R, Andersen MS, Bas F, Bassols J, Darendeliler F, Díaz M, Dieris B, Fanelli F, Fröhlich-Reiterer E, Gambineri A, Glintborg D, López-Bermejo A, Mann C, Marin S, Obermayer-Pietsch B, Ødegård R, Ravn P, Reinehr T, Renzulli M, Salvador C, Singer V, Vanky E, Torres JV, Yildiz M, de Zegher F, Ibáñez L. SPIOMET4HEALTH-efficacy, tolerability and safety of lifestyle intervention plus a fixed dose combination of spironolactone, pioglitazone and metformin (SPIOMET) for adolescent girls and young women with polycystic ovary syndrome: study protocol for a multicentre, randomised, double-blind, placebo-controlled, four-arm, parallel-group, phase II clinical trial. Trials 2023; 24:589. [PMID: 37715279 PMCID: PMC10503102 DOI: 10.1186/s13063-023-07593-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most prevalent, chronic endocrine-metabolic disorder of adolescents and young women (AYAs), affecting 5-10% of AYAs worldwide. There is no approved pharmacological therapy for PCOS. Standard off-label treatment with oral contraceptives (OCs) reverts neither the underlying pathophysiology nor the associated co-morbidities. Pilot studies have generated new insights into the pathogenesis of PCOS, leading to the development of a new treatment consisting of a fixed, low-dose combination of two so-called insulin sensitisers [pioglitazone (PIO), metformin (MET)] and one mixed anti-androgen and anti-mineralocorticoid also acting as an activator of brown adipose tissue [spironolactone (SPI)], within a single tablet (SPIOMET). The present trial will evaluate the efficacy, tolerability and safety of SPIOMET, on top of lifestyle measures, for the treatment of PCOS in AYAs. METHODS In this multicentre, randomised, double-blind, placebo-controlled, four-arm, parallel-group, phase II clinical trial, AYAs with PCOS will be recruited from 7 clinical centres across Europe. Intention is to randomise a total of 364 eligible patients into four arms (1:1:1:1): Placebo, PIO, SPI + PIO (SPIO) and SPI + PIO + MET (SPIOMET). Active treatment over 12 months will consist of lifestyle guidance plus the ingestion of one tablet daily (at dinner time); post-treatment follow-up will span 6 months. Primary endpoint is on- and post-treatment ovulation rate. Secondary endpoints are clinical features (hirsutism, menstrual regularity); endocrine-metabolic variables (androgens, lipids, insulin, inflammatory markers); epigenetic markers; imaging data (carotid intima-media thickness, body composition, abdominal fat partitioning, hepatic fat); safety profile; adherence, tolerability and acceptability of the medication; and quality of life in the study participants. Superiority (in this order) of SPIOMET, SPIO and PIO will be tested over placebo, and if present, subsequently the superiority of SPIOMET versus PIO, and if still present, finally versus SPIO. DISCUSSION The present study will be the first to evaluate-in a randomised, double-blind, placebo-controlled way-the efficacy, tolerability and safety of SPIOMET treatment for early PCOS, on top of a lifestyle intervention. TRIAL REGISTRATION EudraCT 2021-003177-58. Registered on 22 December 2021. https://www.clinicaltrialsregister.eu/ctr-search/search?query=%092021-003177-58 .
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Affiliation(s)
- Cristina Garcia-Beltran
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Rita Malpique
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Marianne S Andersen
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Firdevs Bas
- Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), Girona, Spain
| | | | - Marta Díaz
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain
| | - Barbara Dieris
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Flaminia Fanelli
- Department of Medical and Surgical Science-DIMEC, Division of Endocrinology and Diabetes Prevention and Care, University of Bologna - S. Orsola-Hospital, Bologna, Italy
| | - Elke Fröhlich-Reiterer
- Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Alessandra Gambineri
- Department of Medical and Surgical Science-DIMEC, Division of Endocrinology and Diabetes Prevention and Care, University of Bologna - S. Orsola-Hospital, Bologna, Italy
| | - Dorte Glintborg
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Abel López-Bermejo
- Paediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), Paediatrics, Dr. Josep Trueta Hospital, Department of Medical Sciences, University of Girona, Girona, Spain
| | | | - Silvia Marin
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Rønnaug Ødegård
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Centre for Obesity Research, St. Olavs Hospital, Trondheim University Hospital, Torgarden, Trondheim, Norway
| | - Pernille Ravn
- Department of Gynaecology and Obstetrics and Department of Endocrinology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Thomas Reinehr
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Cristina Salvador
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain
| | - Viola Singer
- Department of Paediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten-Herdecke, Datteln, Germany
| | - Eszter Vanky
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, 7006, Trondheim, Norway
| | | | - Melek Yildiz
- Pediatric Endocrinology Unit, Istanbul University, Istanbul, Turkey
| | - Francis de Zegher
- Leuven Research & Development, University of Leuven, 3000, Louvain, Belgium
| | - Lourdes Ibáñez
- Paediatric Endocrinology, Paediatric Research Institute Sant Joan de Déu, University of Barcelona, 08950, Esplugues, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, 28029, Spain.
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Deshmukh H, Papageorgiou M, Wells L, Akbar S, Strudwick T, Deshmukh K, Vitale SG, Rigby A, Vince RV, Reid M, Sathyapalan T. The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)-A Randomised Controlled Trial. Nutrients 2023; 15:3872. [PMID: 37764656 PMCID: PMC10536436 DOI: 10.3390/nu15183872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
We performed an open-label, randomised controlled trial to compare the effects of a very-low-calorie diet (VLCD) vs. moderate energy deficit approach on body weight, body composition, free androgen index (FAI), and metabolic markers in obese women with polycystic ovary syndrome (PCOS). Forty eligible patients were randomly assigned to a VLCD (n = 21) or a conventional energy deficit approach (n = 19) over the same period. After eight weeks, both groups experienced significant weight loss; however, this was greater in the VLCD arm (-10.9% vs. -3.9%, p < 0.0001). There was also a trend towards a reduction in FAI in the VLCD group compared to the energy deficit group (-32.3% vs. -7.7%, p = 0.07). In the VLCD arm, two women (18%) had a biochemical remission of PCOS (FAI < 4); this was not the case for any of the participants in the energy deficit arm. There was a significant within-group increase in the sex-hormone-binding globulin (p = 0.002) and reductions in fasting blood glucose (p = 0.010) and waist to hip ratio (p = 0.04) in the VLCD arm, but not in the energy deficit arm. The VLCD resulted in significantly greater weight reduction and was accompanied by more pronounced improvements in hyperandrogenaemia, body composition, and several metabolic parameters in obese women with PCOS as compared to the energy deficit approach.
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Affiliation(s)
- Harshal Deshmukh
- Department of Academic Diabetes and Endocrinology, Allam Diabetes Centre, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, UK; (H.D.); (S.A.)
- Department of Academic Diabetes and Endocrinology, Hull York Medical School, University of Hull, Hull HU6 7 RX, UK
| | | | - Liz Wells
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7 RX, UK; (L.W.); (R.V.V.)
| | - Shahzad Akbar
- Department of Academic Diabetes and Endocrinology, Allam Diabetes Centre, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, UK; (H.D.); (S.A.)
| | - Thomas Strudwick
- School of Psychology and Social Work, University of Hull, Hull HU6 7 RX, UK; (T.S.); (M.R.)
| | - Ketki Deshmukh
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7 RX, UK; (L.W.); (R.V.V.)
| | - Salvatore Giovanni Vitale
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09121 Cagliari, Italy;
| | - Alan Rigby
- Institute of Clinical and Applied Health Research, Hull York Medical School, Hull HU6 7 RX, UK;
| | - Rebecca V. Vince
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull HU6 7 RX, UK; (L.W.); (R.V.V.)
| | - Marie Reid
- School of Psychology and Social Work, University of Hull, Hull HU6 7 RX, UK; (T.S.); (M.R.)
| | - Thozhukat Sathyapalan
- Department of Academic Diabetes and Endocrinology, Allam Diabetes Centre, Hull University Teaching Hospitals NHS Trust, Hull HU3 2JZ, UK; (H.D.); (S.A.)
