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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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Hurayb NH, Alshammari GM, Al-Khalifa AS, Alafif N, Aljaroudi DH, Mohammed MA, Yagoub AEA, Yahya MA. A Comparative Study of Food Intake and Adipose Tissue Distribution in Saudi Women with Polycystic Ovarian Syndrome. Healthcare (Basel) 2024; 12:369. [PMID: 38338254 PMCID: PMC10855251 DOI: 10.3390/healthcare12030369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a frequent disorder that affects reproductive-aged women and has reproductive, metabolic, and psychosocial effects. This research was intended to investigate the comparison between food intake and adipose tissue distribution in Saudi women suffering from PCOS and a control group. To determine the sociodemographic variables, a case-control study was performed with patients from King Fahad Medical City's Reproductive Endocrine and Infertility Medicine Department (REIMD). The case-control study comprised 42 PCOS patients (PCOS-Ps) and 63 as a control group, all aged 20-45 years. Three-day records were collected from participants to estimate the nutrient intake of cases and controls. A body composition analyzer was used to measure body mass index (BMI), body fat (BF), and visceral fat (VF). Biochemical measurements were taken to determine the lipid profile, total testosterone, and serum vitamin D-25-OH. The women's frequency distribution based on sociodemographic characteristics revealed significant differences within and between the groups. The variations in dietary intake between the PCOS-P and control groups were primarily in terms of total calories, carbohydrates, niacin, and folate, all of which were significantly higher in the PCOS-P group. Dietary fiber, unsaturated fat, vitamin A, vitamin B12, calcium, phosphorus, and selenium, on the other hand, were significantly higher in the control group. A majority of both groups had significantly higher BMI (overweight or obese) and higher BF, but normal VF. According to the findings, testosterone levels in PCOS-Ps were significantly higher than in the control group, but vitamin D-25-OH and high-density-lipoprotein cholesterol (HDL-C) were significantly lower. Age, monthly income, cholesterol, low-density-lipoprotein cholesterol (LDL-C), and testosterone were the fundamental causes impacting women's anthropometric indices. In conclusion, although both groups were overweight or obese, and differences in calorie and nutrient intake, HDL-C, testosterone, and vitamin D-25-OH levels were observed. The study advises such population groups to limit their consumption of foods high in calories.
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Affiliation(s)
- Nujud H. Hurayb
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (N.H.H.); (A.S.A.-K.); (M.A.M.); (A.E.A.Y.); (M.A.Y.)
| | - Ghedeir M. Alshammari
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (N.H.H.); (A.S.A.-K.); (M.A.M.); (A.E.A.Y.); (M.A.Y.)
| | - Abdulrahman S. Al-Khalifa
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (N.H.H.); (A.S.A.-K.); (M.A.M.); (A.E.A.Y.); (M.A.Y.)
| | - Nora Alafif
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11534, Saudi Arabia;
| | - Dania H. Aljaroudi
- Research Center King Fahad Medical City (KFMC), P.O. Box 59046, Riyadh 11525, Saudi Arabia;
| | - Mohammed A. Mohammed
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (N.H.H.); (A.S.A.-K.); (M.A.M.); (A.E.A.Y.); (M.A.Y.)
| | - Abu ElGasim Ahmed Yagoub
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (N.H.H.); (A.S.A.-K.); (M.A.M.); (A.E.A.Y.); (M.A.Y.)
| | - Mohammed Abdo Yahya
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia; (N.H.H.); (A.S.A.-K.); (M.A.M.); (A.E.A.Y.); (M.A.Y.)
