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Pehlivanturk-Kizilkan M, Akgül S, Güven AG, Düzçeker Y, Derman O, Kanbur N. Binge eating symptomatology in adolescents with polycystic ovary syndrome. Physiol Behav 2024; 279:114532. [PMID: 38552708 DOI: 10.1016/j.physbeh.2024.114532] [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: 02/24/2023] [Revised: 02/29/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Several factors may contribute to binge eating behaviors in PCOS. However, findings are contradictory and studies in the adolescence are limited. We aimed to evaluate the eating attitudes of adolescents with PCOS and the possible etiological factors underlying the association between PCOS and binge eating symptomology. Between 2019 and 2022, 46 newly diagnosed adolescents with PCOS and 56 controls matched for age and BMI z-score were included. The Eating Disorder Examination Questionnaire, Three Factor Eating Questionnaire-R18, and a questionnaire assessing postprandial reactive hypoglycemia symptom severity were given. Binge eating symptomology, in terms of over, uncontrolled, and emotional eating, were more prevalent in the PCOS group. Uncontrolled, emotional, and binge eating were positively correlated with postprandial reactive hypoglycemia symptom score. Overeating was also associated with clinical hyperandrogenism. Improving the disease outcome and reducing the future complications requires early recognition and management of emotional and uncontrolled eating behaviors in adolescents with PCOS.
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Affiliation(s)
- Melis Pehlivanturk-Kizilkan
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
| | - Sinem Akgül
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Gül Güven
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yasemin Düzçeker
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Orhan Derman
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Yüksel S, Gencer FK, Alptekin FB, Saglam NGU. Disordered Eating in Young Women with Polycystic Ovary Syndrome. Reprod Sci 2024; 31:1303-1310. [PMID: 38155280 DOI: 10.1007/s43032-023-01435-1] [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: 07/18/2023] [Accepted: 12/12/2023] [Indexed: 12/30/2023]
Abstract
Polycystic ovary syndrome (PCOS) was the most prevalent endocrine disorder among women. Weight issues were commonly observed and found to be associated with comorbidities. This study aimed to compare Eating Disorder Examination Questionnaire (EDE-Q) scores and Night Eating Questionnaire (NEQ) scores in patients with and without PCOS and analyze the factors associated with disordered eating. Women aged 18-25 years with and without PCOS (n = 110 for each group) were included in the study. All patients completed the EDE-Q, NEQ, Beck Anxiety, and Beck Depression inventories. Disordered eating was found more frequently in women with PCOS than in controls (25.5% vs. 2.7%, p < 0.001). There were no significant differences in NEQ scores between the two groups. Anxiety and depression scores were higher in patients with PCOS than in controls (p = 0.002 and p = 0.001, respectively). PCOS diagnosis (OR: 7.4, CI: [1.63-33.7]; p = 0.010) and high BMI (OR: 1.24, CI: [1.10-1.39]; p < 0.001) were found to be independent factors for disordered eating (EDE-Q global score ≥ 4). Disordered eating was more common in young women with PCOS compared to the control group. PCOS diagnosis and having a high BMI (> 25) were found to be independent factors related to disordered eating in young women with PCOS. Young women with a high BMI or PCOS appear to be at a higher risk of disordered eating than women of the same age. Scanning this group may help clinicians in identifying women at high risk for eating disorders and preventing comorbidities associated with them.
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Affiliation(s)
- Semra Yüksel
- Department of Obstetrics and Gynecology, Basaksehir Cam Ve Sakura City Hospital, Olimpiyat Blv Rd, Basaksehir, Istanbul, Turkey.
| | - Fatma Ketenci Gencer
- Department of Obstetrics and Gynecology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
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Alkheyr Z, Murad M, Das P, Aljenaee K, Kamel C, Hajji SA, Flood J, Atkin SL, Ali KF. Self-esteem and body image satisfaction in women with PCOS in the Middle East: Cross-sectional social media study. PLoS One 2024; 19:e0301707. [PMID: 38662709 PMCID: PMC11045070 DOI: 10.1371/journal.pone.0301707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age, associated with increased incidence of emotional disorders, anxiety and depression. OBJECTIVE The aim was of this study was to investigate whether those women reporting PCOS differed to women without PCOS in measures of psychological well-being including body-image satisfaction and self-esteem across a Middle Eastern population. MATERIALS AND METHODS An online survey link of 21 questions was shared and distributed across social media platforms (Instagram and WhatsApp). The main outcome measured was levels of self-esteem and body image satisfaction in association with symptoms experienced by the participants. RESULTS 12,199 female subjects completed the survey of whom 3,329 respondents (27.3%) self-reported a diagnosis of PCOS. PCOS respondents felt less attractive compared to non-PCOS respondents (73.9% vs 80.5%, p<0.0001). More respondents with PCOS reported avoidance of their reflection in the mirror (61.7% vs 49.8%, p<0.001) and avoidance of social interactions (22.3% vs 32.3%, p<0.0001). More PCOS respondents wanted to lose weight (75.2% vs 68.5%, p<0.001) with increasing weight being associated with being less attractive (p<0.001). Fewer PCOS respondents felt satisfied/confident compared non-PCOS respondents (38.6% vs 50.7%, p<0.001). CONCLUSION PCOS respondents reported significantly lower measures of self-esteem and body image satisfaction compared to non-PCOS respondents in this population.
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Affiliation(s)
- Zainab Alkheyr
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
| | - Mariam Murad
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
| | - Priya Das
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
| | | | - Charlotte Kamel
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
| | | | - John Flood
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
| | - Stephen L. Atkin
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
| | - Khawla F. Ali
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Adliya, Bahrain
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Stefanaki K, Karagiannakis DS, Peppa M, Vryonidou A, Kalantaridou S, Goulis DG, Psaltopoulou T, Paschou SA. Food Cravings and Obesity in Women with Polycystic Ovary Syndrome: Pathophysiological and Therapeutic Considerations. Nutrients 2024; 16:1049. [PMID: 38613082 PMCID: PMC11013286 DOI: 10.3390/nu16071049] [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: 01/12/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, constitutes a metabolic disorder frequently associated with obesity and insulin resistance (IR). Furthermore, women with PCOS often suffer from excessive anxiety and depression, elicited by low self-esteem due to obesity, acne, and hirsutism. These mood disorders are commonly associated with food cravings and binge eating. Hypothalamic signaling regulates appetite and satiety, deteriorating excessive food consumption. However, the hypothalamic function is incapable of compensating for surplus food in women with PCOS, leading to the aggravation of obesity and a vicious circle. Hyperandrogenism, IR, the reduced secretion of cholecystokinin postprandially, and leptin resistance defined by leptin receptors' knockout in the hypothalamus have been implicated in the pathogenesis of hypothalamic dysfunction and appetite dysregulation. Diet modifications, exercise, and psychological and medical interventions have been applied to alleviate food disorders, interrupting the vicious circle. Cognitive-behavioral intervention seems to be the mainstay of treatment, while the role of medical agents, such as GLP-1 analogs and naltrexone/bupropion, has emerged.
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Affiliation(s)
- Katerina Stefanaki
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.S.); (T.P.); (S.A.P.)
| | - Dimitrios S. Karagiannakis
- Academic Department of Gastroenterology, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit and Diabetes Center, Second Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- 3rd Department of Internal Medicine, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Andromachi Vryonidou
- Department of Endocrinology and Diabetes Center, Hellenic Red Cross Hospital, 11526 Athens, Greece;
| | - Sophia Kalantaridou
- 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
| | - Theodora Psaltopoulou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.S.); (T.P.); (S.A.P.)
| | - Stavroula A. Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.S.); (T.P.); (S.A.P.)
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Lalonde-Bester S, Malik M, Masoumi R, Ng K, Sidhu S, Ghosh M, Vine D. Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review. Adv Nutr 2024; 15:100193. [PMID: 38408541 PMCID: PMC10973592 DOI: 10.1016/j.advnut.2024.100193] [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: 08/15/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder affecting females across the lifespan. Eating disorders (EDs) are psychiatric conditions that may impact the development of PCOS and comorbidities including obesity, metabolic syndrome, and type 2 diabetes. The aim of this scoping review was to determine the prevalence of EDs and disordered eating, and to review the etiology of EDs in PCOS. The review was conducted using search terms addressing PCOS, EDs, and disordered eating in databases, including PubMed, Scopus, PsycINFO, and CINAHL. Structured interviews, self-administered questionnaires, chart review, or self-reported diagnosis were used to identify EDs in 38 studies included in the review. The prevalence of any ED in those with PCOS ranged from 0% to 62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios (ORs) of an elevated ED score compared with controls. In those with PCOS, 30% had a higher OR of bulimia nervosa and binge ED was 3-fold higher compared with controls. Studies were limited on anorexia nervosa and other specified feeding or ED (such as night eating syndrome) and these were not reported to be higher in PCOS. To our knowledge, no studies reported on avoidant/restrictive food intake disorder, rumination disorder, or pica in PCOS. Studies showed strong associations between overweight, body dissatisfaction, and disordered eating in PCOS. The etiologic development of EDs in PCOS remains unclear; however, psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied because of the use of different diagnostic and screening tools. Screening of all individuals with PCOS for EDs is recommended and high-quality studies on the prevalence, pathogenesis of specific EDs, relationship to comorbidities, and effective interventions to treat ED in those with PCOS are needed.
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Affiliation(s)
- Sophie Lalonde-Bester
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mishal Malik
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Reihaneh Masoumi
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Ng
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Simran Sidhu
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Donna Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada.
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Kaur I, Kishore K, Suri V, Sahni N, Rana SV, Singh A. Determinants of polycystic ovary syndrome: A matched case-control study. J Hum Nutr Diet 2024; 37:583-592. [PMID: 38234173 DOI: 10.1111/jhn.13282] [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: 07/09/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a multifaceted endocrine disorder of women of reproductive age with a multifactorial aetiology. Despite much research, there is still inconclusive data on the impact of dietary, lifestyle and socio-economic factors on PCOS aetiology. Thus, the present study explored the association of PCOS with diet, eating behaviour, other lifestyle and socio-economic factors. METHODS A matched-pair case-control study was conducted on 150 women with PCOS and 150 healthy controls. Information on diet, eating behaviour and physical activity, and also anthropometric and socio-economic data were collected through standard questionnaires. The adjusted odds ratios (AmOR) were calculated and reported using conditional multivariable logistic regression. RESULTS The results showed low education level (AmOR = 8.44; 95% confidence interval [CI] = 1.63-43.68), high sugar consumption (AmOR = 11.61; 95% CI = 2.05-65.72) along with higher body mass index (BMI) and inactivity to be significantly associated with PCOS. Also, a significant protective effect was found for cognitive dietary restraint (AmOR = 0.79; 95% CI = 0.66-0.93), crude fibre (AmOR = 0.61; 95% CI = 0.45-0.82) and protein intake. CONCLUSIONS Low education status may contribute to higher receptiveness to choosing unhealthy diets and lifestyles, resulting in adiposity and an increased risk of PCOS.