- Department of Academic Diabetes and Endocrinology, Hull York Medical School, University of Hull, Hull HU6 7 RX, UK
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21
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Bays HE. Why does type 2 diabetes mellitus impair weight reduction in patients with obesity? A review. OBESITY PILLARS (ONLINE) 2023; 7:100076. [PMID: 37990681 PMCID: PMC10661899 DOI: 10.1016/j.obpill.2023.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 11/23/2023]
Abstract
Background A common adiposopathic complication of obesity is type 2 diabetes mellitus. Healthful weight reduction in patients with obesity can improve glucose metabolism and potentially promote remission of type 2 diabetes mellitus. However, weight-reduction in patients with increased adiposity is impaired among patients with type 2 diabetes mellitus compared to patients without diabetes mellitus. Methods Data for this review were derived from PubMed and applicable websites. Results Among patients with increased body fat, the mechanisms underlying impaired weight reduction for those with type 2 diabetes mellitus are multifactorial, and include energy conservation (i.e., improved glucose control and reduced glucosuria), hyperinsulinemia (commonly found in many patients with type 2 diabetes mellitus), potential use of obesogenic anti-diabetes medications, and contributions from multiple body systems. Other factors include increased age, sex, genetic/epigenetic predisposition, and obesogenic environments. Conclusions Even though type 2 diabetes mellitus impairs weight reduction among patients with increased adiposity, clinically meaningful weight reduction improves glucose metabolism and can sometimes promote diabetes remission. An illustrative approach to mitigate impaired weight reduction due to type 2 diabetes mellitus is choosing anti-diabetes medications that increase insulin sensitivity and promote weight loss and deprioritize use of anti-diabetes medications that increase insulin exposure and promote weight gain.
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Affiliation(s)
- Harold Edward Bays
- Diplomate of American Board of Medicine, Medical Director / President, Louisville Metabolic and Atherosclerosis Research Center, Clinical Associate Professor, University of Louisville School of Medicine, 3288 Illinois Avenue, Louisville, KY, 40213, USA
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22
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Nowicki GJ, Polak M, Ślusarska B, Czernecki K. The Relationship between Diet and the Occurrence of Depressive Symptoms in a Community Example with High Rates of Social Deprivation: A Cross-Sectional Study. Nutrients 2023; 15:3778. [PMID: 37686809 PMCID: PMC10489963 DOI: 10.3390/nu15173778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Research suggests that various biological and psychosocial mechanisms are involved in the heterogeneous and complex relationship between dietary patterns and depressive symptoms. The occurrence of depressive symptoms is thought to be related to socioeconomic status (SES), with those with lower SES being more likely to experience persistent depression. The aim of the undertaken study was to investigate whether socioeconomic and health variables are associated with dietary assessment in a population with high rates of social deprivation and whether a relationship exists between dietary assessment and depressive symptoms (DS). The respondents' nutrition was evaluated through a qualitative method, using the Perinumeric Periodic Table questionnaire by Starzyńska. At the same time, the prevalence of DS was assessed employing the Patient Health Questionnaire-9 (PHQ-9). In the DS screening (PHQ-9 ≥ 10), in the entire study population, the risk of DS was 16.1% (n = 605). In our entire study population, up to 61.2% (n = 2297) of the respondents exhibited poor dietary patterns. In the multivariate model, women with almost adequate or poor dietary assessment were 1.62 and 2.18 times more likely to score at least 10 on the PHQ-9 questionnaire, as compared to women whose dietary assessment was good or adequate. In conclusion, it was determined that sociodemographic variables affect nutritional habits. Women who lived in rural areas limited to a vocational education had significantly poorer diets. Moreover, men, younger men, smokers, and those without chronic diseases were characterized by a poorer dietary assessment. Additionally, women who had a better dietary assessment were significantly more likely to have lower scores on the questionnaire assessing the occurrence of DS (PHQ-9 10).
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Affiliation(s)
- Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Skawińska 8 Str., PL-31-066 Krakow, Poland;
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
| | - Karol Czernecki
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Str., PL-20-081 Lublin, Poland; (B.Ś.); (K.C.)
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Nasiri-Amiri F, Faramarzi M, Omidvar S, Alizadeh-Navaei R. Depression and anxiety in adolescents and young women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Adolesc Med Health 2023:ijamh-2022-0065. [PMID: 37158791 DOI: 10.1515/ijamh-2022-0065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To evaluate the depression and anxiety symptoms, or both in adolescents and young women with polycystic ovary syndrome (PCOS) to those without PCOS. CONTENTS A comprehensive electronic search was conducted to identify observational studies on PCOS patients (January 1991-December 2020). The population study included adolescents and young women (14-29 years of age) in two groups of cases (with PCOS) and controls (without PCOS) who were diagnosed with PCOS using the Rotterdam or National Institutes of Health criteria (NIH). Symptoms of depression, anxiety, or both, reported separately, were of interest. Mean (SD) of depression or anxiety symptoms, or both, as measured by a quantitatively validated scale for both the case and control groups. All eligible studies were quality assessed using the Newcastle-Ottawa Scale (NOS) tool. The initial database search resulted in the discovery of 1,582 papers, of which 806 were selected after screening the titles and abstracts and removing duplicates. A total of 49 papers were found to be suitable for full-text reading. This meta-analysis included ten studies comprising 941 adolescent/young women (391 with PCOS and 550 without PCOS). The standard mean difference (SMD) and its corresponding confidence interval (CI) at 95 % were used to compare depression or anxiety symptoms, or both, between two groups. SUMMARY AND OUTLOOK The results, which included 192 cases, demonstrated that adolescents/young women with PCOS had significantly more depressive symptoms than those without PCOS (n=360) (SMD 0.72; 95 % CI, 0.09-1.34; Z=2.25, p=0.025; Heterogeneity: I2=89.7 %; p=0.000). Also, the results which included 299 cases demonstrated that adolescents/young women with PCOS had significantly more anxiety symptoms than those without PCOS (n=421) (SMD 0.59; 95 % CI, 0.13-1.05; Z=2.51, p=0.012; Heterogeneity: I2=86.1 %; p=0.000). This meta-analysis demonstrates that adolescent/young women with PCOS have significantly more depression or anxiety symptoms than those without PCOS.
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Affiliation(s)
- Fatemeh Nasiri-Amiri
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I. R. Iran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Reproductive Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Midwifery School of Nursing & Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Reza Alizadeh-Navaei
- Biomedical Sciences, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Akintoye OO, Ajibare AJ, Oriyomi IA, Olofinbiyi BA, Oyiza YG, Christanah AD, Babalola TK, Esther FO, Seun O, Owoyele VB. Synergistic action of carvedilol and clomiphene in mitigating the behavioral phenotypes of letrozole-model of PCOS rats by modulating the NRF2/NFKB pathway. Life Sci 2023; 324:121737. [PMID: 37127183 DOI: 10.1016/j.lfs.2023.121737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Psychiatric and cognitive impairment has been observed in premenopausal women with a hormonal disorder called polycystic ovary syndrome (PCOS). This study aimed to explore the possibility of combining pharmacological agents: Carvedilol and Clomiphene citrate, with antiestrogenic, antioxidant and anti-inflammatory properties in letrozole-induced PCOS rats. METHODS PCOS was induced in rats by the administration of letrozole (1 mg/kg) daily for 21 days. They were subsequently divided into four groups, each receiving either the vehicle or Clomiphene citrate (1 mg/kg) or Carvedilol or a combination of Clomiphene citrate and Carvedilol, respectively from days 22-36. Neurobehavioral studies were conducted on day 35 (Elevated plus maze and Y maze) and day 36 (Novel object recognition). The serum levels of the antioxidants Superoxide dismutase, Catalase, Interleukin 1B (IL-1B), and the gene expression of nuclear factor-erythroid factor 2-related factor 2 (Nrf2), Nuclear Factor k-Beta (NFKB), and acetylcholine esterase in the frontal brain homogenate was determined. RESULT Both Carvedilol and the combination therapy reversed the anxiety-like behavior, while Clomiphene citrate and the combination therapy ameliorated the spatial and non-spatial memory impairment observed in PCOS rats. Carvedilol, Clomiphene citrate, and the combination therapy increased the serum concentration of SOD and Catalase and decreased the serum concentration of IL-1B. The combination therapy up-regulated the NRF-2, NFKB, and acetylcholine esterase gene expression. CONCLUSION Study showed that the combination of carvedilol and clomiphene citrate has anxiolytic potential and improved cognitive functions in PCOS rats. This might have been achieved by carvedilol and clomiphene citrate's ability to modulate the cholinergic system and the Nrf2 pathway while downregulating the NFκB signaling pathway.