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Guo Y, Liu Y, Ding R, Yan X, Tan H, Wang Y, Wang X, Wang L. A structural equation model linking health literacy, self-efficacy, and quality of life in patients with polycystic ovary syndrome. BMC Womens Health 2023; 23:98. [PMID: 36894980 PMCID: PMC9999555 DOI: 10.1186/s12905-023-02223-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Health literacy is a crucial factor that affects health outcomes. Understanding the current status of health literacy among patients with polycystic ovary syndrome (PCOS) is the basis for helping patients better manage risk factors and improve their health outcomes. This study aimed to explore the status of and factors influencing health literacy in patients with PCOS, and to validate the pathway between health literacy, quality of life, and self-efficacy for these patients. METHODS A cross-sectional study was conducted using a convenience sample of 300 patients with PCOS in the gynecology outpatient clinic of a tertiary hospital in Zunyi from March to September 2022. Data on health literacy, demographic features, quality of life, and self-efficacy were collected. Multiple stepwise linear regression was conducted to assess the risk factors associated with health literacy for the study participants. A structural equation model was used to construct and validate the pathways. RESULTS Most participants exhibited low health literacy (3.61 ± 0.72), and only 25.70% had adequate health literacy. Multiple regression analysis revealed that the main factors associated with health literacy among participants included Body Mass Index (BMI) (B = -0.95, p < 0.01), education (B = 3.44, p < 0.01), duration of PCOS (B = 4.66, p < 0.01), quality of life (B = 0.25, p < 0.01), and self-efficacy (B = 0.76, p < 0.01). Multiple fit values indicated that the model fit the data effectively. The direct effect of health literacy on self-efficacy and quality of life was 0.06 and 0.32, respectively. The indirect effect of health literacy on quality of life was -0.053, and the total effect of health literacy on quality of life was 0.265. CONCLUSIONS Health literacy was low among patients with PCOS. Healthcare providers should pay more attention to health literacy and to developing the corresponding intervention strategies urgently needed to improve the quality of life and health behavior of patients with PCOS.
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Affiliation(s)
- Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - LianHong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China. .,Nursing College, Zunyi Medical University, Zunyi, China.
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Naous E, Zouein G, Asmar S, Saad E, Achkar A, Hajj G. Phenotype Prevalence and Health-Related Quality of Life of Lebanese Women With Polycystic Ovary Syndrome. Endocr Pract 2023; 29:127-134. [PMID: 36494019 DOI: 10.1016/j.eprac.2022.12.001] [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: 08/02/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders. Our study aimed to assess, for the first time, the phenotype prevalence and the health-related quality of life of Lebanese women with PCOS. METHODS This was a cross-sectional study conducted on 322 Lebanese women with PCOS, using a questionnaire containing sociodemographic data, comorbidities, disease-related clinical questions, and the validated PCOS questionnaire (PCOSQ). The quality of life mean scores and phenotypes were compared and correlated among the different sociodemographic data, comorbidities, and disease-related questions. RESULTS Phenotype A (67%) was the most common phenotype. High waist circumference and higher Body Mass Index (BMI) were reported mostly in classic phenotypes in comparison with nonclassic (P < .05). The mean total score of all PCOSQ domains was 3.61 ± 1.60. The mean score for each domain (from the greatest to the least serious concern) was menstrual problems (3.31 ± 1.26), emotion (3.33 ± 1.22), weight (3.41 ± 2.12), body hair (3.86 ± 1.79), and infertility (4.15 ± 1.61). Age was negatively correlated only to weight domain score (r = -0.17, P = .002). BMI was associated only with emotion and weight domain scores (P = .017 and P < .001, respectively). A bigger impairment in nearly all subscales of the PCOSQ in patients presenting with abdominal obesity, glucose intolerance, and increased blood pressure was noted (P < .05). CONCLUSION Most Lebanese women with PCOS present phenotype A and have a serious impairment in their health-related quality of life, particularly in the menstrual and emotional domains. This highlights the need for community and individual support.
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Affiliation(s)
- Elie Naous
- Department of Internal Medicine, St. Elizabeth's Medical Center, Tufts Medical Center and Boston Medical Center, Brighton, Massachusetts.