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Affiliation(s)
- Ishwarpreet Kaur
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kamal Kishore
- Department of Biostatistics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vanita Suri
- Department of Obstetrics & Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nancy Sahni
- Department of Dietetics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Satya Vati Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amarjeet Singh
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Calcaterra V, Magenes VC, Massini G, De Sanctis L, Fabiano V, Zuccotti G. High Fat Diet and Polycystic Ovary Syndrome (PCOS) in Adolescence: An Overview of Nutritional Strategies. Nutrients 2024; 16:938. [PMID: 38612972 PMCID: PMC11013055 DOI: 10.3390/nu16070938] [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: 02/07/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a multifaceted and heterogeneous disorder, linked with notable reproductive, metabolic, and psychological outcomes. During adolescence, key components of PCOS treatment involve weight loss achieved through lifestyle and dietary interventions, subsequently pursued by pharmacological or surgical therapies. Nutritional interventions represent the first-line therapeutic approach in adolescents affected by PCOS, but different kinds of dietary protocols exist, so it is necessary to clarify the effectiveness and benefits of the most well-known nutritional approaches. We provided a comprehensive review of the current literature concerning PCOS definition, pathophysiology, and treatment options, highlighting nutritional strategies, particularly those related to high-fat diets. The high-fat nutritional protocols proposed in the literature, such as the ketogenic diet (KD), appear to provide benefits to patients with PCOS in terms of weight loss and control of metabolic parameters. Among the different types of KD studies, very low-calorie ketogenic diets (VLCKD), can be considered an effective dietary intervention for the short-term treatment of patients with PCOS. It rapidly leads to weight loss alongside improvements in body composition and metabolic profile. Even though extremely advantageous, long-term adherence to the KD is a limiting factor. Indeed, this dietary regimen could become unsustainable due to the important restrictions required for ketosis development. Thus, a combination of high-fat diets with more nutrient-rich nutritional regimens, such as the Mediterranean diet, can amplify positive effects for individuals with PCOS.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
| | - Vittoria Carlotta Magenes
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
| | - Giulia Massini
- Pediatric Endocrinology, Regina Margherita Children Hospital, 10131 Torino, Italy; (G.M.); (L.D.S.)
- Department of Public Health and Pediatric Sciences, University of Torino, 10131 Torino, Italy
| | - Luisa De Sanctis
- Pediatric Endocrinology, Regina Margherita Children Hospital, 10131 Torino, Italy; (G.M.); (L.D.S.)
- Department of Public Health and Pediatric Sciences, University of Torino, 10131 Torino, Italy
| | - Valentina Fabiano
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (V.F.); (G.Z.)
- Department of Biomedical and Clinical Science, Università degli Studi di Milano, 20157 Milan, Italy
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Percy C, Turner A, Orr C. Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Mixed Methods Study With Patients and Health Care Professionals. JMIR Form Res 2024; 8:e52427. [PMID: 38451567 PMCID: PMC10958350 DOI: 10.2196/52427] [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: 09/11/2023] [Revised: 10/18/2023] [Accepted: 01/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way. OBJECTIVE We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them. METHODS We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify "antecedents" (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention. RESULTS Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place). CONCLUSIONS We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention's acceptability, scalability, and cost-effectiveness.
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Affiliation(s)
- Carol Percy
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Charys Orr
- Harris Church of England Academy, Diocese of Coventry Multi Academy Trust, Coventry, United Kingdom
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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: 1] [Impact Index Per Article: 1.0] [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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10
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Vine D, Ghosh M, Wang T, Bakal J. Increased Prevalence of Adverse Health Outcomes Across the Lifespan in Those Affected by Polycystic Ovary Syndrome: A Canadian Population Cohort. CJC Open 2024; 6:314-326. [PMID: 38487056 PMCID: PMC10935704 DOI: 10.1016/j.cjco.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/11/2023] [Indexed: 03/17/2024] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is the most common metabolic-endocrine disorder impacting the health and quality of life of women over the lifespan. Evidence-based data on the scope of adverse health outcomes in those affected by PCOS is critical to improve healthcare and quality of life in this population. The aim of this study was to determine the prevalence of adverse health outcomes in those with PCOS compared to age-matched controls. Methods We conducted a retrospective observational case-control study in those diagnosed with PCOS and age-matched controls using the Alberta Health Services Health Analytics database and the International Classification of Diseases, for the period from 2002-2018 in Alberta, Canada. Results The cohort consisted of n = 16,531 exposed PCOS cases and n = 49,335 age-matched un-exposed controls. The prevalences of hypertension, renal disease, gastrointestinal disease, eating disorders, mental illness, depression-anxiety, rheumatoid arthritis, respiratory infections, and all malignancies were 20%-40% (P < 0.0001) higher in those with PCOS, compared to controls. The prevalence of obesity, dyslipidemia, nonalcoholic fatty liver disease, and type 2 diabetes was 2-3 fold higher in those with PCOS (P < 0.001). Cardiovascular, cerebrovascular, and peripheral vascular disease were 30%-50% higher, and they occurred 3-4 years earlier in those with PCOS (P < 0.0001); a 2-fold higher prevalence of dementia occurred in those with PCOS, compared to controls. Conclusion These findings provide evidence that PCOS is associated with a higher prevalence of morbidities over the lifespan, and the potential scope of the healthcare burden in women affected by PCOS.
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Affiliation(s)
- Donna Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ting Wang
- Alberta Strategy for Patient Orientated Research, Provincial Research Data Services, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jeffrey Bakal
- Alberta Strategy for Patient Orientated Research, Provincial Research Data Services, Alberta Health Services, Edmonton, Alberta, Canada
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11
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Scannell N, Mantzioris E, Rao V, Pandey C, Ee C, Mousa A, Moran L, Villani A. Type and Frequency in Use of Nutraceutical and Micronutrient Supplementation for the Management of Polycystic Ovary Syndrome: A Systematic Scoping Review. Biomedicines 2023; 11:3349. [PMID: 38137570 PMCID: PMC10742329 DOI: 10.3390/biomedicines11123349] [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: 11/21/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
Lifestyle strategies are considered first-line treatment for the management of polycystic ovary syndrome (PCOS). However, complementary therapies, including nutrient supplementation, have been identified as a potential adjunct therapy. Therefore, we systematically mapped the available literature to identify the type and frequency of the use of nutraceutical and micronutrient supplementation for the management of PCOS features. A systematic search of the literature was conducted using CINAHL, Cochrane reviews, Medline, PsycINFO, Scopus and LILACS. All types of study designs were included if they reported on the use of nutraceuticals and/or micronutrient supplementation on features of PCOS in women aged ≥18 years. A total of 344 articles were included. Forty-one supplements were identified, with the most frequently investigated being inositols (n = 86), vitamin D (n = 53), N-acetylcysteine (n = 27) and omega-3 fatty acids (n = 25). Reproductive outcomes were the most commonly reported (n = 285; 83%), followed by metabolic (n = 229; 67%), anthropometric (n = 197; 57%) and psychological (n = 8; 2%). Our results identified that nutraceutical and micronutrient supplementation require further investigation of psychological outcomes in women with PCOS. Moreover, adequately powered primary studies are warranted to investigate therapeutic doses needed for clinical benefits.
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Affiliation(s)
- Nicole Scannell
- School of Health, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia;
| | - Evangeline Mantzioris
- UniSA Clinical & Health Sciences, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA 5000, Australia;
| | - Vibhuti Rao
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2145, Australia; (V.R.); (C.E.)
| | - Chhiti Pandey
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (C.P.); (A.M.); (L.M.)
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2145, Australia; (V.R.); (C.E.)
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (C.P.); (A.M.); (L.M.)
| | - Lisa Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (C.P.); (A.M.); (L.M.)
| | - Anthony Villani
- School of Health, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia;
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12
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Herbert S, Woolf K. Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS). Nutrients 2023; 15:5069. [PMID: 38140328 PMCID: PMC10745999 DOI: 10.3390/nu15245069] [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: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder experienced by women. PCOS is a lifelong condition associated with reproductive, metabolic, and psychological presentations. PCOS is also linked with increased prevalence of cardiometabolic risk factors. While an association between body weight and PCOS has been noted, cardiometabolic risk factors are prevalent in individuals with PCOS across body weights. Currently, no consensus exists as to the most appropriate lifestyle strategy for mitigating cardiometabolic risk in PCOS. A large proportion of the literature is focused on weight loss for individuals with PCOS who are overweight or experience obesity, despite PCOS being prevalent across body sizes. The aim of this narrative review is to assess dietary and lifestyle interventions aimed at reducing cardiometabolic risk in individuals with PCOS across body sizes. A total of 51 articles are included in this review. Overall, randomized controlled trials are limited and most studies focus on weight loss, excluding individuals classified within a healthy body weight range. Studies that modified the dietary pattern without an energy deficit saw improvements in cardiometabolic risk. Thus, less restrictive dietary approaches may be effective at reducing cardiometabolic risk in this population. This review also highlights the need for more sustainable lifestyle interventions that meet the needs of individuals with PCOS of varying body weights.