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Affiliation(s)
| | | | - Isaac Adeola Oriyomi
- Physiology Department, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | - Babatunde Ajayi Olofinbiyi
- Department of Obstetrics and Gynaecology, College of Medicine, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
| | - Yusuf Grace Oyiza
- Physiology Department, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | | | | | | | - Oludipe Seun
- Physiology Department, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria
| | - Victor Bamidele Owoyele
- Physiology Department, Faculty of Basic Medical Sciences, College of Health Science, University of Ilorin, Nigeria
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25
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Adamczak A, Płotek W, Głowińska A, Sobol M, Wysocka E, Polak G, Dymanowska-Dyjak I, Spaczyńska J, Adamczak Ł, Banaszewska B. Time Perspective as a Mediator of Depressive Symptoms in Patients with Polycystic Ovary Syndrome. Healthcare (Basel) 2023; 11:healthcare11070993. [PMID: 37046920 PMCID: PMC10094433 DOI: 10.3390/healthcare11070993] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy characterized by oligo- or anovulation, clinical and/or biochemical markers of hyperandrogenism, and polycystic ovaries, and it is associated with an increased prevalence of depression. Research conducted on psychiatric patients has shown correlations between depression and decreased cognitive function. The aim of this study was to examine the possible mediation of the time perspective (TP) in the development of depressive symptoms in patients with PCOS. Methods: A study was conducted on 83 patients with PCOS and 65 healthy women. Standardized questionnaires were used to assess depressive symptoms (Beck Depression Inventory—BDI-II) and time perspective (Zimbardo Time Perspective Inventory—ZTPI). Results: Our study revealed an indirect influence of depressive symptoms on PCOS through the positive future time perspective. In the logistic regression model, which included depression and a given time perspective as predictors of PCOS, only the future TP (β = −0.004, p < 0.003, OR = 1.004, 95% CI [1.001, 1.008]) was significantly independently related to the occurrence of PCOS. Conclusions: Our result is another argument for the role of psychoeducation and appropriate communication with a patient from the risk group in a way that builds hope and allows to regain influence on life situation.
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Alkan I, Kaplan S. An investigation of the potential effects of amitriptyline on polycystic ovary syndrome induced by estradiol valerate. Histochem Cell Biol 2023:10.1007/s00418-023-02188-3. [DOI: 10.1007/s00418-023-02188-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
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Salajegheh Z, Ahmadi A, Shahrahmani H, Jahani Y, Alidousti K, Nasiri Amiri F, Salari Z. Mindfulness-based stress reduction (MBSR) effects on the worries of women with poly cystic ovary syndrome (PCOS). BMC Psychiatry 2023; 23:185. [PMID: 36944940 PMCID: PMC10032018 DOI: 10.1186/s12888-023-04671-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION Polycystic ovary syndrome is one of the women's most common endocrine disorders that can cause anxiety, psychological distress, and reduced quality of life. Therefore, the present study aimed to determine the effect of mindfulness-based stress reduction counseling on the worries of women with polycystic ovary syndrome. MATERIALS AND METHODS This quasi-experimental was implemented on 60 women with polycystic ovary syndrome, referring to health centers in Kerman, Iran, from April to September 2021. In the intervention group, MBSR was conducted in eight 90-minute sessions twice a week. A researcher-made questionnaire with 34 questions (with six domains including worries related to mental complications, interpersonal problems, non-pregnancy physical complications, pregnancy complications, sexual complications, and religious issues) on the worries of women with polycystic ovary syndrome was completed by the participants in two intervention and control groups as pre-and post-test and one month later. 22 SPSS statistical software was used for analysis. RESULTS The mean score of worries in the intervention group (48.18 ± 5.18) compared to the control group (75.73 ± 8.08) was significantly reduced in total and all six domains immediately after the intervention (P < 0.0001). One month later also, the total mean score of worries and subtitles decreased significantly (P < 0.0001) in the intervention group (38.27 ± 3.58) in comparison with the control group (76.13 ± 7.52). CONCLUSION Results showed that the method of reducing stress based on mindfulness had caused a significant reduction in worries in the intervention group. Therefore, this method can be used to improve the mental health of this group of patients in health centers.
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Affiliation(s)
- Zahra Salajegheh
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Atefeh Ahmadi
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadis Shahrahmani
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Katayoun Alidousti
- Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
| | - Fatemeh Nasiri Amiri
- Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zohreh Salari
- Obstetrics and Gynecology Center, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Cai M, Ni Z, Yuan Z, Yu J, Zhang D, Yao R, Zhou L, Yu C. Past and present: a bibliometric study on polycystic ovary syndrome. J Ovarian Res 2023; 16:42. [PMID: 36803912 PMCID: PMC9938353 DOI: 10.1186/s13048-022-01072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 12/08/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disease that has a great impact on women's physical and mental health. It is a burden to social and patients' economy. In recent years, researchers' understanding of PCOS has reached a new level. However, many PCOS reports have different directions, and overlapping phenomena exist. Therefore, clarifying the research status of PCOS is important. This study aims to summarise the research status of PCOS and predict the hot spots of PCOS in the future by Bibliometricx. RESULTS The keywords of PCOS research focused on PCOS, insulin resistance (IR), obesity and metformin. Keywords plus co-occurrence network showed that PCOS, IR and prevalence were hot spots in the recent 10 years. Moreover, we found that gut microbiota may be a carrier that can be used to study hormone levels, IR-related mechanisms, prevention and treatment in the future. CONCLUSIONS This study is helpful for researchers to quickly grasp the current situation of PCOS research and enlighten researchers to explore new problems in PCOS.
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Affiliation(s)
- Mengcheng Cai
- grid.73113.370000 0004 0369 1660Basic Medicine School, Naval Medical University, Shanghai, 200433 China
| | - Zhexin Ni
- grid.506261.60000 0001 0706 7839Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, 100850 China
| | - Zike Yuan
- grid.73113.370000 0004 0369 1660Basic Medicine School, Naval Medical University, Shanghai, 200433 China
| | - Jin Yu
- Department of Traditional Chinese Gynecology, the First Affiliated Hospital of Naval Military Medical University, Shanghai, 200433 China
| | - Danying Zhang
- Department of Traditional Chinese Gynecology, the First Affiliated Hospital of Naval Military Medical University, Shanghai, 200433 China
| | - Ruipin Yao
- Department of Traditional Chinese Gynecology, the First Affiliated Hospital of Naval Military Medical University, Shanghai, 200433 China
| | - Ling Zhou
- Department of Traditional Chinese Gynecology, the First Affiliated Hospital of Naval Military Medical University, Shanghai, 200433, China.
| | - Chaoqin Yu
- Department of Traditional Chinese Gynecology, the First Affiliated Hospital of Naval Military Medical University, Shanghai, 200433, China.