| | - Georges Zouein
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Serena Asmar
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Eddy Saad
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Angela Achkar
- Department of Internal Medicine, Endocrinology Division, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Georges Hajj
- Department of Internal Medicine, Endocrinology Division, Bellevue Medical Center, Beirut, Lebanon
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Association Between Dietary Fiber and Female Fertility: a NHANES-Based Study. Reprod Sci 2022; 30:1555-1564. [PMID: 36315393 DOI: 10.1007/s43032-022-01103-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022]
Abstract
This study aimed to evaluate whether dietary fiber content and density were associated with female infertility in the USA. Data on current dietary fiber and current or past female infertility were collected from the National Health and Nutrition Examination Surveys (NHANES) in 2013-2014, 2015-2016, and 2017-2018 cycles. Infertility was identified with the question "Have you ever tried a year to become pregnant: ever attempted to become pregnant over a period of at least a year without becoming pregnant?" The association between dietary fiber and female infertility was analyzed by weighted multivariate logistic regression. Subgroup analysis was performed based on the body mass index (BMI) of women. False discovery rate (FDR)-adjusted P values (q values) < 0.05 indicated statistical significance. Totally 2370 women were eligible for analysis. Dietary fiber content was negatively associated with female infertility [odds ratio (OR) = 0.643, 95% confidence interval (CI) = 0.480-0.861, P = 0.004, q = 0.020]. Dietary fiber density was not associated with the odds of female infertility (OR = 0.734, 95% CI = 0.573-0.941, P = 0.016, q = 0.079). Subgroup analysis exhibited that dietary fiber content was not associated with infertility in underweight and normal-weight (OR = 0.620, 95% CI = 0.332-1.157, P = 0.130, q = 0.467) and overweight (OR = 0.764, 95% CI = 0.523-1.117, P = 0.160, q = 0.553) women; dietary fiber content was inversely associated with infertility in obese women (OR = 0.610, 95% CI = 0.443-0.841, P = 0.003, q = 0.015). There were no significant associations between dietary fiber density and female infertility in underweight and normal-weight (OR = 0.673, 95% CI = 0.393-1.153, P = 0.146, q = 0.410), overweight (OR = 0.769, 95% CI = 0.534-1.107, P = 0.153, q = 0.523), and obese (OR = 0.753, 95% CI = 0.581-0.975, P = 0.032, q = 0.160) populations. In conclusion, a negative association was found between dietary fiber content and female infertility especially among obese women. Future studies are warranted to confirm our findings and the causal relationship between dietary fiber, obesity, and female infertility.
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Alesi S, Villani A, Mantzioris E, Takele WW, Cowan S, Moran LJ, Mousa A. Anti-Inflammatory Diets in Fertility: An Evidence Review. Nutrients 2022; 14:nu14193914. [PMID: 36235567 PMCID: PMC9570802 DOI: 10.3390/nu14193914] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 11/16/2022] Open
Abstract
Infertility is a global health concern affecting 48 million couples and 186 million individuals worldwide. Infertility creates a significant economic and social burden for couples who wish to conceive and has been associated with suboptimal lifestyle factors, including poor diet and physical inactivity. Modifying preconception nutrition to better adhere with Food-Based Dietary Guidelines (FBDGs) is a non-invasive and potentially effective means for improving fertility outcomes. While several dietary patterns have been associated with fertility outcomes, the mechanistic links between diet and infertility remain unclear. A key mechanism outlined in the literature relates to the adverse effects of inflammation on fertility, potentially contributing to irregular menstrual cyclicity, implantation failure, and other negative reproductive sequelae. Therefore, dietary interventions which act to reduce inflammation may improve fertility outcomes. This review consistently shows that adherence to anti-inflammatory diets such as the Mediterranean diet (specifically, increased intake of monounsaturated and n-3 polyunsaturated fatty acids, flavonoids, and reduced intake of red and processed meat) improves fertility, assisted reproductive technology (ART) success, and sperm quality in men. Therefore, integration of anti-inflammatory dietary patterns as low-risk adjunctive fertility treatments may improve fertility partially or fully and reduce the need for prolonged or intensive pharmacological or surgical interventions.