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Affiliation(s)
| | - Kathleen Woolf
- Department of Nutrition and Food Studies, Steinhart School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA;
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13
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Sydora BC, Wilke MS, McPherson M, Chambers S, Ghosh M, Vine DF. Challenges in diagnosis and health care in polycystic ovary syndrome in Canada: a patient view to improve health care. BMC Womens Health 2023; 23:569. [PMID: 37925392 PMCID: PMC10625259 DOI: 10.1186/s12905-023-02732-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is the most common endocrine-metabolic disorder affecting health and quality of life of those affected across the lifespan. We currently have limited evidence-based data on the experience of those living with PCOS in the health care system including diagnosis, health concerns and disease management. The aim of this study was to assess the perceptions of health status, health care experience and disease management support in those affected by PCOS in Alberta, Canada. METHODS An online questionnaire was completed via REDCap by individuals self-reporting a diagnosis of PCOS. Question categories included demographics, symptoms of PCOS and time to confirm a diagnosis, follow-up care, health concerns, and information resources. Descriptive statistics were used and thematic analyses was applied to open-response questions. RESULTS Responses from 194 participants living in Canada (93% in Alberta) were included. The average age was 34 ± 8 years and BMI was 35 ± 9. Menstrual irregularity was identified in 84% of respondents as the first symptom noticed and the primary reason for seeking a medical consultation. A PCOS diagnosis occurred on average 4.3 years following awareness of first symptoms and required consultation with more than one primary care provider for 57% of respondents. Half (53%) of respondents reported not receiving a referral to specialists for follow-up care and 70% were not informed about long-term health morbidity such as diabetes or cardiovascular disease. Most respondents (82%) did their own research about PCOS using on-line sources, academic literature and advice from peer support. The participant themes from open questions for improving health care included more resources and support, increased and reliable information, better education and training for clinicians, timely diagnosis, prompt referrals to specialists, and generally more compassion and empathy to the challenges faced by those managing their disease. CONCLUSION Our findings highlight the health concerns and challenges in health care for those with PCOS. In Alberta, Canada we have identified major gaps in health care including a timely diagnosis, follow up care and supports, and multidisciplinary care. This evidence-based data can be used to inform development of pathways to improve the health care experience in those affected by PCOS.
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Affiliation(s)
- Beate C Sydora
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Michaelann S Wilke
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Maggie McPherson
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Sarah Chambers
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Donna F Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Canada.
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14
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Markopoulos M, Barber TM, Bargiota A, Skevaki C, Papassotiriou I, Kumar S, Vlahos NF, Mastorakos G, Valsamakis G. Acute iv CRH administration significantly increases serum active ghrelin in postmenopausal PCOS women compared to postmenopausal controls. Endocrine 2023; 81:613-620. [PMID: 37249728 DOI: 10.1007/s12020-023-03406-7] [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: 11/13/2022] [Accepted: 05/17/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE In women with Polycystic Ovarian Syndrome (PCOS), an increased risk of disordered eating has been described. There is growing interest regarding a possible interconnection between psychological states and increased appetite in women with PCOS. Acute stress is characterized by increased Corticotropin Releasing Hormone (CRH) secretion. The aim was to estimate the ghrelin concentrations during CRH test. METHODS Twenty postmenopausal women with PCOS and twenty age- and BMI- matched postmenopausal control women were recruited at Aretaieion University Hospital. In the morning (9 am) all subjects had anthropometric measurements (weight, height, waist circumference) and a fasting sample for hormonal measurements. An intravenous (iv) CRH stimulation test conducted over 1 min. Serum active ghrelin levels were measured at 0, 15, 30, 60, 90, 120 min after iv CRH administration. RESULTS The postmenopausal PCOS group had a higher waist circumference compared to postmenopausal controls. Active ghrelin concentrations increased significantly from 0 to 15 min, to 30 min, to 60 min, to 90 min and then decreased to 120 min. However, within the postmenopausal control group there were no significant changes in serum active ghrelin levels. Serum active ghrelin concentrations were significantly greater in the postmenopausal control group at 0, 15 and 120 min compared to the postmenopausal PCOS group. At 90 min active ghrelin concentrations were significantly greater in the postmenopausal PCOS group. Delta Area Under the Curve of active ghrelin (ΔAUCghr) was significantly greater in the postmenopausal PCOS group compared to controls. CONCLUSIONS In postmenopausal PCOS, but not in postmenopausal controls, iv CRH administration induces increased serum active ghrelin secretion, suggesting a possible anti-stress adaptive mechanism. An increase in serum active ghrelin may induce hunger as a side-effect of this presumed adaptive mechanism.
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Affiliation(s)
- Marios Markopoulos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, School of Medicine, "Aretaieion" University Hospital, Athens, Greece
| | | | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, Larissa, Greece
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center, Phillips Universitat Marburg, German Center of Lung Research, Marburg, Germany
| | - Ioannis Papassotiriou
- First Department of Pediatrics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Nikos F Vlahos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, School of Medicine, "Aretaieion" University Hospital, Athens, Greece
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, School of Medicine, "Aretaieion" University Hospital, Athens, Greece
| | - Georgios Valsamakis
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, School of Medicine, "Aretaieion" University Hospital, Athens, Greece.
- Warwick Medical School, Warwick, UK.
- Department of Endocrinology and Metabolic Disorders, University Hospital of Larissa, Medical School of Larissa, University of Thessaly, Larissa, Greece.
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15
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Yadav S, Delau O, Bonner AJ, Markovic D, Patterson W, Ottey S, Buyalos RP, Azziz R. Direct economic burden of mental health disorders associated with polycystic ovary syndrome: Systematic review and meta-analysis. eLife 2023; 12:e85338. [PMID: 37534878 PMCID: PMC10471160 DOI: 10.7554/elife.85338] [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: 12/03/2022] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is the most common hormone disorder affecting about one in seven reproductive-aged women worldwide and approximately 6 million women in the United States (U.S.). PCOS can be a significant burden to those affected and is associated with an increased prevalence of mental health (MH) disorders such as depression, anxiety, eating disorders, and postpartum depression. We undertook this study to determine the excess economic burden associated with MH disorders in women with PCOS in order to allow for a more accurate prioritization of the disorder as a public health priority. Methods Following PRISMA reporting guidelines for systematic review, we searched PubMed, Web of Science, EBSCO, Medline, Scopus, and PsycINFO through July 16, 2021, for studies on MH disorders in PCOS. Excluded were studies not in humans, without controls, without original data, or not peer reviewed. As anxiety, depression, eating disorders, and postpartum depression were by far the most common MH disorders assessed by the studies, we performed our meta-analysis on these disorders. Meta-analyses were performed using the DerSimonian-Laird random effects model to compute pooled estimates of prevalence ratios (PRs) for the associations between PCOS and these MH disorders and then calculated the excess direct costs related to these disorders in U.S. dollars (USD) for women suffering from PCOS in the U.S. alone. The quality of selected studies was assessed using the Newcastle-Ottawa Scale. Results We screened 78 articles by title/abstract, assessed 43 articles in full text, and included 25 articles. Pooled PRs were 1.42 (95% confidence interval [CI]: 1.32-1.52) for anxiety, 1.65 (95% CI: 1.44-1.89) for depression, 1.48 (95% CI: PR: 1.06-2.05) for eating disorders, and 1.20 (95% CI: 0.96-1.50) for postpartum depression, for PCOS relative to controls. In the U.S., the additional direct healthcare costs associated with anxiety, depression, and eating disorders in PCOS were estimated to be $1.939 billion/yr, $1.678 billion/yr, and $0.644 billion/yr in 2021 USD, respectively. Postpartum depression was excluded from the cost analyses due to the non-significant meta-analysis result. Taken together, the additional direct healthcare costs associated with anxiety, depression, and eating disorders in PCOS were estimated to be $4.261 billion/yr in 2021 USD. Conclusions Overall, the direct healthcare annual costs for the most common MH disorders in PCOS, namely anxiety, depression, and eating disorders, exceeds $4 billion in 2021 USD for the U.S. population alone. Taken together with our prior work, these data suggest that the healthcare-related economic burden of PCOS exceeds $15 billion yearly, considering the costs of PCOS diagnosis, and costs related to PCOS-associated MH, reproductive, vascular, and metabolic disorders. As PCOS has much the same prevalence across the world, the excess economic burden attributable to PCOS globally is enormous, mandating that the scientific and policy community increase its focus on this important disorder. Funding The study was supported, in part, by PCOS Challenge: The National Polycystic Ovary Syndrome Association and by the Foundation for Research and Education Excellence.
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Affiliation(s)
- Surabhi Yadav
- School of Global Public Health, New York UniversityNew YorkUnited States
| | - Olivia Delau
- School of Global Public Health, New York UniversityNew YorkUnited States
| | - Adam J Bonner
- Department of Obstetrics and Gynecology, Heersink School of Medicine, University of Alabama at BirminghamBirminghamUnited States
| | - Daniela Markovic
- Division of General Internal Medicine and Health Services Research, University of California, Los AngelesLos AngelesUnited States
| | - William Patterson
- PCOS Challenge: The National Polycystic Ovary SyndromeAtlantaUnited States
| | - Sasha Ottey
- PCOS Challenge: The National Polycystic Ovary SyndromeAtlantaUnited States
| | - Richard P Buyalos
- Department of Obstetrics and Gynecology, University of California, Los AngelesLos AngelesUnited States
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, Heersink School of Medicine, University of Alabama at BirminghamBirminghamUnited States
- Department of Health Policy, Management and Behavior, University at Albany, State University of New YorkRensselaerUnited States
- Department of Medicine, Heersink School of Medicine, University of Alabama at BirminghamBirminghamUnited States
- Department of Healthcare Organization and Policy, School of Public Health, University of Alabama at BirminghamBirminghamUnited States
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16
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Barabasz-Gembczyk A, Mędrala W, Rodek P, Alli-Balogun B, Chrobak J, Cwynar M, Sikora D, Wójtowicz M, Franik G, Madej P, Kucia K. Correlation between Selected Clinical Symptoms and Severity of Aggression, Impulsiveness and Their Selected Behavioral Manifestations in Patients with Polycystic Ovary Syndrome Phenotype A. Metabolites 2023; 13:646. [PMID: 37233687 PMCID: PMC10224027 DOI: 10.3390/metabo13050646] [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: 02/16/2023] [Revised: 03/24/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023] Open
Abstract
Previous studies on aggressiveness and impulsiveness in women with polycystic ovary syndrome (PCOS) are ambiguous. Furthermore, no biochemical or clinical factors related to these variables have been definitively confirmed. The aim of the study was to clarify whether, in women with phenotype A of PCOS, variables such as body mass index and clinical and biochemical hyperandrogenism have an impact on either the intensity of impulsivity or aggression or on other selected behavioral manifestations of these variables. The study included 95 patients diagnosed with PCOS phenotype A. The criterion for recruitment into the study group and the control group was body mass index. The study was conducted with the use of a closed-format questionnaire and calibrated clinical scales. Higher body mass index (BMI) values in women with PCOS phenotype A are associated with poor eating habits. The severity of impulsivity and aggression syndrome, as well as the tendency to engage in risky sexual behavior and patterns of alcohol consumption among patients diagnosed with PCOS phenotype A, are not dependent on BMI. The severity of impulsiveness and the syndrome of aggression in women with phenotype A PCOS are not associated with clinical symptoms of hyperandrogenism or with androgen levels.