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Association study to evaluate Foxo1 and Foxo3 gene polymorphisms in polycystic ovary syndrome: a preliminary case-control study and in silico analysis. Mol Biol Rep 2023; 50:3569-3580. [PMID: 36790598 DOI: 10.1007/s11033-023-08292-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is known as a multifactorial and multi-gene-mediated endocrine disorder among women of reproductive age. FoxO1 and FoxO3 are members of the forkhead transcriptional factors family that play a pivotal role in the function of ovaries. The current work is aimed at investigating the association between gene variants of FoxO1 and FoxO3 and the risk of PCOS in a sample of the Iranian population. METHODS AND RESULTS We recruited 200 women diagnosed with PCOS and 200 healthy women. Both polymerase PCR-RFLP and ARMS-PCR methods were used for genotyping. Sanger sequencing was recruited to confirm the genotyping results. The T allele of rs17592236 and the C allele of rs12585277 decreased PCOS risk by 29 and 28%, respectively. In contrast, the C allele of rs2253310 and G allele of rs2802292 increased the risk of PCOS by 1.39 and 1.63 folds, correspondingly. Bioinformatics results showed that some genes, including matrix metallopeptidase 9 (MMP-9), phosphoinositide-3-Kinase Regulatory Subunit 224 1 (PIK3R1), peroxisome proliferator-activated receptor Gamma (PPARG), and glycogen synthase 225 kinase-3 beta (GSK-3 beta) have significant interactions with FoxO1, suggesting that FoxO1 might have crucial roles in regulating different signaling pathways in ovarian cells. CONCLUSION We found that FoxO1 rs17592236C > T and rs12585277C > T had a protective role against PCOS, while FoxO3 rs2253310C > G and rs2802292G > T enhanced the risk of this metabolic disorder in our population. Additional studies on larger populations with varying races are needed to confirm these findings.
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Pokora K, Kowalczyk K, Wikarek A, Rodak M, Pędrys K, Wójtowicz M, Wyskida K, Jonderko M. Depressive Symptoms and Control of Emotions among Polish Women with Polycystic Ovary Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16871. [PMID: 36554751 PMCID: PMC9779637 DOI: 10.3390/ijerph192416871] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/05/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is a disorder that substantially affects women's health. It is particularly diagnosed in young patients. Women with PCOS are burdened with excessive weight gain, overweight and obesity (74%) compared to a healthy female population. Excessive weight influences psychological state and emotional well-being, whereas in the meantime, psychological and behavioral dysfunction is increasingly being diagnosed among patients with PCOS. AIM To assess depressive symptoms and emotional control among women with PCOS in relation to BMI. METHODS The study was conducted among 671 self-reported PCOS women. The standardized Beck Depression Inventory (BDI) was used to assess depressive disorders. Emotion control was assessed using the Courtauld Emotional Control Scale (CECS). RESULTS Moderate and severe depressive symptoms were more common in PCOS women with abnormal BMI compared to normal BMI subjects (p < 0.01). In total, 27.1% of obese women had moderate depression and 28.8% had severe depression. Among overweight women, 19.9% suffered from moderate and 25% from severe depressive symptoms. Underweight women also reported moderate (25.6%) and severe (33.3%) depressive signs. There were no statistically significant differences between the body weight of the women studied and the CECS scores. CONCLUSIONS Depressive symptoms are more common in women with PCOS and abnormal BMI than in women with PCOS and proper BMI. The severity of depressive symptoms increases with BMI, but underweight women with PCOS are also at risk of depressive disorders. The level of suppression of negative emotions is independent of BMI in women with PCOS.
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Affiliation(s)
- Karolina Pokora
- Department of Endocrinological Gynecology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Karolina Kowalczyk
- Department of Endocrinological Gynecology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Agnieszka Wikarek
- Department of Endocrinological Gynecology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
- Pathophysiology Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Małgorzata Rodak
- Department of Endocrinological Gynecology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Karolina Pędrys
- Department of Endocrinological Gynecology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Mariusz Wójtowicz
- Department of Gynecological and Obstetrics Women’s and Child Health Center, Medical University of Silesia, 41-803 Zabrze, Poland
| | - Katarzyna Wyskida
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia, 40-029 Katowice, Poland
| | - Mariola Jonderko
- Department of Endocrinological Gynecology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
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Ali S, Khaleel F, Ali F. Estimation of renin and d-dimer levels in women with polycystic ovary disease with or without coronavirus infection. BAGHDAD JOURNAL OF BIOCHEMISTRY AND APPLIED BIOLOGICAL SCIENCES 2022. [DOI: 10.47419/bjbabs.v3i04.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and objective: Polycystic ovarian syndrome (PCOS) is a common endocrinologic disorder among women of childbearing age. Coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to determine the levels of renin, d-dimer, and some relevant biomarkers in patients with PCOS (with and without COVID-19) compared with non-PCOS patients (with and without COVID-19).
Methods: This cross-sectional study included 120 women [80 PCOS women (40 with COVID-19 and 40 without COVID-19) and 40 non-PCOS women (20 with COVID-19 and 20 without)] with age range of 15–40 years old. Blood samples were collected from participants, and biochemical assays were carried out. Renin and d-dimer levels were determined using the enzyme-linked-immunosorbent-assay (ELISA), lipid-profile and fasting blood glucose concentrations were assessed by using the colorimetric methods, and hormones were evaluated by VIDAS.
Results: Renin and d-dimer levels were found to be significantly higher in PCOS-women groups compared to non-PCOS group. In addition, the results showed that hormones, fasting blood glucose, and lipid-profile are significantly increased in PCOS patients compared to non-PCOS women, while high-density-lipoprotein and follicle-stimulating-hormone levels were low when comparing PCOS patients with non-PCOS ones. The results also showed that a highly significant increase in renin and d-dimer levels can be detected in PCOS patients with COVID-19.
Conclusions: In the present study, we found there is a possible relationship between renin and d-dimer in PCOS patients who are also COVID-19 infected.
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Kocak DY, Ugurlu M. Depression symptoms and quality of life in women with polycystic ovary syndrome. Perspect Psychiatr Care 2022; 58:2837-2845. [PMID: 35735241 DOI: 10.1111/ppc.13131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine depression symptoms and quality of life in women with polycystic ovary syndrome (PCOS). METHODS The data were collected using the Participant Information Form, PCOS Quality of Life Questionnaire (PCOSQ-50), and Beck Depression Inventory (BDI). The study was conducted with 131 women. FINDINGS The average BDI score was found to be lower in women with PCOS who perceived their income as sufficient (p = 0.033) and who worked (p = 0.003) and was found to be higher in the participants who had hirsutism (p = 0.008) and acne (p = 0.045). The PCOSQ-50 average score was 178.15 ± 27.27 in women without depression symptoms and 139.14 ± 31.33 in women with depression symptoms. The PCOSQ-50 total score was higher in women without depressive symptoms (p = 0.000). PRACTICE IMPLICATIONS Healthcare professionals should evaluate depression symptom levels using standard measurement tools and provide appropriate counseling.
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Affiliation(s)
- Derya Yuksel Kocak
- Department of Nursing, Hitit University Faculty of Health Sciences, Corum, Turkey
| | - Meltem Ugurlu
- Department of Midwifery, University of Health Sciences, Gülhane Faculty of Health Sciences, Ankara, Turkey
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Blanco CE. Early diagnosis in polycystic ovary syndrome. Nurse Pract 2022; 47:18-24. [PMID: 36165968 DOI: 10.1097/01.npr.0000873528.58247.9e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT NPs are in an ideal position to educate patients on the lifelong implications of polycystic ovary syndrome (PCOS). A timely diagnosis and comprehensive plan are needed to appropriately manage patients with PCOS. This article highlights diagnostic criteria, common comorbid conditions, psychological impacts of the clinical manifestations, management approaches, and implications for NPs.