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Affiliation(s)
- Simon Alesi
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia
| | - Anthony Villani
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
| | - Evangeline Mantzioris
- Clinical and Health Sciences & Alliance for Research in Nutrition, Exercise and Activity (ARENA), University of South Australia, Adelaide, SA 5001, Australia
| | - Wubet Worku Takele
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia
| | - Stephanie Cowan
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3168, Australia
- Correspondence: ; Fax: +61-3-9594-7554
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Comparison of health-related quality of life in different polycystic ovary syndrome phenotypes: a cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2022; 271:189-194. [DOI: 10.1016/j.ejogrb.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/29/2022] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
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Mizgier M, Watrowski R, Opydo-Szymaczek J, Jodłowska-Siewert E, Lombardi G, Kędzia W, Jarząbek-Bielecka G. Association of Macronutrients Composition, Physical Activity and Serum Androgen Concentration in Young Women with Polycystic Ovary Syndrome. Nutrients 2021; 14:73. [PMID: 35010948 PMCID: PMC8746804 DOI: 10.3390/nu14010073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 02/08/2023] Open
Abstract
The roles of dietary macronutrients and physical activity (PA) in patients with PCOS have not been sufficiently reported, especially in adolescent girls. To address this knowledge gap, we evaluated the associations between serum concentrations of total testosterone (tT), free testosterone (fT), androstenedione (A), dehydroepiandrosterone-sulfate (DHEA-S), sex hormone-binding globulin (SHBG) and dietary macronutrients intake as well as different types and levels of PA. The study population consisted of 96 girls of Caucasian ancestry, aged 14-18 years: 61 participants with polycystic ovary syndrome (PCOS) and 35 healthy controls. Serum tT, fT, A, DHEA-S, and SHBG were determined in fasting blood. Macronutrient intake and PA levels were assessed by using the three-day food record method and the Beliefs and Eating Habits Questionnaire (KomPAN), respectively. We found several positive correlations between dietary macronutrients such as total fat, saturated fatty acids (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), and hormonal parameters across the entire cohort and in healthy girls. A positive correlation between SHBG and total protein consumption as well as an inverse correlation between SHBG and carbohydrate intake could be determined. No correlation between androgens and macronutrients was found in the PCOS group. In contrast, we observed an inverse correlation between androgen concentrations (except of DHEA-S) and "work/school" and/or "leisure time" PA only in PCOS patients. Moreover, the hormone levels differed according to PA intensity. In conclusion, the impact of diet and PA was strikingly different in adolescents with and without PCOS. These findings indicate that disturbed hormonal homeostasis in PCOS, at least in the youngest patients, likely "overtrump" dietary influences, and otherwise, PA offers a therapeutic potential that requires further evaluation of the long-term effects in randomized studies. (ClinicalTrial.gov Identifier: NCT04738409.).
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Affiliation(s)
- Małgorzata Mizgier
- Dietetic Department, Faculty of Physical Culture, Poznan University of Physical Education, 66-400 Gorzów Wielkopolski, Poland
| | - Rafał Watrowski
- Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany;
| | - Justyna Opydo-Szymaczek
- Department of Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland;
| | - Elżbieta Jodłowska-Siewert
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznan, Poland;
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milano, Italy;
- Department of Athletics, Strength and Conditioning, Poznań University of Physical Education, 61-871 Poznań, Poland
| | - Witold Kędzia
- Department of Perinatology and Gynecology, Division of Developmental Gynecology and Sexology, Poznan University of Medical Sciences, 60-535 Poznan, Poland; (W.K.); (G.J.-B.)
| | - Grażyna Jarząbek-Bielecka
- Department of Perinatology and Gynecology, Division of Developmental Gynecology and Sexology, Poznan University of Medical Sciences, 60-535 Poznan, Poland; (W.K.); (G.J.-B.)
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Benjamin JJ, K. M, Koshy T, K. N. M, R. P. DHEA and polycystic ovarian syndrome: Meta-analysis of case-control studies. PLoS One 2021; 16:e0261552. [PMID: 34932604 PMCID: PMC8691613 DOI: 10.1371/journal.pone.0261552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/04/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Polycystic ovarian syndrome is a heterogenous endocrine disorder characterized by irregular menstrual cycles, hirsuitism and polycystic ovaries. It is further complicated by metabolic syndrome, infertility and psychological stress. Although the etiopathogenesis is unclear, many studies have pointed out the role of stress in this syndrome. DHEA, being a stress marker is being used by scientists to compare the stress levels between polycystic ovarian cases and healthy controls. However, the results obtained from previous studies are equivocal. OBJECTIVE To perform meta-analysis and find the association between stress and the syndrome. DATA SOURCES Relevant data till January 2021 were retrieved from PubMed, Scopus, Embase and Web of Science using MeSH terms. STUDY SELECTION Case-control studies having PCOS subjects as cases and healthy women as controls were selected provided; their basal DHEA levels were mentioned in the published articles. DATA EXTRACTION Two authors independently extracted the articles and qualified the final studies. DATA SYNTHESI Pooled meta-analysis was done using random effect model and showed level of DHEA statistically significant in PCOS compared to healthy controls (SMD = 1.15, 95% CI = 0.59-1.71).Heterogeneity was statistically significant as well (I2 = 95%). CONCLUSION Thismeta-analysis on DHEA and PCOS has helped in generating evidence regarding the involvement of stress in the pathogenesis of PCOS.