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Affiliation(s)
- Aleksandra Barabasz-Gembczyk
- Department and Clinic of Adult Psychiatry, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland (B.A.-B.)
| | - Wojciech Mędrala
- Department and Clinic of Adult Psychiatry, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland (B.A.-B.)
| | - Patryk Rodek
- Department and Clinic of Adult Psychiatry, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland (B.A.-B.)
| | - Barbara Alli-Balogun
- Department and Clinic of Adult Psychiatry, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland (B.A.-B.)
| | - Jan Chrobak
- Department and Clinic of Adult Psychiatry, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland (B.A.-B.)
| | - Marlena Cwynar
- Department of Gynecological Endocrinology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland (G.F.)
| | - Dominika Sikora
- Department of Gynecological Endocrinology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland (G.F.)
| | - Mariusz Wójtowicz
- Department of Gynecological and Obstetrics Women’s and Child Health Center, Medical University of Silesia, 41-803 Zabrze, Poland
| | - Grzegorz Franik
- Department of Gynecological Endocrinology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland (G.F.)
- Infertility Outpatient Clinic, University Clinical Center, Medical University of Silesia, 40-042 Katowice, Poland
| | - Paweł Madej
- Department of Gynecological Endocrinology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland (G.F.)
- Infertility Outpatient Clinic, University Clinical Center, Medical University of Silesia, 40-042 Katowice, Poland
| | - Krzysztof Kucia
- Department and Clinic of Adult Psychiatry, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Ziołowa 45/47, 40-635 Katowice, Poland (B.A.-B.)
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17
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Quesnel DA, Cooper M, Fernandez-Del-Valle M, Reilly A, Calogero RM. Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review. J Eat Disord 2023; 11:3. [PMID: 36627654 PMCID: PMC9832767 DOI: 10.1186/s40337-022-00685-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/01/2022] [Indexed: 01/12/2023] Open
Abstract
Individuals with eating disorders (ED) experience prolonged malnutrition, binge episodes, and compensatory behaviours that affect every organ system. Psychological and physiological symptoms are worsened with comorbid dysfunctional exercise, seen in up to 80% of those with an ED. Although return to exercise is an important component of treatment and recovery, little is known about the contraindications and risks of exercise engagement specific to those with an ED. This paper provides a comprehensive narrative review of the medical and physiological complications of engaging in exercise during ED treatment and outlines when exercise may be contraindicated or used in modified or cautionary ways. We conducted a literature search on MEDLINE, PubMed, and PsychArticles to identify relevant articles, which yielded six categories of medical and physiological complications of ED that may be exacerbated by exercise: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.
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Affiliation(s)
- Danika A Quesnel
- Department of Psychological Clinical Science, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada.
| | - Marita Cooper
- Department of Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maria Fernandez-Del-Valle
- Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - Alanah Reilly
- Alanah Reilly Exercise Physiologist, Brisbane, Australia
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18
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Burnatowska E, Wikarek A, Oboza P, Ogarek N, Glinianowicz M, Kocelak P, Olszanecka-Glinianowicz M. Emotional Eating and Binge Eating Disorders and Night Eating Syndrome in Polycystic Ovary Syndrome-A Vicious Circle of Disease: A Systematic Review. Nutrients 2023; 15:nu15020295. [PMID: 36678165 PMCID: PMC9865055 DOI: 10.3390/nu15020295] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/16/2022] [Accepted: 12/27/2022] [Indexed: 01/10/2023] Open
Abstract
Obesity is an established risk factor for the development of polycystic ovary syndrome (PCOS), especially phenotype A. PCOS is an important cause of fertility disorders in a large group of women of reproductive age. For many years, effective methods of treating hormonal disorders associated with PCOS have been sought in order to restore ovulation with regular menstrual cycles. Numerous studies support obesity treatment as an effective therapeutic method for many women. A seemingly simple method of treatment may prove to be particularly difficult in this group of women. The reason for this may be the lack of recognition the primary cause of obesity development or the occurrence of a vicious circle of disease. Primary causes of developing obesity may be emotional eating (EE) and eating disorders (EDs), such as binge eating disorder (BED) and its extreme form, addictive eating, as well as night eating syndrome (NES). All of these are caused by impaired function of the reward system. Consequently, these disorders can develop or be exacerbated in women with obesity and PCOS as a result of depression and anxiety related to hirsutism and fertility disturbances. Therefore, for the effective treatment of obesity, it is very important to recognize and treat EE, BED, and NES, including the appropriate selection of pharmacotherapy and psychotherapy. Therefore, the aim of our manuscript is to analyze the available data on the relationships between EE, BED, NES, obesity, and PCOS and their impact on the treatment of obesity in women with PCOS.
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Affiliation(s)
- Ewelina Burnatowska
- Students’ Scientific Society at the Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, 40-752 Katowice, Poland
| | - Agnieszka Wikarek
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, 40-752 Katowice, Poland
| | - Paulina Oboza
- Students’ Scientific Society at the Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, 40-752 Katowice, Poland
| | - Natalia Ogarek
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, 40-752 Katowice, Poland
| | - Mateusz Glinianowicz
- Department of Psychology, Social Sciences, and Humanities, School of Health Sciences in Katowice, the Medical University of Silesia, 40-752 Katowice, Poland
| | - Piotr Kocelak
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, 40-752 Katowice, Poland
- Correspondence:
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, The Medical University of Silesia, 40-752 Katowice, Poland
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19
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Suchta K, Smolarczyk R, Czajkowski K, Rudnicka E, Kokoszka A. Binge Eating Disorder-The Point Prevalence among Polish Women with Polycystic Ovary Syndrome and Validity of Screening Tool for This Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:546. [PMID: 36612867 PMCID: PMC9819692 DOI: 10.3390/ijerph20010546] [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: 10/28/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders which is associated with an increased risk of metabolic dysregulation. The elevated prevalence of obesity has been observed in women with PCOS. Since obesity is commonly associated with eating disturbances, including the binge eating disorder (BED), and since the hormonal changes in PCOS patients could influence the food intake model, we decided to estimate the prevalence of BED in PCOS patients and to assess the sensitivity and specificity of the Questionnaire for Binge Eating Screening (QBES) in PCOS patients. METHODS A total of 122 hospitalized women with PCOS aged 16-45 (M = 26; SD = 5.22) took part in the study. Binge eating disorder (BED) was diagnosed according to the DSM-5 diagnostic criteria. QBES was used as a screening tool for BED. RESULTS The point prevalence of BED in PCOS women according to DMS-5 criteria was 51 (42%). At least two positive answers to four QBES items had 100% sensitivity and 91% specificity. Positive answers to even only the first two questions from QBES had 98% sensitivity and 85% specificity. CONCLUSIONS Women with polycystic ovary syndrome are at a very high risk of binge eating behaviors. Screening for eating disorders should be a routine procedure in women with PCOS. The first two questions from QBES are a brief and relatively reliable screening tool that may be used in everyday practice with POSC patients.
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Affiliation(s)
- Katarzyna Suchta
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetric and Gynaecology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Ewa Rudnicka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Andrzej Kokoszka
- II Department of Psychiatry, Medical University of Warsaw, 02-091 Warsaw, Poland
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Assessment of Eating Disorders and Eating Behavior to Improve Treatment Outcomes in Women with Polycystic Ovary Syndrome. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111906. [PMID: 36431041 PMCID: PMC9692921 DOI: 10.3390/life12111906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
The essential role of the frequent coexistence of mental disorders and polycystic ovary syndrome (PCOS) is being increasingly recognized in the management of PCOS patients since it influences the success of weight loss interventions. Patients frequently experience disrupted eating behaviors, evidenced by the high prevalence of eating disorders in this population. Therefore, assessment and potential modification of eating disorders and eating-related behavior might be especially relevant to improve obesity treatment outcomes in this population, which remains the most efficient causal treatment in PCOS patients with high metabolic risk. Following a literature overview on common eating disorders and eating behaviors in PCOS, the aim of this review was to explore the prevalence and underlying mechanisms behind those occurrences. Understanding the clinical relevance of those associations and the addition of the assessments of eating disorders as well as eating phenotypes, eating chronotypes, and eating content as essential determinants of eating behavior could aid in the successful management of women with PCOS. In addition, the review also covers the potential of using eating disorders and eating behavior as a tool for the personalization of obesity treatment in PCOS.
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21
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Barberis N, Calaresi D, Cannavò M, Verrastro V. Body mass index and quality of life in individuals with polycystic ovary syndrome: Dysmorphic concerns and eating disorders as mediators. Front Public Health 2022; 10:962083. [PMID: 36276397 PMCID: PMC9581187 DOI: 10.3389/fpubh.2022.962083] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/06/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Weight issues, dysmorphic concerns and eating disorders are common among individuals with polycystic ovary syndrome (PCOS) and are linked to poor quality of life (QoL). The goal of the current study was to examine whether the association between body mass index (BMI) and QoL was mediated by dysmorphic concerns, examining also the relations with eating disorder symptomatology. Methods Questionnaires were administered to 435 individuals with PCOS aged between 18 and 40 years (M = 27.62; SD = 4.83) to measure dysmorphic concerns, eating disorder symptoms and QoL. Participants were also asked to report their height and weight to compute their BMI. Results Structural equation modeling was used to observe the relationship between the variables. The results revealed a direct relationship between QoL, BMI, dysmorphic concerns and eating disorder symptomatology. In addition, dysmorphic concerns were related to BMI and eating disorder symptomatology. Furthermore, the results showed the mediating role of dysmorphic concerns and eating disorder symptoms in the relationship between BMI and QoL. Conclusion The current results highlight the potential importance of harmful relationships with one's own body and food, explaining why weight issues may be linked to different levels of QoL in PCOS individuals. The implications of these findings are discussed.