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Affiliation(s)
- Christy E Blanco
- Christy E. Blanco is an associate professor at Hunt School of Nursing at Texas Tech University Health Sciences Center El Paso in El Paso, Tex
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Huddleston HG, Casaletto KB, Jaswa EG, Rasgon NL, Maki PP, Cedars MI, Pasch L. Endophenotypic correlates of cognitive function in reproductive-age individuals with polycystic ovary syndrome. F S Rep 2022; 3:372-379. [PMID: 36568925 PMCID: PMC9783146 DOI: 10.1016/j.xfre.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 12/27/2022] Open
Abstract
Objective To characterize cognitive performance in relation to hormonal and metabolic factors in women with polycystic ovary syndrome (PCOS). Design Cross-sectional study. Setting Tertiary university center. Patients A total of 48 individuals, aged 21-46 years, with PCOS according to the Rotterdam criteria. Interventions Complete history and physical examinations, endovaginal ultrasounds, dermatologic assessments, neuropsychological assessments, and metabolic and hormonal serum tests. Main Outcome Measures Sample-based z-scores on a comprehensive cognitive test battery. Results Subjects were defined as having an androgenic (n = 31) or a nonandrogenic (n = 17) PCOS phenotype. Compared with their nonandrogenized counterparts, subjects with hyperandrogenism demonstrated lower relative performance on the tests of executive function (β-coefficient for the executive function composite z-score, -0.44; 95% confidence interval, -0.79 to -0.09), despite similar performance on the tests of memory, verbal reasoning, and perceptual reasoning. These differences were independent of age, years of education, and obesity. In an exploratory analysis in which subjects were stratified by the presence of insulin resistance (IR), subjects with PCOS with both IR and hyperandrogenism showed the lowest performance on a composite score of executive function, followed by those with hyperandrogenism alone. Conclusions In this small study, subjects with hyperandrogenic PCOS demonstrated lower performance on the tests of executive function than subjects with nonandrogenic PCOS. Additional research is needed to confirm these findings in larger cohorts and investigate the role of modifiable factors, including IR, on cognitive outcomes.
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Affiliation(s)
- Heather G. Huddleston
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California,Reprint requests: Heather G. Huddleston, M.D., Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 2356 Sutter Street, 7th Floor, San Francisco, California 94115-0916.
| | - Kaitlin B. Casaletto
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Eleni G. Jaswa
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Natalie L. Rasgon
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | - Pauline P. Maki
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | - Marcelle I. Cedars
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Lauri Pasch
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California,Department of Psychology, University of Illinois Chicago, Chicago, Illinois,Department of Psychiatry, University of California San Francisco, San Francisco, California
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Łagowska K, Pieczyńska JM. Not only diet quality and physical activity but also snacking and skipping meals could be related with menstrual disorders in PCOS. Women Health 2022; 62:667-677. [DOI: 10.1080/03630242.2022.2106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- K. Łagowska
- Department of Human Nutrition and Dietetics, Poznan University of Life Science, Poznań, Poland
| | - J. M. Pieczyńska
- Department of Human Nutrition and Dietetics, Poznan University of Life Science, Poznań, Poland
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Williams S, Fido D, Sheffield D. Polycystic Ovary Syndrome (PCOS) and Non-Suicidal Self-Injury (NSSI): A Community-Based Study. Healthcare (Basel) 2022; 10:healthcare10061118. [PMID: 35742167 PMCID: PMC9222400 DOI: 10.3390/healthcare10061118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still little to no understanding of how non-suicidal self-injury and suicidal ideation and intention manifest in women with PCOS and how this might differ from women without PCOS. Within this cross-sectional investigation, women with and without a diagnosis of PCOS (n = 418) completed validated metrics of emotion dysregulation, rumination and non-suicidal self-injury (NSSI), as well as self-reported indices of previous suicidal ideation and future suicidal intention. Group comparisons indicated that women with, relative to those without, PCOS reported significantly greater metrics across all variables. Moreover, serial mediation analyses were conducted to test the ideation-to-action framework of suicide in women with PCOS, with the positive relationship between a PCOS diagnosis and future suicidal intention being explained through the indirect pathway of increased emotion dysregulation, recent suicidal ideation and NSSI. Our findings call to action the need for international screening for suicide intention and self-harm in women with PCOS.
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Young CC, Monge M, Minami H, Rew L, Conroy H, Peretz C, Tan L. Outcomes of a Mindfulness-Based Healthy Lifestyle Intervention for Adolescents and Young Adults with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol 2022; 35:305-313. [PMID: 34742935 PMCID: PMC9065214 DOI: 10.1016/j.jpag.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 01/18/2023]
Abstract
STUDY OBJECTIVE The purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a mindfulness-based healthy lifestyle self-management intervention with adolescents and young adults diagnosed with polycystic ovary syndrome (PCOS). DESIGN A pilot randomized controlled trial using a pre-post design was used. SETTING Central Texas. PARTICIPANTS Individuals aged 14-23 with a diagnosis of PCOS. INTERVENTIONS The PCOS Kind Mind Program integrates a manualized mindfulness training program (Taming the Adolescent Mind) with health education in 4 key areas of self-management and health promotion: (1) medication adherence, (2) nutrition, (3) physical activity, and (4) sleep. MAIN OUTCOME MEASURES Psychological distress, mindfulness, physical activity strategies, nutrition, and exercise self-efficacy. RESULTS Linear regression models revealed that those in the PCOS Kind Mind condition reported significantly higher nutrition self-efficacy (β = 6.50, 95% CI, 1.71-11.28, P = 0.013, d = 0.48), physical activity strategies (β = 0.41, 95% CI, 0.04-0.79, P = 0.040, d = 0.67), and physical activity self-efficacy (β = 0.48, 95% CI, 0.07-0.88, P = 0.028, d = 0.46). CONCLUSION The PCOS Kind Mind Program improved self-efficacy in the key areas of nutrition and physical activity and increased physical activity strategies in adolescents and young people with PCOS. These findings are encouraging and suggest the need for larger-scale, randomized controlled trials with longer-term follow-up to more robustly evaluate the effects of the PCOS Kind Mind Program on the psychological and physiological health of adolescents and young people with PCOS.
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Affiliation(s)
- Cara C Young
- The University of Texas at Austin, School of Nursing, Austin, Texas, United States of America.
| | - Maria Monge
- The University of Texas at Austin, Dell Medical School, Austin, Texas, United States of America
| | - Haruka Minami
- Fordham University, Bronx, New York, United States of America
| | - Lynn Rew
- The University of Texas at Austin, School of Nursing, Austin, Texas, United States of America
| | - Haley Conroy
- PhD student, University of Houston, Houston, Texas, United States of America
| | - Clara Peretz
- The University of Texas at Austin, Steve Hicks School of Social Work, Austin, Texas, United States of America
| | - Lucy Tan
- Lucy Tan Psychological Services, Ashgrove, Queensland, Australia
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Jiskoot G, van der Kooi AL, Busschbach J, Laven J, Beerthuizen A. Cognitive behavioural therapy for depression in women with Polycystic Ovary Syndrome (PCOS): systematic review and meta-analysis. Reprod Biomed Online 2022; 45:599-607. [DOI: 10.1016/j.rbmo.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
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The Problem of Malnutrition Associated with Major Depressive Disorder from a Sex-Gender Perspective. Nutrients 2022; 14:nu14051107. [PMID: 35268082 PMCID: PMC8912662 DOI: 10.3390/nu14051107] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/03/2023] Open
Abstract
Major depressive disorder (MDD) is an incapacitating condition characterized by loss of interest, anhedonia and low mood, which affects almost 4% of people worldwide. With rising prevalence, it is considered a public health issue that affects economic productivity and heavily increases health costs alone or as a comorbidity for other pandemic non-communicable diseases (such as obesity, cardiovascular disease, diabetes, inflammatory bowel diseases, etc.). What is even more noteworthy is the double number of women suffering from MDD compared to men. In fact, this sex-related ratio has been contemplated since men and women have different sexual hormone oscillations, where women meet significant changes depending on the age range and moment of life (menstruation, premenstruation, pregnancy, postpartum, menopause…), which seem to be associated with susceptibility to depressive symptoms. For instance, a decreased estrogen level promotes decreased activation of serotonin transporters. Nevertheless, sexual hormones are not the only triggers that alter neurotransmission of monoamines and other neuropeptides. Actually, different dietary habits and/or nutritional requirements for specific moments of life severely affect MDD pathophysiology in women. In this context, the present review aims to descriptively collect information regarding the role of malnutrition in MDD onset and course, focusing on female patient and especially macro- and micronutrient deficiencies (amino acids, ω3 polyunsaturated fatty acids (ω3 PUFAs), folate, vitamin B12, vitamin D, minerals…), besides providing evidence for future nutritional intervention programs with a sex-gender perspective that hopefully improves mental health and quality of life in women.