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Affiliation(s)
- Jiby Jolly Benjamin
- Department of Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
| | - MaheshKumar K.
- Department of Physiology, Government Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Teena Koshy
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
| | - Maruthy K. N.
- Department of Physiology, Narayana Medical College and Hospital, Nellore, Andra Pradesh, India
| | - Padmavathi R.
- Department of Physiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
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Doğan H, Demir Çaltekin M. Does polycystic ovary syndrome with phenotype D affect the cardiovascular endurance, core endurance, body awareness, and the quality of life? A prospective, controlled study. Turk J Obstet Gynecol 2021; 18:203-211. [PMID: 34580552 PMCID: PMC8480217 DOI: 10.4274/tjod.galenos.2021.72547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: This study evaluates cardiovascular endurance, core endurance, body awareness, and the quality of life in normal-weight women with polycystic ovary syndrome. Materials and Methods: This study included a total of 101 normal-weight women (51 with and 50 without polycystic ovary syndrome). Cardiovascular endurance was evaluated with the 20-meter Shuttle Run test, and maximum oxygen consumption was calculated. Core endurance was evaluated with core stability tests, body awareness with the body awareness questionnaire, and the quality of life with short form-36. Blood lipids, glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), hormonal profile, and high-density and low-density lipoprotein cholesterols were measured. Results: Maximum oxygen consumption, core endurance, body awareness questionnaire, and short form-36 results were lower in women with polycystic ovary syndrome than healthy women (p<0.05). There was a significant correlation between core endurance tests, high-density lipoprotein cholesterol, maximum oxygen consumption, and homeostatic model assessment for insulin resistance scores (p<0.05). Conclusion: When normal-weight women with polycystic ovary syndrome and control groups with similar androgen levels and body mass index profiles were compared, women with polycystic ovary syndrome had lower aerobic capacity and muscle endurance. This suggests that the adverse metabolic profile of polycystic ovary syndrome can limit physical function.
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Affiliation(s)
- Hanife Doğan
- Yozgat Bozok University, Sarıkaya School of Physiotherapy and Rehabilitation, Yozgat, Turkey
| | - Melike Demir Çaltekin
- Yozgat Bozok University Faculty of Medicine, Department of Gynecology and Obstetrics, Yozgat, Turkey
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Bijlholt M, Ameye L, Van Uytsel H, Devlieger R, Bogaerts A. The INTER-ACT E-Health Supported Lifestyle Intervention Improves Postpartum Food Intake and Eating Behavior, but Not Physical Activity and Sedentary Behavior-A Randomized Controlled Trial. Nutrients 2021; 13:nu13041287. [PMID: 33919758 PMCID: PMC8070698 DOI: 10.3390/nu13041287] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/20/2022] Open
Abstract
Unhealthy postpartum lifestyle is related to long-term adverse psychological, metabolic and cardiovascular health outcomes as well as to complications in the next pregnancy. Especially women with preceding excessive gestational weight gain are at risk. This paper aims to evaluate the effect of the postpartum phase of the INTER-ACT randomized controlled trial (RCT) on food intake, eating behavior, physical activity and sedentary time at the end of the intervention (six months postpartum) and at six-months follow-up (12 months postpartum). The study population comprised women with excessive gestational weight gain in the preceding pregnancy. The lifestyle intervention combined a smartphone application with four face-to-face coaching sessions between six weeks and six months postpartum. After the intervention, restrained eating score was 1 point higher (95% CI 0.5, 1.5; p < 0.001), uncontrolled eating score was 1 point lower (95% CI −1.9, −0.2; p = 0.02) and energy intake was 69 kcal lower (95% CI −123, −15; p = 0.01) in the intervention group compared to the control group. The differences were no longer statistically significant at follow-up. No significant effects on emotional eating, physical activity and sedentary behavior were found. In conclusion, the postpartum phase of the INTER-ACT RCT was effective in improving nutrition-related outcomes, however, these improvements could not be sustained at follow-up. ClinicalTrials.gov identifier: NCT02989142.