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Affiliation(s)
- Nadia Barberis
- Department of Health Sciences, Magna Græcia University, Catanzaro, Italy
| | - Danilo Calaresi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Marco Cannavò
- Department of Health Sciences, Magna Græcia University, Catanzaro, Italy,*Correspondence: Marco Cannavò
| | - Valeria Verrastro
- Department of Health Sciences, Magna Græcia University, Catanzaro, Italy
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22
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Impact of social isolation during COVID-19 pandemic on health behaviors and weight management in women with polycystic ovary syndrome. Eat Weight Disord 2022; 27:2407-2413. [PMID: 35195885 PMCID: PMC8865179 DOI: 10.1007/s40519-022-01369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE COVID-19 pandemic has far-reaching psychosocial implications for chronic health conditions. We aimed to investigate whether COVID-19 associated social isolation affects lifestyle and weight control in women with polycystic ovary syndrome (PCOS). METHODS We conducted an online survey involving 232 women with PCOS and 157 healthy controls on weight changes, physical activity, sleep and eating patterns using Three-Factor Eating Questionnaire (TFEQ-18), Pittsburgh Sleep Quality Index (PSQI), and International Physical Activity Questionnaire Short Form (IPAQ-SF). PCOS-related quality of life questionnaire (PCOSQ) was also completed by the patients. RESULTS While 48.5% of all participants gained weight, 13.9% maintained a stable weight, and 37.6% lost weight during the 14-week social isolation. The distribution of weight change was similar between groups (p = 0.44). All participants reported a decrease in physical activity (p < 0.001). While eating behavior showed no significant change in both groups, reduced sleep quality was found only in the PCOS group (p < 0.001). In women with weight gain, increase in BMI values was higher in patients (1.3 ± 1 kg/m2) than controls (1.0 ± 0.6 kg/m2; p = 0.01). Among those who gained weight, delta BMI values showed positive correlations with delta sleep induction time (r = 0.25, p = 0.001), delta PSQI (r = 0.24, p = 0.004) and delta TFEQ-18 scores (r = 0.25, p = 0.001). CONCLUSION Weight changes during social isolation are similar in women with PCOS and healthy women. However, within those who gain weight, increase in BMI is more pronounced in women with PCOS. Weight gain appears to be related to alterations in sleep quality and eating habits rather than reduced physical activity. LEVEL III Evidence obtained from cohort or case-control analytic studies.
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23
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Ralph AF, Brennan L, Byrne S, Caldwell B, Farmer J, Hart LM, Heruc GA, Maguire S, Piya MK, Quin J, Trobe SK, Wallis A, Williams-Tchen AJ, Hay P. Management of eating disorders for people with higher weight: clinical practice guideline. J Eat Disord 2022; 10:121. [PMID: 35978344 PMCID: PMC9386978 DOI: 10.1186/s40337-022-00622-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. AIM The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. METHODS The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. RECOMMENDATIONS Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. CONCLUSIONS This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
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Affiliation(s)
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Wodonga, Australia
| | - Sue Byrne
- Department of Psychology, University of Western Australia, Perth, Australia
| | | | - Jo Farmer
- Lived Experience Advocate, Melbourne, Australia
| | - Laura M. Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Gabriella A. Heruc
- Eating Disorders and Nutrition Research Group (ENRG), School of Medicine, Western Sydney University, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia
- Sydney Local Health District, NSW Health, Sydney, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, Macarthur Clinical School, Sydney, Australia
- Camden and Campbelltown Hospitals, Sydney, Australia
| | - Julia Quin
- Lived Experience Advocate, Melbourne, Australia
| | - Sarah K. Trobe
- National Eating Disorders Collaboration, Sydney, Australia
| | - Andrew Wallis
- Sydney Children’s Hospitals Network, The Children’s Hospital Westmead, Sydney, Australia
| | | | - Phillipa Hay
- Eating Disorders and Body Image (EDBI), Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- South Western Sydney Local Health District, Sydney, Australia
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Jiskoot G, de Loos AD, Timman R, Beerthuizen A, Laven J, Busschbach J. Changes in eating behavior through lifestyle treatment in women with polycystic ovary syndrome (PCOS): a randomized controlled trial. J Eat Disord 2022; 10:69. [PMID: 35581616 PMCID: PMC9116037 DOI: 10.1186/s40337-022-00593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating behaviors like emotional eating, external eating and restrained eating play an important role in weight gain and weight loss in the general population. Improvements in eating behavior are important for long-term weight. This has not yet been studied in women with Polycystic Ovary Syndrome (PCOS). The aim of this study is to examine if a three-component lifestyle intervention (LI) is effective for improving disordered eating behavior in women with PCOS. METHODS Women diagnosed with PCOS (N = 183), with a body mass index (BMI) > 25 kg/m2 and trying to achieve a pregnancy were either assigned to 1 year of 20 group sessions of cognitive behavioral therapy (CBT) combined with nutritional advice and exercise with or without additional feedback through Short Message Service (SMS) or Care As Usual (CAU), which includes the advice to lose weight using publicly available services. RESULTS The Eating Disorder Examination Questionnaire (EDEQ) scores worsened in CAU (47.5%) and improved in the LI (4.2%) at 12 months. The difference between the LI and CAU was significant (P = 0.007) and resulted in a medium to large effect size (Cohen's d: - 0.72). No significant differences were observed in EDEQ scores between LI with SMS compared to LI without SMS (Cohen's d: 0.28; P = 0.399). Also, weight loss did not mediate the changes in eating behavior. An overall completion rate of 67/183 (36.6%) was observed. CONCLUSIONS A three-component CBT lifestyle program resulted in significant improvements in disordered eating behavior compared to CAU. Changes in disordered eating behavior are important for long-term weight loss and mental health. TRIAL REGISTRATION NTR, NTR2450. Registered 2 August 2010, https://www.trialregister.nl/trial/2344.
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Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Alexandra Dietz de Loos
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Annemerle Beerthuizen
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Joop Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jan Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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25
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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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Nemchikova O, Frontoni S. The role of dietitian in the multidisciplinary treatment of PCOS. Nutr Metab Cardiovasc Dis 2022; 32:827-832. [PMID: 35168829 DOI: 10.1016/j.numecd.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/28/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
It is well accepted by the medical literature that polycystic ovary syndrome (PCOS) is an extremely heterogeneous condition and that a multidisciplinary approach, involving gynecologists, endocrinologists, primary healthcare providers, mental health professionals, and nutritional professionals, especially dietitians, is fundamental to provide an immediate care and to counteract long-term risk factors related to the comorbidity of PCOS. Although lifestyle modifications are the first step intervention in the treatment of PCOS, unfortunately, the involvement of dietitian in clinical practice remains sporadic. The goal of this viewpoint is to put a greater emphasis on the role of dietitian in the management of PCOS by highlighting frequently faced difficulties in the clinical settings and the importance of a three-step nutritional care: accurate assessment; lifestyle, nutritional, and supplementary intervention; long-term follow-up. The intention is to raise awareness among dietitians themselves and other health providers as well as to express an exceeding necessity of evidence-based guidelines formulated specifically for nutritional professionals, which would allow a uniform approach with respect to heterogeneity and complexity of PCOS at the international level.
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Affiliation(s)
- Olga Nemchikova
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Simona Frontoni
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; Unit of Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita, Fatebenefratelli Hospital, 00186 Rome, Italy.
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27
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Rył A, Szylińska A, Bohatyrewicz A, Jurewicz A, Pilarczyk B, Tomza-Marciniak A, Rotter I. Relationships Between Indicators of Metabolic Disorders and Selected Concentrations of Bioelements and Lead in Serum and Bone Tissue in Aging Men. Diabetes Metab Syndr Obes 2022; 15:3901-3911. [PMID: 36540347 PMCID: PMC9759988 DOI: 10.2147/dmso.s387444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the relationships between serum and bone concentrations of selected bioelements, ie, zinc (Zn), copper (Cu), iron (Fe), chrome (Cr), magnesium (Mg), and selenium (Se), and a heavy metal, ie, lead (Pb), and the selected indicators of metabolic disorders - Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP) and Body Mass Index (BMI). MATERIAL AND METHODS The study comprised 151 men aged 60 to 75 years who were scheduled for hip replacement surgery due to osteoarthritis. The concentrations of elements in the serum and bone tissue were measured using inductively coupled plasma optical emission spectrometry (Mg, Zn, Cu, Cr, Fe, and Pb) and the spectrofluorometric method (Se). Fasting plasma glucose (FPG), high-density cholesterol (HDL-Ch), and triacylglycerols (TAG) were determined. Lipid accumulation product (LAP) and visceral adiposity index (VAI) were calculated. RESULTS There was no relationship between serum and bone concentrations of bioelements and lead and the BMI index. Bone Mg was significantly higher in men with higher VAI, but no such relation was observed in the serum. Similarly, bone Mg and Zn were higher in patients with higher LAP, which was not observed in the serum. Multivariate logistic regression analysis with adjustment for age was performed. There was a correlation between serum Zn concentration and the cut-off point for VAI. The cut-off point for LAP was related to the bone tissue concentrations of Mg, Zn, and Cu. CONCLUSION We found some relationships between the concentrations of selected bioelements and Pb and VAI, LAP, and BMI in bone but not in the serum. VAI positively correlated with bone Mg, while LAP positively correlated with bone Cu, Zn, and Mg.