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Andan C, Aydin MF. Evaluation of the Reliability and Quality of YouTube Videos on Ovarian Cysts. Cureus 2022; 14:e22739. [PMID: 35386475 PMCID: PMC8969909 DOI: 10.7759/cureus.22739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/28/2022] Open
Abstract
Aim The aim of this study is to investigate the quality and reliability of YouTube videos containing content related to ovarian cysts. Methods The search terms “Ovarian Cyst”, “Ovarian Cyst Symptoms”, “Ovarian Cyst Treatment”, and “Ovarian Cyst Diagnosis” were searched on YouTube. A total of 110 videos were examined and repetitive videos, non-English videos, videos with advertising content, videos with entertainment and news content, and videos with very poor image and sound quality were excluded. Finally, the videos included in the study were evaluated using DISCERN and Global Quality Scale (GQS). Results It was found that 50 videos examined in this study were uploaded between the years 2014 and 2020, with an average of 492.252 ± 710.768 and a total of 24.612.595 views. The mean DISCERN score given to 50 videos analyzed by two researchers was 2.81 ± 1.3 and the mean GQS score was 2.88 ± 1.4. When we divided the scores given to the videos by two researchers into three groups, it was determined that 27 (54%) of the 50 videos were in the misleading/poor quality group, nine (18%) were in the medium quality group, and 14 (28%) were in the useful/quality group. Conclusion It has been determined that the videos with "ovarian cyst" content on YouTube are generally of poor quality. Bad quality videos were uploaded by non-doctors and attracted more attention than videos uploaded by doctors.
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Abu-Zaid A, Bhagavathula AS, Rahmani J, Alyoubi RA, Alomar O, Baradwan S, Alkhamis WH, Khalifa M, Alshahrani MS, Khadawardi K, Salem H, A Al-Badawi I. Maternal polycystic ovary syndrome and the potential risk of attention-deficit/hyperactivity disorder and autism spectrum disorder in the offspring: a systematic review and meta-analysis. EUR J CONTRACEP REPR 2022; 27:253-260. [PMID: 35191798 DOI: 10.1080/13625187.2022.2040983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are two increasing important problems among children. This study aims to explore the link between maternal polycystic ovary syndrome (PCOS) and the risk of ASD and ADHD in the offspring. METHOD The MOOSE guidelines were followed in the conduct of this meta-analysis. A literature search was done in PubMed/MEDLINE, Scopus, and Web of Science from inception until January 2021. The DerSimonian and Laird random-effects model was used to estimate the combined risk ratios (RR) and 95% confidence intervals (CI). Sensitivity analysis was also used to investigate the effect of each study on the combined results. RESULTS Seven studies, with 1,358,696 participants, comprising 7,334 ADHD cases and 3,920 ASD cases, were included in this study. Children born to mothers with maternal PCOS had higher risks of developing ASD (RR = 1.46, 95% CI: 1.26-1.69, I2 = 64%) and ADHD (RR = 1.43, 95% CI: 1.35-1.41, I2 = 0%) when compared with children born to mothers without maternal PCOS. CONCLUSION This study showed that there might be a link between maternal PCOS and the risk of developing ASD and ADHD in the offspring. This important issue must be considered in PCOS women during and after pregnancy.
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Affiliation(s)
- Ahmed Abu-Zaid
- College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Akshaya Srikanth Bhagavathula
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Jamal Rahmani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reem Abdullah Alyoubi
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama Alomar
- Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Waleed H Alkhamis
- Department of Obstetrics and Gynecology, College of Medicine, King Saud University, King Saud University, Medical City, Saudi Arabia
| | - Mahir Khalifa
- Department of Obstetrics and Gynecology, Hera General Hospital, Makkah, Saudi Arabia
| | - Majed Saeed Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Khalid Khadawardi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hany Salem
- Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ismail A Al-Badawi
- Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Адамян ЛВ, Андреева ЕН, Абсатарова ЮС, Григорян ОР, Дедов ИИ, Мельниченко ГА, Сутурина ЛВ, Филиппов ОС, Шереметьева ЕВ, Чернуха ГЕ, Ярмолинская МИ. [Clinical guidelines «Polycystic Ovary Syndrome»]. PROBLEMY ENDOKRINOLOGII 2022; 68:112-127. [PMID: 35488762 PMCID: PMC9764272 DOI: 10.14341/probl12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. Depending on the period of a woman's life, the clinical picture, diagnosis, and treatment tactics of the disease are different. PCOS has a complex of reproductive, metabolic and psychological characteristics. The target audience of these clinical recommendations are obstetrician-gynecologists, endocrinologists, general practitioners, general practitioners. In these clinical guidelines, all information is ranked according to the level of persuasiveness of recommendations and the reliability of evidence, depending on the number and quality of studies on this issue.
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Affiliation(s)
- Л. В. Адамян
- Национальный исследовательский центр акушерства, гинекологии и перинатологии им. В.И. Кулакова;
Московский государственный медико-стоматологический университет им. А.И. Евдокимова
| | - Е. Н. Андреева
- Национальный медицинский исследовательский центр эндокринологии;
Московский государственный медико-стоматологический университет им. А.И. Евдокимова
| | | | - О. Р. Григорян
- Национальный медицинский исследовательский центр эндокринологии
| | - И. И. Дедов
- Национальный медицинский исследовательский центр эндокринологии
| | | | - Л. В. Сутурина
- Научный центр проблем здоровья семьи и репродукции человека
| | - О. С. Филиппов
- Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет);
Министерство здравоохранения Российской Федерации
| | | | - Г. Е. Чернуха
- Национальный исследовательский центр акушерства, гинекологии и перинатологии им. В.И. Кулакова
| | - М. И. Ярмолинская
- Научно-исследовательский институт акушерства, гинекологии и репродукции им. Д.О. Отта;
Северо-Западный государственный медицинский университет им. И.И. Мечникова
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Donbaloğlu Z, Tuhan H, Çoban ÖG, Kızılay DÖ, İsmailoğlu E, Önder A, Acar S, Bedel A, Çetiner EB, Singin B, Erdem H, Parlak M. Hyperandrogenism correlates with psychological symptoms in adolescents with polycystic ovary syndrome. Clin Pediatr Endocrinol 2022; 31:68-76. [PMID: 35431449 PMCID: PMC8981047 DOI: 10.1297/cpe.2022-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/26/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to analyze the depressive and anxiety states of adolescent girls with
polycystic ovary syndrome (PCOS). This was a cross-sectional, multicenter, case–control
study. A total of 100 participants (PCOS group, 51; control group, 49) aged 13–18 yr were
included in the study. Body mass index was higher in patients with PCOS (P = 0.002). In
the PCOS group, 28.5% of the patients had moderate-to-severe depressive symptoms, whereas
the incidence was lower in controls (8.3%, P = 0.021). The State-Trait Anxiety Inventory
(STAI)-State, STAI-Trait, and physical, psychosocial, and total Pediatric Quality of Life
Inventory PedsQL scores were higher in the PCOS group, suggesting that anxiety was more
common and the quality of life was worse in patients with PCOS than in healthy
participants (P = 0.01, P = 0.03, P = 0.02, P = 0.046, and P = 0.047, respectively). The
serum free testosterone (fT) levels were positively correlated with the depression and
anxiety scores and negatively correlated with the psychosocial PedsQL scores. In
conclusion, adolescent girls diagnosed with PCOS demonstrated higher depressive and
anxiety symptoms and lower psychosocial quality of life scores than their healthy
counterparts. A relationship was found between the fT level and all psychological
measures.