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Affiliation(s)
- Margriet Bijlholt
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
| | - Lieveke Ameye
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
| | - Hanne Van Uytsel
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
| | - Roland Devlieger
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
- Department of Obstetrics and Gynecology, University Hospital Leuven, 3000 Leuven, Belgium
| | - Annick Bogaerts
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
- Faculty of Health, University of Plymouth, Devon PL4 8AA, UK
- Correspondence:
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Knowledge, Attitudes, and Barriers towards Dietary Pulse Consumption in Women with Polycystic Ovary Syndrome Participating in a Multi-Disciplinary Lifestyle Intervention to Improve Women’s Health. SEXES 2021. [DOI: 10.3390/sexes2010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pulse (beans, lentils, chickpeas, peas) consumption is low in developed countries. Pulses have the potential to benefit the management of polycystic ovary syndrome (PCOS) because they improve aspects of metabolic derangements (dyslipidaemia, insulin resistance), which contribute to reproductive disturbances (oligo-amenorrhea, hyperandrogenism). We compared changes in knowledge, attitudes, and barriers towards pulse consumption in PCOS cohorts who participated in a pulse-based or a Therapeutic Lifestyle Changes (TLC) dietary intervention. Thirty women (18–35 years old) randomised to a pulse-based diet (supplied with pulse-based meals) and 31 women in a TLC group completed pulse consumption questionnaires before and after a 16-week intervention. The pulse-diet group demonstrated increased knowledge of pulses per Canada’s Food Guide recommendations versus the TLC group post-intervention (p < 0.05). In both groups, increased scores were evident in the domain of attitude about pulses (p < 0.01). The top-ranked barrier to pulse consumption in no-/low-consumers was lack of knowledge about cooking pulses pre- and post-intervention. We attributed increased knowledge about pulse consumption in the pulse group to greater awareness through education and consuming pulse foods during the intervention. Our observations highlight the importance of multi-dimensional behavioural counselling and education to integrate healthy dietary practices for improving reproductive and sexual health in this under-studied high-risk population (ClinicalTrials.gov identifier: NCT01288638).
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Wang X, Xu T, Liu R, Wu G, Gu L, Zhang Y, Zhang F, Fu H, Ling Y, Wei X, Luo Y, Shen J, Zhao L, Peng Y, Zhang C, Ding X. High-Fiber Diet or Combined With Acarbose Alleviates Heterogeneous Phenotypes of Polycystic Ovary Syndrome by Regulating Gut Microbiota. Front Endocrinol (Lausanne) 2021; 12:806331. [PMID: 35185786 PMCID: PMC8847200 DOI: 10.3389/fendo.2021.806331] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/31/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Gut microbial dysbiosis is associated with high heterogeneity of polycystic ovary syndrome (PCOS); however, studies about gut microbiota targeted clinical intervention in PCOS are limited. Our study aimed to evaluate the effects of high-fiber diet or combined with acarbose on the clinical phenotypes of PCOS, focusing on the possible influence of gut microbiota in this process. METHODS Twenty-five patients with PCOS were recruited and randomly divided into two groups, W group (n = 14) received the WTP diet (a high-fiber diet composed of whole grains, traditional Chinese medicinal foods, and prebiotics), and A group (n = 11) received the WTP diet combined with acarbose. The follow-up time was 12 weeks. The sex hormonal and glycolipid metabolic parameters, inflammatory factors, brain-gut peptides, and alteration of gut microbiota were evaluated. RESULTS The PCOS clinical phenotypes, inflammatory state, and brain-gut peptides secretion were all alleviated in both groups, while the hyperandrogenism, insulin resistance, and brain-gut peptides secretion were better improved in the A group. Alpha and beta diversities were altered more significantly in the A group. Amplicon sequence variants (ASVs) were clustered into 14 co-abundant groups (CAGs) as potential functional groups that may respond to the intervention. The CAGs predominantly comprised of Bifidobacterium and Lactobacillus were more enriched, while the CAGs predominantly comprised of Bacteroides vulgatus, Alistipes, Blautia, Lachnospira, and Roseburia were more inhibited in the A group than in W group. Moreover, the CAGs enriched in the A group had a stronger negative correlation with the luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio, testosterone, homeostasis model assessment-insulin resistance (HOMA-IR), α-1-acid glycoprotein (α-AGP), and leptin, and positive correlation with adiponectin and spexin, while the CAGs inhibited showed an opposite trend. CONCLUSIONS High-fiber diet could alleviate the chronic metabolic inflammation, reproductive function, and brain-gut peptides secretion of patients with PCOS, and high-fiber diet combined with acarbose could better improve the PCOS clinical phenotypes. The remodeling of gut microbiota by our intervention may play an important role in these improvements. CLINICAL TRIAL REGISTRATION http://www.chictr.org.cn/showproj.aspx?proj=4500, ChiCTR-TRC-14005075.