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Affiliation(s)
- Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland
- Correspondence: Aleksandra Rył, Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Żołnierska 54, Szczecin, 71-210, Poland, Tel +4891 810 62 61, Email
| | - Aleksandra Szylińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Bohatyrewicz
- Department of Orthopedics, Traumatology and Orthopedic Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Alina Jurewicz
- Department of Orthopedics, Traumatology and Orthopedic Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Bogumiła Pilarczyk
- Department of Animal Reproduction Biotechnology and Environmental Hygiene, West Pomeranian University of Technology, Szczecin, Poland
| | - Agnieszka Tomza-Marciniak
- Department of Animal Reproduction Biotechnology and Environmental Hygiene, West Pomeranian University of Technology, Szczecin, Poland
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland
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28
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Aversa A, La Vignera S, Rago R, Gambineri A, Nappi RE, Calogero AE, Ferlin A. Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. Front Endocrinol (Lausanne) 2021. [PMID: 32849300 DOI: 10.3389/fendo.2020.00516.pmid:32849300;pmcid:pmc7431619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rocco Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University Alma Mater Studiorum, Bologna, Italy
| | - Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Evaluation of the relationship between serum ferritin and insulin resistance and visceral adiposity index (VAI) in women with polycystic ovary syndrome. Eat Weight Disord 2021; 26:1581-1593. [PMID: 32772321 DOI: 10.1007/s40519-020-00980-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/30/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE There is a relationship between polycystic ovary syndrome (PCOS) and adipose tissue dysfunction (ADD), but this relationship is not clear. It has been recently shown that iron accumulation in adipose tissue is among the causes of adipose tissue dysfunction. Data on adipose tissue dysfunction in women with PCOS are insufficient. In this study, we aimed to evaluate the relationship between serum ferritin levels (iron accumulation biomarker) and visceral adiposity index (an indicator of adipose tissue dysfunction). METHODS The study is a case-control study. Women with diagnosed PCOS with 2003 Rotterdam Diagnostic Criteria (n = 40) were compared with non-PCOS group (n = 40). In this study, the cholesterol ratios, the homeostatic model evaluation index for insulin resistance (HOMA-IR) and the quantitative insulin sensitivity control index were calculated using biochemical parameters, and the visceral adiposity index (VAI) and the lipid accumulation product (LAP) were calculated using both anthropometric and biochemical parameters. In this study, insulin resistance was evaluated by HOMA-IR and adipose tissue dysfunction was evaluated by VAI index. RESULTS According to the results of this study, women with PCOS have a worse metabolic status than women without PCOS. However, this has been shown only in overweight and obese women, not in women with normal weight. CONCLUSION As a result, the presence of obesity in women with PCOS exacerbates metabolic status. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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30
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Zhou S, Ji Y, Wang H. The risk factors of gestational hypertension in patients with polycystic ovary syndrome: a retrospective analysis. BMC Pregnancy Childbirth 2021; 21:336. [PMID: 33906610 PMCID: PMC8080329 DOI: 10.1186/s12884-021-03808-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The hypertensive disorders complicating pregnancy (HDCP) is common in patients with polycystic ovary syndrome (PCOS), yet the potential influencing factors remained unclear. We aimed to assess the independent risk factors of HDCP in patients with PCOS, to provide clinical evidences for the management of PCOS. METHODS Pregnant PCOS patients treated in our hospital from June 1, 2018 to November 30, 2020 were approached. The personal and clinical characteristics of patients with and without gestational hypertension were evaluated. Logistic regressions were conducted to identify the independent risk factors of HDCP, Receiver operating characteristics (ROC)curve analysis was conducted to evaluate the predicting value. RESULTS A total of 188 PCOS patients were included, the incidence of HDCP in patients with PCOS was 27.66 %. There were significant differences in the age, BMI, family history of hypertension, the history of adverse pregnancy, history of contraceptive pills use and family history of HDCP between HDCP group and no-HDCP group (all p < 0.05), and there were no significant differences in the family history of diabetes, multiple pregnancy and long-term smoking history between HDCP group and no-HDCP group (all p > 0.05). Age ≥ 27y(OR2.048, 95 %CI1.121 ~ 3.208), BMI ≥ 24 kg/m2(OR1.463, 95 %CI1.069 ~ 2.011), family history of hypertension(OR2.129, 95 %CI1.093 ~ 3.042), the history of adverse pregnancy(OR2.435, 95 %CI1.264 ~ 4.085), history of contraceptive pills use(OR3.806, 95 %CI1.184 ~ 6.102), family history of HDCP(OR1.934, 95 %CI1.016 ~ 2.774) were the independent risk factors of HDCP in patients with PCOS (all p < 0.05). ROC curve analyses indicated that those factors had good predictive value on HDCP in PCOS patients. CONCLUSIONS The incidence of HDCP in PCOS patients is relatively high. In clinical practice, medical workers should carry out early prevention and intervention measures for these risk factors to reduce the incidence of HDCP.
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Affiliation(s)
- Shu Zhou
- Department of gynaecology, The 5th Affiliated Hospital of Nantong University (Taizhou People's Hospital), Taizhou, China
| | - Yiping Ji
- Department of gynaecology, Lian Shui county People's Hospital, Huai'an, China.
| | - Haimei Wang
- Department of Urology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, No.62, Huaihai Road, Jiangsu, 223002, Huai'an, China.
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Huffman AM, Rezq S, Basnet J, Yanes Cardozo LL, Romero DG. SARS-CoV-2 Viral Entry Proteins in Hyperandrogenemic Female Mice: Implications for Women with PCOS and COVID-19. Int J Mol Sci 2021; 22:4472. [PMID: 33922918 PMCID: PMC8123333 DOI: 10.3390/ijms22094472] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/14/2021] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
SARS-CoV-2, the causative agent of COVID-19, infects host cells using the angiotensin I converting enzyme 2 (ACE2) as its receptor after priming by host proteases, including TMPRSS2. COVID-19 affects multiple organ systems, and male patients suffer increased severity and mortality. Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in reproductive-age women and is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. PCOS is associated with obesity and cardiometabolic comorbidities, both being risk factors associated with severe COVID-19 pathology. We hypothesize that elevated androgens in PCOS regulate SARS-CoV-2 entry proteins in multiple tissues increasing the risk for this population. Female mice were treated with dihydrotestosterone (DHT) for 90 days. Body composition was measured by EchoMRI. Fasting glucose was determined by an enzymatic method. mRNA and protein levels of ACE2, Tmprss2, Cathepsin L, Furin, Tmprss4, and Adam17 were quantified by RT-qPCR, Western-blot, or ELISA in tissues, serum, and urine. DHT treatment increased body weight, fat and lean mass, and fasting glucose. Ace2 mRNA was upregulated in the lung, cecum, heart, and kidney, while downregulated in the brain by DHT. ACE2 protein was upregulated by DHT in the small intestine, heart, and kidney. The SARS-CoV-2 priming proteases Tmprss2, Cathepsin L, and Furin mRNA were upregulated by DHT in the kidney. ACE2 sheddase Adam17 mRNA was upregulated by DHT in the kidney, which corresponded with increased urinary ACE2 in DHT treated mice. Our results highlight the potential for increased cardiac, renal, and gastrointestinal dysfunction in PCOS women with COVID-19.
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Affiliation(s)
- Alexandra M. Huffman
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA; (A.M.H.); (S.R.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Samar Rezq
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA; (A.M.H.); (S.R.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Jelina Basnet
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA; (A.M.H.); (S.R.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Licy L. Yanes Cardozo
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA; (A.M.H.); (S.R.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Damian G. Romero
- Department of Cell and Molecular Biology, University of Mississippi Medical Center, Jackson, MS 39216, USA; (A.M.H.); (S.R.); (J.B.); (L.L.Y.C.)
- Mississippi Center of Excellence in Perinatal Research, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Women’s Health Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
- Cardio Renal Research Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Cooney LG, Dokras A. Cardiometabolic Risk in Polycystic Ovary Syndrome: Current Guidelines. Endocrinol Metab Clin North Am 2021; 50:83-95. [PMID: 33518188 DOI: 10.1016/j.ecl.2020.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Polycystic ovary syndrome is a common endocrine disorder in reproductive-aged women and is associated with an increased risk of metabolic abnormalities, including obesity, impaired glucose tolerance, diabetes, dyslipidemia, metabolic syndrome, venous thromboembolism, and subclinical atherosclerosis. Clinicians and patients alike need to be aware of these increased risks as well as new international guidelines that recommend frequent screening and active management of metabolic abnormalities. Given that the data on risk of cardiovascular events, such as myocardial infarction and stroke, in women with PCOS is mixed, future large-scale, longitudinal studies are needed to clarify these potential risks.
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Affiliation(s)
- Laura G Cooney
- Department of Obstetrics and Gynecology, University of Wisconsin, Generations Fertility Care, 2365 Deming Way, Middleton, WI 53562, USA
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Penn Fertility Care, 3701 Market Street, Suite 800, Philadelphia, PA 19085, USA.
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Douglas CC, Jones R, Green R, Brown K, Yount G, Williams R. University Students with PCOS Demonstrate Limited Nutrition Knowledge. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1877218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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The mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis. Arch Womens Ment Health 2021; 24:11-27. [PMID: 32514730 DOI: 10.1007/s00737-020-01043-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
Polycystic ovary syndrome (PCOS) has been proposed to be associated with several mental health problems, including anxiety, depression, diminished sexual satisfaction, and lowered health-related quality of life, etc. A systematic review and meta-analysis of published literature was conducted comparing the mental health of women with and without PCOS. Ten English and Chinese databases were searched up to 12/31/2018. Random-effects models were introduced, and subgroup analysis, sensitivity test, and meta-regression were carried out to determine the source for heterogeneity among studies. Forty-six studies, including 30,989 participants (9265 women with PCOS and 25,638 controls), were qualified for review according to the inclusion criteria. Twenty-eight studies reported depression symptoms, 22 studies were on anxiety, 16 studies showed quality of life (QoL) status, 12 studies were about sexual dysfunction, five on emotional distress, four on binge eating, and four on somatization. Women with PCOS reported significantly higher depression (SMD = 0.64; 95% CI 0.50-0.78), anxiety (SMD = 0.63; 95% CI 0.50-0.77), lower QoL (SMD = - 0.55; 95% CI -0.69 to -0.40), and not significant sexual dysfunction (SMD = - 0.24; 95% CI - 0.49 to 0.01). Studies from different countries, adopting various diagnosis criteria, using diverse instruments, as well as in different years, have reported heterogenetic results. Women with PCOS in China reported a larger effect size of depression and anxiety than patients from other countries. The results of this study have indicated that women with PCOS suffer from depression, anxiety, and experience a lower quality of life, whereas their sexual function is not distinct from that of healthy women. Psychological health care interventions for women with PCOS were addressed.
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Clinical Obstetrics & Gynecology: Polycystic Ovary Disease Ethnicity, Diversity, and Psychosocial Ramifications. Clin Obstet Gynecol 2020; 64:76-82. [PMID: 33306498 DOI: 10.1097/grf.0000000000000582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Polycystic ovary disease is a heterogenous disorder that presents differently in each individual. Some of this variation is due to racial and ethnic differences, which has been shown to affect hirsutism scores, metabolic comorbidities, cardiovascular risk factors, and long-term health outcomes. Psychosocial factors, including mental health diagnoses, body image distress measures, and disordered eating behaviors have also been shown to affect women with polycystic ovarian syndrome at a higher rate than the general population, and contribute to a decreased quality of life among many patients with this chronic condition.