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Affiliation(s)
- Zeynep Donbaloğlu
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Hale Tuhan
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry, Akdeniz University Hospital, Antalya, Turkey
| | - Deniz Özalp Kızılay
- Department of Pediatric Endocrinology, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Eren İsmailoğlu
- Department of Radiology, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Akdeniz University Hospital, Antalya, Turkey
| | - Sezer Acar
- Department of Pediatric Endocrinology, Behçet Uz Children Hospital, İzmir, Turkey
| | - Aynur Bedel
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Ebru Barsal Çetiner
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Berna Singin
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Harun Erdem
- Department of Child and Adolescent Psychiatry, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Mesut Parlak
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
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Karsten MDA, Wekker V, Groen H, Painter RC, Mol BWJ, Laan ETM, Roseboom TJ, Hoek A. The role of PCOS in mental health and sexual function in women with obesity and a history of infertility. Hum Reprod Open 2021; 2021:hoab038. [PMID: 34877412 PMCID: PMC8643501 DOI: 10.1093/hropen/hoab038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 08/27/2021] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do mental health and sexual function differ between women with or without polycystic ovary syndrome (PCOS) with comparable BMI and fertility characteristics? SUMMARY ANSWER Women with PCOS have a poorer mental quality of life than women without PCOS, but there were no differences in symptoms of depression, anxiety, physical quality of life or sexual function. WHAT IS KNOWN ALREADY Various studies suggest that women with PCOS have poorer mental health, such as higher symptoms of anxiety and depression with a lower quality of life, and have an impaired sexual function compared to women without PCOS. However, in most studies, BMI and infertility status differ between women with and without PCOS, which may hamper comparability. STUDY DESIGN SIZE DURATION This study is a cross-sectional analysis of a 5-year follow-up of a randomized controlled trial (RCT) among women with obesity and a history of infertility. PARTICIPANTS/MATERIALS SETTING METHODS Participants in this follow-up study of an RCT were women with obesity and infertility randomized to a lifestyle intervention followed by infertility treatment or prompt infertility treatment (control), stratified by ovulatory status and trial centre. In total, 173 (30.0%) women of the 577 women randomized in the initial trial participated in this follow-up study, with a mean follow-up of 5.5 years (range 3.7-7.0 years); of these women 73 had been diagnosed with PCOS and 100 did not have PCOS. Participants completed questionnaires on symptoms of anxiety and depression (Hospital Anxiety and Depression scale (HADS)), quality of life (36-item Short Form Health Survey (SF-36)) and sexual function (McCoy Female Sexuality Questionnaire (MFSQ)). We also compared quality of life subscale scores in women with and without PCOS and compared them to an age-matched Dutch reference population with average BMI. Effect sizes were calculated to assess the differences. MAIN RESULTS AND THE ROLE OF CHANCE Symptoms of anxiety and depression, physical quality of life and sexual function did not differ significantly between obese women with and without PCOS. However, women with PCOS had a worse mental quality of life summary component score (-3.60 [95% CI -6.72 to -0.56]), mainly due to a lower score on the subscale 'role limitations due to emotional problems' (-12.41 [95% CI -22.78 to -2.28]), compared to women without PCOS. However, compared to an age-matched Dutch reference population, the obese infertile women with and without PCOS both scored lower on almost all physical and mental quality of life subscales. LIMITATIONS REASONS FOR CAUTION These are secondary analyses of the follow-up study of the RCT. No power analysis was performed for the outcomes included in this analysis and, as our study had a relatively small sample size, the null findings could be based on insufficient power to detect small differences between the groups. Our study population had a high mean BMI (average total group 34.5 [SD ± 5.1]); therefore, our results may only be generalizable to women with obesity. WIDER IMPLICATIONS OF THE FINDINGS Our results indicate that PCOS status is associated with impaired mental quality of life. Anxiety and depression, physical quality of life and sexual function in obese infertile women with PCOS seem more related to the obesity than the PCOS status. STUDY FUNDING/COMPETING INTERESTS The initial study and follow-up were supported by grants from: ZonMw (50-50110-96-518), the Dutch Heart Foundation (2013T085) and the European Commission (633595). The Department of Obstetrics and Gynaecology of the UMCG received an unrestricted educational grant from Ferring pharmaceuticals BV, The Netherlands, outside the submitted work. A.H. reports consultancy for Ferring pharmaceuticals. B.W.J.M. is supported by an NHMRC Practitioner Fellowship (GNT1082548). B.W.J.M. reports consultancy for ObsEva, Merck Merck KGaA, iGenomix and Guerbet. All other authors declare no competing interests. TRIAL REGISTRATION NUMBER The initial trial was registered on 16 November 2008 in the Dutch trial register; clinical trial registry number NTR1530.
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Affiliation(s)
- M D A Karsten
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - V Wekker
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - H Groen
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - R C Painter
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - B W J Mol
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, Clayton, VIC, Australia
| | - E T M Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - T J Roseboom
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - A Hoek
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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Santoro N, Wierman ME. Do Women Need Androgens Like a Fish Needs a Bicycle? A Review of the Literature and Clinical Guidelines. Clin Obstet Gynecol 2021; 64:784-792. [PMID: 34560765 DOI: 10.1097/grf.0000000000000658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Biopotent androgens such as testosterone circulate in low levels in women. However, androgen precursors, such as dehyroepiandrosterone, are among the most abundant hormones produced in both men and women. While testosterone exerts obvious phenotypic effects in men and is essential for male sexual function, considerable debate and controversy abounds over the role of androgens in women and whether androgens exert an analogous role in women as they do in men. This piece reviews androgen economy in women and the clinical case for and against androgen treatment for women for specific indications.
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Affiliation(s)
- Nanette Santoro
- E Stewart Taylor Chair of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of Colorado School of Medicine
| | - Margaret E Wierman
- Department of Medicine and Obstetrics and Gynecology, University of Colorado School of Medicine
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado
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46
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Symptom profiles of women at risk of mood disorders: A latent class analysis. J Affect Disord 2021; 295:139-147. [PMID: 34450523 DOI: 10.1016/j.jad.2021.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Depression is the leading cause of disease burden among women worldwide. However, an understanding of symptom profiles among women at risk of mood disorders is limited. We determined distinct profiles of affective symptoms among high risk women, along with their distinguishing characteristics. METHODS Women were recruited from 17 clinical sites affiliated with the National Network of Depression Centers. They completed measures of depression (Patient Health Questionnaire - 9) and anxiety (Generalized Anxiety Disorder - 7) as well as questions regarding demographics, reproductive status, behavioral/mental health history, and life stress/adversity. Latent class analysis and multinomial logistic regression were used to identify and characterize symptom profiles. RESULTS 5792 women participated, ages 18 to 90 (M = 38). Three latent classes were identified: generally asymptomatic (48%), elevated symptoms of comorbid anxiety and depression (16%), and somatic symptoms (36%). Financial security and greater social support were protective factors that distinguished asymptomatic women. The profile of the class with elevated anxiety/depressive symptoms constituted a complex mix of adverse social determinants and potentially heritable clinical features, including a diagnosis of Bipolar Disorder. Women in the 3rd latent class were characterized by menstrual irregularity and a stronger expression of neurovegetative symptoms, especially sleep disturbance and fatigue. LIMITATIONS Limitations included less than optimal racial diversity of our sample and reliance on self-report. CONCLUSIONS Different symptom profiles may reflect distinct subtypes of women at risk of mood disorders. Understanding the etiology and mechanisms underlying clinical and psychosocial features of these profiles can inform more precisely targeted interventions to address women's diverse needs.