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Affiliation(s)
- Xuejiao Wang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Xu
- State Key Laboratory of Microbial Metabolism and Ministry of Education Key Laboratory of Systems Biomedicine, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Liu
- State Key Laboratory of Microbial Metabolism and Ministry of Education Key Laboratory of Systems Biomedicine, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Guojun Wu
- Department of Biochemistry and Microbiology and New Jersey Institute for Food, Nutrition, and Health, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Liping Gu
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yahui Zhang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Zhang
- State Key Laboratory of Microbial Metabolism and Ministry of Education Key Laboratory of Systems Biomedicine, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Huaqing Fu
- State Key Laboratory of Microbial Metabolism and Ministry of Education Key Laboratory of Systems Biomedicine, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Yunxia Ling
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohui Wei
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunchen Luo
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Shen
- Shanghai Centre for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liping Zhao
- State Key Laboratory of Microbial Metabolism and Ministry of Education Key Laboratory of Systems Biomedicine, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Department of Biochemistry and Microbiology and New Jersey Institute for Food, Nutrition, and Health, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Yongde Peng
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenhong Zhang
- State Key Laboratory of Microbial Metabolism and Ministry of Education Key Laboratory of Systems Biomedicine, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoying Ding
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Quality of Life in Infertile Women with Polycystic Ovary Syndrome: a Comparative Study. Reprod Sci 2020; 28:1901-1909. [PMID: 33215316 DOI: 10.1007/s43032-020-00394-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
To investigate the quality of life (QoL) of infertile women with polycystic ovary syndrome (PCOS) and analyze the association between the clinical/biochemical features of PCOS and the physical/psychological well-being of patients. An observational study with three independent groups women was designed including 37 infertile PCOS patients, 36 women with tubal factor infertility, and 31 women with male factor infertility referred to the Reproductive Medicine Unit of the Hospital Clinic Barcelona from December 2017 to June 2019. Clinical history, physical examination including Ferriman-Gallwey scores, and vaginal ultrasound were carried out in all patients. All subjects completed the 36-item Short Form Health Survey, and PCOS patients were asked to fill out the Polycystic Ovary Syndrome Questionnaire. The IBM SPSS 23.0 was used for the statistical analysis. Infertile women with PCOS reported significantly worse QoL scores of social functioning (p = 0.049), emotional role functioning (p = 0.041), mental health (p = 0.002), and the mental component summary (p = 0.002) compared with women with other causes of infertility. In addition, body pain (p = 0.006), general health (p < 0.001), and vitality (p = 0.002) scores were significantly lower in women with PCOS compared with those with male factor infertility. Infertile PCOS patients showed low scores in all domains of the PCOSQ. Hirsutism and weight gain were the factors most associated with impaired health-related QoL in PCOS. Infertile PCOS women presented worse QoL mainly due to psychological and emotional distress. The main predictors were clinical manifestations of hyperandrogenism and weight gain.