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Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence. Int J Mol Sci 2020; 21:ijms21218211. [PMID: 33153014 PMCID: PMC7663730 DOI: 10.3390/ijms21218211] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine condition associated with reproductive and psychiatric disorders, and with obesity. Eating disorders, such as bulimia and recurrent dieting, are also linked to PCOS. They can lead to the epigenetic dysregulation of the hypothalamic-pituitary-gonadal (HPG) axis, thereby impacting on ovarian folliculogenesis. We postulate that PCOS is induced by psychological distress and episodes of overeating and/or dieting during puberty and adolescence, when body dissatisfaction and emotional distress are often present. We propose that upregulated activation of the central HPG axis during this period can be epigenetically altered by psychological stressors and by bulimia/recurrent dieting, which are common during adolescence and which can lead to PCOS. This hypothesis is based on events that occur during a largely neglected stage of female reproductive development. To date, most research into the origins of PCOS has focused on the prenatal induction of this disorder, particularly in utero androgenization and the role of anti-Müllerian hormone. Establishing causality in our peripubertal model requires prospective cohort studies from infancy. Mechanistic studies should consider the role of the gut microbiota in addition to the epigenetic regulation of (neuro) hormones. Finally, clinicians should consider the importance of underlying chronic psychological distress and eating disorders in PCOS.
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Garcia SC, Mikhail ME, Keel PK, Burt SA, Neale MC, Boker S, Klump KL. Increased rates of eating disorders and their symptoms in women with major depressive disorder and anxiety disorders. Int J Eat Disord 2020; 53:1844-1854. [PMID: 32844425 PMCID: PMC7669595 DOI: 10.1002/eat.23366] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Individuals with eating disorders (EDs) have increased rates of major depressive disorder (MDD) and anxiety disorders. Yet, few studies have investigated rates of EDs and their symptoms in individuals presenting with MDD/anxiety disorders. Identifying potential disordered eating in people with MDD/anxiety disorders is important because even subclinical disordered eating is associated with reduced quality of life, and undiagnosed eating pathology may hinder treatment progress for both MDD/anxiety disorders and comorbid EDs. METHOD We compared rates of EDs (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding and eating disorders) and their symptoms in 130 women with, and 405 women without, lifetime MDD or an anxiety disorder (generalized anxiety disorder, obsessive-compulsive disorder, social phobia, specific phobia, panic disorder, agoraphobia, or post-traumatic stress disorder) recruited from the population-based Michigan State University Twin Registry. Lifetime ED and MDD/anxiety diagnoses, and lifetime clinically significant disordered eating behaviors (e.g., binge eating, excessive exercise) were assessed using the Structured Clinical Interview for DSM-IV (SCID). RESULTS Among participants with lifetime MDD or any anxiety disorder, 13% met criteria for a lifetime ED and 39% reported engaging in at least one lifetime clinically significant disordered eating behavior (e.g., binge eating) on the SCID. In contrast, only 3% of participants without a history of MDD/an anxiety disorder met criteria for a lifetime ED, and only 11% reported lifetime clinically significant disordered eating behavior. DISCUSSION Our findings suggest that women with MDD and anxiety disorders have elevated rates of EDs, and it is therefore imperative to screen for disordered eating in these populations.
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Affiliation(s)
- Susana C. Garcia
- Department of Psychology, John Jay College of Criminal Justice, New York, New York
| | - Megan E. Mikhail
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - S. Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Michael C. Neale
- Departments of Psychiatry, Human Genetics, and Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Steven Boker
- Department of Psychology, University of Virginia, Charlottesville, Virginia
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan
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Risk Factors of Overweight and Obesity Related to Diet and Disordered Eating Attitudes in Adolescent Girls with Clinical Features of Polycystic Ovary Syndrome. J Clin Med 2020; 9:jcm9093041. [PMID: 32967289 PMCID: PMC7564079 DOI: 10.3390/jcm9093041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background: We aimed to find the difference between girls with clinical features of Polycystic ovary syndrome (PCOS), divided into two groups: Overweight/obesity (Ov/Ob) and normal weight (N), related to diet, disordered eating attitudes (DEA), metabolic and hormonal differences, and to identify the risk factors of being overweight or obese. Methods: Seventy-eight adolescents with PCOS, aged 14-18 years, were divided into Ov/Ob and N groups. Patients underwent blood tests for determination of follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, DHEA-S, estradiol, of sex hormone-binding globulin (SHBG), fasting glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and lipid profile. Nutrition was evaluated using a 3-day food record. To examine the level of DEA, the Eating Attitudes Test-26 (EAT-26) was used. We defined an EAT-26 score ≥20 as positive for DEA. Logistic regression was carried out to identify the independent predictors of being overweight and obese. Results: An increase of 10 g in plant protein intake decreased the probability of being overweight and of obesity (OR = 0.54; p = 0.036). EAT-26 score ≥20 was correlated with a 7-fold (OR = 6.88; p = 0.02) increased odds of being overweight or of obesity. Conclusion: Being overweight and obesity in adolescents with PCOS may be associated with DEA and the type and amount of protein intake.
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Başar Gökcen B, Akdevelioğlu Y, Canan S, Bozkurt N. Increased risk of eating disorders in women with polycystic ovary syndrome: a case-control study. Gynecol Endocrinol 2020; 36:764-767. [PMID: 32238016 DOI: 10.1080/09513590.2020.1744554] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Data on eating disorders in women with PCOS is insufficient. The objective of this case study was to examine the hypothesis that women with PCOS exhibit more impaired eating than healthy women. Women diagnosed with PCOS under the 2003 Rotterdam Diagnostic Criteria (n = 40) were compared with a healthy control group (n = 40). The groups also were divided into two as normal body weight and overweight/obese. The Eating Disorders Assessment Questionnaire (EDE-Q) and the Three Factor Eating Questionnaire (TFEQ-R21), were completed by all participants in order to evaluate eating behaviors in addition to eating disorders. Among the overweight/obese group, the average total and subscale scores of the EDE-Q as well as the total and sub-factor scores of the TFEQ-R21 were higher in women with PCOS compared to controls (p < .05). However, this statistically significant result was not shown among the women with normal weight (p > .05). In comparison to the controls, the PCOS women displayed higher values of the tool scores indicating abnormal restraint eating, body shape concern and weight concern subscale scores (p < .05). This result suggests that the evaluation of eating disorders should be added to routine screening and the monitoring of women with PCOS.
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Affiliation(s)
- Büşra Başar Gökcen
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Yasemin Akdevelioğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Sultan Canan
- Department of Obstetrics and Gynecology Department, School of Medicine, Gazi University, Ankara, Turkey
| | - Nuray Bozkurt
- Department of Obstetrics and Gynecology Department, School of Medicine, Gazi University, Ankara, Turkey
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Karjula S, Morin-Papunen L, Franks S, Auvinen J, Järvelin MR, Tapanainen JS, Jokelainen J, Miettunen J, Piltonen TT. Population-based Data at Ages 31 and 46 Show Decreased HRQoL and Life Satisfaction in Women with PCOS Symptoms. J Clin Endocrinol Metab 2020; 105:5709653. [PMID: 31970392 PMCID: PMC7150615 DOI: 10.1210/clinem/dgz256] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 04/03/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is associated with decreased health-related quality of life (HRQoL), but longitudinal data beyond the reproductive years are lacking, and the impact of isolated PCOS symptoms is unclear. OBJECTIVE To study generic HRQoL using the 15D questionnaire, life satisfaction, and self-reported health status in women with PCOS symptoms at ages 31 and 46 years. DESIGN A longitudinal assessment using the Northern Finland Birth Cohort 1966. SETTING General community. PARTICIPANTS The 15D data were available for women reporting isolated oligo-amenorrhea (OA; at age 31 years, 214; and 46 years, 211), isolated hirsutism (H; 31 years, 211; and 46 years, 216), OA + H (PCOS; 31 years, 74; and 46 years, 75), or no PCOS symptoms (controls; 31 years, 1382; and 46 years, 1412). Data for life satisfaction and current health status were available for OA (31 years, 329; and 46 years, 247), H (31 years, 323; and 46 years, 238), PCOS (31 years, 125; and 46 years, 86), control (31 years, 2182; and 46 years, 1613) groups. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) 15D HRQoL, questionnaires on life satisfaction, and self-reported health status. RESULTS HRQoL was lower at ages 31 and 46 in women with PCOS or H than in the controls. PCOS was an independent risk factor for low HRQoL, and the decrease in HRQoL in PCOS was similar to that of women with other chronic conditions, such as asthma, migraine, rheumatoid arthritis, and depression. The risk for low HRQoL in PCOS remained significant after adjusting for body mass index, hyperandrogenism, and socioeconomic status. Mental distress was the strongest contributing factor to HRQoL. PCOS was also associated with a risk for low life satisfaction and a 4-fold risk for reporting a poor health status. CONCLUSIONS Women with PCOS present with low HRQoL, decreased life satisfaction, and a poorer self-reported health status up to their late reproductive years. Assessments and interventions aiming to improve HRQoL in PCOS should be targeted beyond the fertile age.
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Affiliation(s)
- Salla Karjula
- Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, University Hospital of Oulu, University of Oulu, Oulu, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, University Hospital of Oulu, University of Oulu, Oulu, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, London, UK; Centre for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, University Hospital of Oulu, University of Oulu, Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Jouko Miettunen
- Center for Life Course Health Research, Faculty of Medicine Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, University Hospital of Oulu, University of Oulu, Oulu, Finland
- Correspondence and Reprint Requests: Terhi Piltonen, Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Centre Oulu, Oulu University Hospital, University of Oulu, PL 23 90029 OYS, Oulu, Finland. E-mail:
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Obesity and depression are risk factors for future eating disorder-related attitudes and behaviors in women with polycystic ovary syndrome. Fertil Steril 2020; 113:1039-1049. [DOI: 10.1016/j.fertnstert.2020.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/09/2019] [Accepted: 01/10/2020] [Indexed: 01/03/2023]
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Castelo-Branco C, Naumova I. Quality of life and sexual function in women with polycystic ovary syndrome: a comprehensive review. Gynecol Endocrinol 2020; 36:96-103. [PMID: 31559883 DOI: 10.1080/09513590.2019.1670788] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy among women of reproductive age. PCOS is a polysimptomatic disease, the leading manifestations of which are hyperandrogenic dermopathy, menstrual dysfunction, infertility and obesity. Dissatisfaction with one's own appearance, low self-esteem, a feeling of sexual unattractiveness cause chronic psychological discomfort, mood disturbances and problems in the relationship with a partner. The article presents an overview of scientific sources on the effect of polycystic ovary syndrome on the quality of life and the sexual function of women. Data recorded confirm the hypothesis that PCOS is not only an endocrine disorder, but a heterogeneous condition with reproductive, metabolic, and mental manifestations. The association of PCOS manifestations with a decrease in the quality of life and disorders in the sexual sphere of women was well assessed. Data presented in the review ensure the absolute medical and social importance of the study of PCOS.