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47
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Zhang L, Sun J, Zhang D. The relationship between urine polycyclic aromatic hydrocarbons and depressive symptoms in American adults. J Affect Disord 2021; 292:227-233. [PMID: 34130188 DOI: 10.1016/j.jad.2021.05.097] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/27/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Studies have shown that Polycyclic aromatic hydrocarbons (PAHs) were neurotoxic, and PAHs exposure may be related to depressive symptoms. Thus, we conducted this study for further explorations. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) database of the 2005-2014 cycles were used. The independent variables were urine PAHs metabolites, including 1-hydroxynaphthalene (1-NAP), 2-hydroxynaphthalene (2-NAP), 3-hydroxyfluorene (3-FLU), 2-hydroxyfluorene (2-FLU), 1-hydroxyphenanthrene (1-PHE), and 1-hydroxypyrene (1-PYR). The dependent variable was depressive symptoms according to the Patient Health Questionnaire (PHQ)-9. Multivariate logistic regression analyses and the restricted cubic splines were used in the analyses. RESULTS A total of 7647 adults aged 20 or above were included in the analyses. In the Crude model and Model 1 (adjusted for age and gender), compared with quartile (Q) 1, the risk of depressive symptoms increased in Q4 for all the six PAHs metabolites. However, in Model 2, after adjusted for more covariates, the results were no more significant. In the stratified analysis by gender, in Model 2, the weighted OR (95% CIs) of depressive symptoms were 2.78(1.04,7.38), 3.17(1.23,8.18) for 1-NAP, 2-NAP in Q4 for females, respectively. Besides, a non-linear dose-response relationship was found between 1-NAP, 2-NAP, and depressive symptoms in females, too. LIMITATIONS Cross-sectional study could not infer causality. CONCLUSIONS Our study found a positive association between urine PAHs and depressive symptoms in females, and more studies are needed to explore the relationships between PAHs exposure and depressive symptoms in the general adult populations.
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Affiliation(s)
- Liming Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No.308 Ningxia Road, Qingdao 266021, China
| | - Jing Sun
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No.308 Ningxia Road, Qingdao 266021, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, No.308 Ningxia Road, Qingdao 266021, China.
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48
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Zehravi M, Maqbool M, Ara I. Depression and anxiety in women with polycystic ovarian syndrome: a literature survey. Int J Adolesc Med Health 2021; 33:367-373. [PMID: 34420269 DOI: 10.1515/ijamh-2021-0092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 11/15/2022]
Abstract
Polycystic ovarian syndrome (PCOS) is the most frequent endocrine disorder among women of reproductive age. Some of the indications and symptoms of PCOS include amenorrhoea, hirsutism, infertility, obesity, acne vulgaris and androgenic alopecia. PCOS is a crippling condition that affects a woman's identity, mental health and overall quality of life (QOL). In persons with PCOS, anxiety and sadness are assumed to be multifactorial. According to some specialists, physical symptoms like acne, hirsutism and obesity have been linked to psychiatric morbidities. Many aspects of it remain unknown, including its cause, progression throughout life, symptom spectrum and level of morbidity. PCOS is a complex disease that has an impact on many aspects of a person's health, including their mental health. Anxiety and depression are three times as common in PCOS patients as in non-PCOS people. Anxiety and depression symptoms are also more common and more intense in those with PCOS. There isn't enough research on the prevalence of anxiety and depression in patients with PCOS. It's unclear what causes persons with PCOS to be more anxious and depressed. It could be the result of PCOS symptoms, hormonal changes, or a combination of factors that are currently unclear. Our review article will help to highlight the most recent research on anxiety and depression in PCOS women.
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Affiliation(s)
- Mehrukh Zehravi
- Department of Clinical Pharmacy Girls Section, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudia Arabia
| | - Mudasir Maqbool
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Irfat Ara
- Regional Research Institute of Unani Medicine, Srinagar, Jammu and Kashmir, India
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49
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Yin MXC, Du LB, Zou XN, Fung YL, Sun YY, Chan CHY, Chan CLW. Can Psychosocial Intervention Suppress Testosterone and Triglycerides Among Women With Polycystic Ovary Syndrome? A Feasibility Trial. Front Psychol 2021; 12:690539. [PMID: 34367014 PMCID: PMC8339270 DOI: 10.3389/fpsyg.2021.690539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Women with polycystic ovary syndrome (PCOS) suffer significant psychological distress, which may activate the hypothalamus-pituitary-ovary axis and further affect their physiological state. They often experience elevated levels of testosterone and triglycerides. Considering reports of psychological distress among women with PCOS, this study aimed to develop a psychosocial intervention to improve their emotional and physical health, particularly in Chinese society. This pilot study employed the Integrative Body-Mind-Spirit (I-BMS) intervention model for women with PCOS in China. After a 2 h health information session, 18 participants were randomly assigned to the I-BMS group (9) or the control group (9). The intervention group received 6 weekly, 3 h I-BMS sessions. Pre- and post-blood tests and psychosocial questionnaires were collected from all participants. Retention to treatment was high with 79.6% treatment adherence gained and an overall average of five sessions completed. Compared with the control group, depression and anxiety symptoms reduced significantly for those in the intervention group (d = -1.24, p < 0.05 and d = -1.33, p < 0.01), their health-related quality of life improved significantly (d = 1.02, p < 0.01) both at post-intervention and 3 month follow-up, and their testosterone and triglycerides levels reduced significantly (d = -0.97, p < 0.001 and d = -0.41, p < 0.05) after joining the intervention. The I-BMS model is feasible and appears promising in improving psychological health, and reducing testosterone and triglyceride levels, in women with PCOS in China. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR1900027606.
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Affiliation(s)
- Margaret X. C. Yin
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - L. B. Du
- Reproductive Medicine Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - X. N. Zou
- Kids Caring Corner, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Y. L. Fung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Y. Y. Sun
- Kids Caring Corner, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Celia H. Y. Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
| | - Cecilia L. W. Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
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Polycystic Ovary Syndrome Can Lead to Neurocognitive Changes in Female Rats Treated with Letrozole. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.112023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in premenopausal women. Brain functions may be affected in PCOS, and studies reported that PCOS patients are at greater risk for developing mental health conditions, including anxiety or depression. Objectives: This study was designed to evaluate the neurocognitive changes in letrozole-induced PCOS model. Methods: Twenty female Wistar rats (eight-week-old; 160 ± 10 g) were divided into two groups. Group one received vehicle only (carboxymethyl cellulose, orally) once daily, and group two received letrozole (1 mg/kg, orally) once daily. Drugs or vehicles were administered for 21 days. Afterward, behavioral tests, including forced swimming test, open field test, and Y-maze alteration task, were performed. Ovaries were removed after behavioral tests and assessed histologically to confirm the induction of PCOS. Results: Animals with PCOS developed depressive-like behaviors compared with control in forced swimming test (P < 0.001). Anxiety-like behaviors were detected in letrozole-induced PCOS group (P < 0.05). Moreover, animals with PCOS exhibited memory impairment in comparison to normal animals in Y-maze memory assessment (P < 0.05). Conclusions: Rats with PCOS showed a neurocognitive decline in the model of letrozole administration. Future studies should be conducted to clarify the exact mechanisms of these changes and possible approaches to restore them.
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