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Affiliation(s)
- Camil Castelo-Branco
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, University of Barcelona, Hospital Clinic-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Iuliia Naumova
- Faculty of General Medicine, Department of Obstetrics and Gynecology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia
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Abstract
Polycystic ovary syndrome (PCOS), characterized by hormonal imbalance and ovarian dysfunction, often starts during adolescence. Inconsistent diagnostic criteria, variable provider knowledge, and lack of consensus pose specific challenges for the care of women with PCOS. These factors encourage inaccurate diagnosis with both under and overdiagnosis. This unfavorable diagnostic experience exasperates affected women and limits timely opportunities for intervention to minimize associated comorbidities, especially during the transition from pediatric to adult care. Recognition of these issues in the care of adolescents and women with PCOS inspired the development of the International Evidence-Based PCOS Guidelines, which emphasize the prevention, screening, and treatment of PCOS across the reproductive lifespan. The Guidelines and accompanying meta-analyses focus on three major categories of associated comorbidities: (1) reproductive; (2) metabolic; and (3) psychological. With the exception of infertility, this article considers common manifestations and comorbidities associated with PCOS throughout the lifecycle. Healthy lifestyle interventions with prevention of excess weight gain comprise the primary intervention for all comorbidities. Hence, early identification of girls "at risk" for PCOS and those with PCOS is a priority. Extensive guidelines for provider and patient education aim to decrease the medical, psychosocial, and economic burdens attributable to PCOS and its associated comorbidities.
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Aversa A, La Vignera S, Rago R, Gambineri A, Nappi RE, Calogero AE, Ferlin A. Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. Front Endocrinol (Lausanne) 2020; 11:516. [PMID: 32849300 PMCID: PMC7431619 DOI: 10.3389/fendo.2020.00516] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, University “Magna Graecia”, Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rocco Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University Alma Mater Studiorum, Bologna, Italy
| | - Rossella E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- *Correspondence: Alberto Ferlin
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Pirotta S, Barillaro M, Brennan L, Grassi A, Jeanes YM, Joham AE, Kulkarni J, Couch LM, Lim SS, Moran LJ. Disordered Eating Behaviours and Eating Disorders in Women in Australia with and without Polycystic Ovary Syndrome: A Cross-Sectional Study. J Clin Med 2019; 8:jcm8101682. [PMID: 31615157 PMCID: PMC6832459 DOI: 10.3390/jcm8101682] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/24/2019] [Accepted: 09/27/2019] [Indexed: 12/13/2022] Open
Abstract
Psychological co-morbidities common in polycystic ovary syndrome (PCOS) may contribute to disordered eating and subsequent weight gain. This cross-sectional study aimed to determine the prevalence of disordered eating and a range of eating disorders and demographic risk factors associated with these behaviours within an Australian group of women with and without PCOS. Data from 899 women with (n = 501) and without (n = 398) PCOS were analysed as possibly indicative of disordered eating or eating disorders using the Eating Disorder Examination Questionnaire (EDE-Q) and The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. Disordered eating (p = 0.012) but not eating disorders (p = 0.076) were more prevalent in women with PCOS compared to controls. Increased body mass index (BMI) [Odds Ratio (OR): 1.03; 95%; Confidence Interval (CI): 1.01, 1.05, p = 0.012] and older age [OR: 1.05; 95%CI: 1.02, 1.08, p = 0.002] but not PCOS diagnosis [OR: 1.43; 95%CI: 0.96, 2.13 p = 0.078] increased the odds of disordered eating. Increased BMI [OR: 1.04; 95%CI: 1.02, 1.06, p < 0.001] and younger age [OR: -0.95; 95%CI: 0.93–0.95, p < 0.001] but not PCOS diagnosis [OR: 1.38; 95%CI: 0.97, 1.95, p = 0.076] increased the odds of an eating disorder. Clinicians are recommended to screen all women with PCOS for possible disordered eating behaviours, with particular attention to women with elevated BMI.
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Affiliation(s)
- Stephanie Pirotta
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC 3168, Australia.
| | - Mary Barillaro
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
| | - Leah Brennan
- Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
| | - Angela Grassi
- Nutrition Department, West Chester University of Pennsylvania, West Chester, PA 19383, USA.
| | - Yvonne M Jeanes
- Health Sciences Research Centre, Department of Life Sciences, University of Roehampton, London SW15 5PJ, UK.
| | - Anju E Joham
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC 3168, Australia.
- Department of Diabetes, Monash Health, Melbourne, VIC 3168, Australia.
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, VIC 3004, Australia.
| | - Lynn Monahan Couch
- Nutrition Department, West Chester University of Pennsylvania, West Chester, PA 19383, USA.
| | - Siew S Lim
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC 3168, Australia.
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC 3168, Australia.
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Lee I, Cooney LG, Saini S, Sammel MD, Allison KC, Dokras A. Increased odds of disordered eating in polycystic ovary syndrome: a systematic review and meta-analysis. Eat Weight Disord 2019; 24:787-797. [PMID: 29947018 PMCID: PMC7918293 DOI: 10.1007/s40519-018-0533-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 06/18/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE We aimed to identify the risk of eating disorders (ED) in women with polycystic ovary syndrome (PCOS) compared to controls. METHODS We performed a systematic review and meta-analysis of studies that included women with well-defined PCOS and controls and used validated ED screening/diagnostic tools to measure mean ED score, prevalence of abnormal ED scores, and/or prevalence of specific ED diagnoses such as bulimia nervosa and binge eating disorder. RESULTS Eight studies, including 470 women with PCOS and 390 controls, met inclusion criteria for the systematic review. Meta-analysis of seven of those studies found that the odds of an abnormal ED score (OR 3.05; 95% CI 1.33, 6.99; four studies) and the odds of any ED diagnosis (OR 3.87; 95% CI 1.43, 10.49; four studies) were higher in women with PCOS compared to controls. CONCLUSIONS Our study suggests that women with PCOS are at increased odds of having abnormal ED scores and specific ED diagnoses. Given the potential implications of an ED on weight management strategies, our findings support routine screening for ED in this population. LEVEL OF EVIDENCE Level I, systematic review and meta-analysis.
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Affiliation(s)
- Iris Lee
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Laura G Cooney
- Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market Street, Philadelphia, PA, 19103, USA
| | - Shailly Saini
- Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market Street, Philadelphia, PA, 19103, USA
| | - Mary D Sammel
- Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market Street, Philadelphia, PA, 19103, USA
- Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Kelly C Allison
- Center for Weight and Eating Disorders, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market Street, Philadelphia, PA, 19103, USA.
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Abstract
Binge eating disorder (BED) is the most common eating disorder and is accompanied by multiple medical comorbidities, many of which are associated with obesity-related diseases. However, the BED itself is likely to confer additional risk factors. BED presents with medical symptoms in virtually every body system and can have devastating consequences on both quality and length of life. This review covers the major comorbidities of BED and highlights areas of ongoing research in this disorder.
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Affiliation(s)
| | - Julie Friedman
- Binge Eating Treatment and Recovery, Eating Recovery Center, Northwestern University Medical School, Department of Psychiatry, Eating Recovery Center Insight, 333 North Michigan Avenue, 19th Floor, Chicago, IL 60601, USA
| | - Philip S Mehler
- Eating Recovery Center, ACUTE @ Denver Health, Glassman Professor of Medicine, University of Colorado School of Medicine, 7351 East Lowry Boulevard, Suite 200, Denver, CO 80230, USA
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Li Y, Hou L, Wang Y, Xie L, Zhang M, Pan Z, Li Y, Ding Y, Sun M, Qu Y, Liu S. Auricular points acupressure for insulin resistance in overweight/obese women with polycystic ovary syndrome: protocol for a randomised controlled pilot trial. BMJ Open 2019; 9:e027498. [PMID: 31142530 PMCID: PMC6549699 DOI: 10.1136/bmjopen-2018-027498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Approximately 5%-20% of reproductive women suffer from polycystic ovary syndrome (PCOS). Auricular points acupressure (AA) may serve as alternative management for PCOS for its benefits in both physical and psychological well-being. However, the effects of AA for insulin resistance (IR) in overweight/obese PCOS women have not been confirmed. METHODS AND ANALYSIS The present study is designed as a randomised, placebo-controlled pilot trial to evaluate the effectiveness and safety of AA in treating IR in women with PCOS. A total of 60 eligible PCOS subjects will be randomised into an intervention group (AA group) and a control group (sham AA group) in a ratio of 1:1. Magnetic beads will be taped to the auricular points by the same senior acupuncture specialist from the First Affiliated Hospital, Heilongjiang University of Chinese Medicine. The treatment will last for 12 weeks. Primary outcome measure will be changes in homeostasis model assessment of IR between baseline and after 3 months of AA/sham AA treatment. Secondary outcomes include hormonal profile, weight, waist/hip circumference, body mass index, blood pressure, Ferriman-Gallwey score, acne and the assessment of health-related quality of life. Outcome measures are collected at baseline and the end of treatment visit. ETHICS AND DISSEMINATION The protocol has been approved by the ethics committee of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine (HZYLLKY201800301). Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed journals for publications. TRIAL REGISTRATION NUMBER NCT03546595; Pre-results.
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Affiliation(s)
- Yan Li
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lihui Hou
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yingji Wang
- School of Pharmacy, Harbin Medical University, Harbin, China
| | - Liangzhen Xie
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Meiwei Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zimeng Pan
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yangyang Li
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yicheng Ding
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Miao Sun
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yufang Qu
- Qiqihar Traditional Chinese Medicine Hospital, Qiqihar, China
| | - Songjiang Liu
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
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Krug I, Giles S, Paganini C. Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies. Neuropsychiatr Dis Treat 2019; 15:1273-1285. [PMID: 31190833 PMCID: PMC6529622 DOI: 10.2147/ndt.s168944] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 03/18/2019] [Indexed: 12/28/2022] Open
Abstract
Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
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Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Sarah Giles
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Chiara Paganini
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
- Faculty of Health, Federation University, Ballarat, VIC, Australia
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