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15
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Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases. Nutrients 2020; 12:nu12041066. [PMID: 32290535 PMCID: PMC7230471 DOI: 10.3390/nu12041066] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/06/2020] [Accepted: 04/10/2020] [Indexed: 12/11/2022] Open
Abstract
Insulin resistance (IR), defined as an attenuated biological response to circulating insulin, is a fundamental defect in obesity and type 2 diabetes (T2D), and is also linked to a wide spectrum of pathological conditions, such as non-alcoholic fatty liver disease (NAFLD), cognitive impairment, endothelial dysfunction, chronic kidney disease (CKD), polycystic ovary syndrome (PCOS), and some endocrine tumors, including breast cancer. In obesity, the unbalanced production of pro- and anti-inflammatory adipocytokines can lead to the development of IR and its related metabolic complications, which are potentially reversible through weight-loss programs. The Mediterranean diet (MedDiet), characterized by high consumption of extra-virgin olive oil (EVOO), nuts, red wine, vegetables and other polyphenol-rich elements, has proved to be associated with greater improvement of IR in obese individuals, when compared to other nutritional interventions. Also, recent studies in either experimental animal models or in humans, have shown encouraging results for insulin-sensitizing nutritional supplements derived from MedDiet food sources in the modulation of pathognomonic traits of certain IR-related conditions, including polyunsaturated fatty acids from olive oil and seeds, anthocyanins from purple vegetables and fruits, resveratrol from grapes, and the EVOO-derived, oleacein. Although the pharmacological properties and clinical uses of these functional nutrients are still under investigation, the molecular mechanism(s) underlying the metabolic benefits appear to be compound-specific and, in some cases, point to a role in gene expression through an involvement of the nuclear high-mobility group A1 (HMGA1) protein.
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16
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Hu Z, Qin L, Kaminga AC, Xu H. Relationship between multiple lifestyle behaviors and health-related quality of life among elderly individuals with prediabetes in rural communities in China: A STROBE-compliant article. Medicine (Baltimore) 2020; 99:e19560. [PMID: 32282705 PMCID: PMC7440255 DOI: 10.1097/md.0000000000019560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Evidence of the effect of lifestyle behaviors on health-related quality of life (HRQoL) is scarce or ambiguous. The objective of the present study was to explore the associations between multiple lifestyle behaviors and HRQoL among the elderly individuals with prediabetes.Four hundred thirty-four elderly individuals with prediabetes were included in this cross-sectional study. The Medical Outcomes Study 36-Item Short Form Health Survey Questionnaire (SF-36) was used to assess HRQoL. Multiple lifestyle behaviors, including smoking, alcohol consumption, physical activity, dietary habits, daily sedentary time and sleep duration were self-reported. The associations between HRQoL and multiple lifestyle behaviors were examined using a multivariate linear regression analysis.Lower-risk physical activities (β =3 .19, 95% CI: 1.32, 5.64), dietary habits (β = 2.60, 95% CI: 1.50, 4.72), and sedentary time (β = 2.49, 95% CI: 1.21, 4.81) were positively associated with the physical health component score (PCS) for HRQoL. Meanwhile, a lower-risk behavior, such as sleep duration (β = 2.64, 95% CI: 1.77, 4.51), was associated with a higher mental health component score (MCS) for HRQoL after adjusting for socio-demographic factors, chronic diseases, anthropometric data and all other lifestyle behaviors. Engaging in a greater number of lower-risk lifestyle behaviors was positively correlated with a better HRQoL.Multiple lifestyle behaviors were associated with HRQoL among the elderly individuals with prediabetes in rural areas. These results highlight the need for multiple lifestyle behavioral interventions to maintain and improve HRQoL in the elderly individuals with prediabetes.
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Affiliation(s)
- Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University
| | - Lulu Qin
- Department of Social Medicine and Health Management, School of Medicine, Hunan Normal University, Changsha, China
| | - Atipatsa Chiwanda Kaminga
- Department of Mathematics and Statistics, Mzuzu University, Luwinga, Mzuzu, Malawi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University
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17
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Melekoglu E, Goksuluk D, Akal Yildiz E. Association between Dietary Glycaemic Index and Glycaemic Load and Adiposity Indices in Polycystic Ovary Syndrome. J Am Coll Nutr 2019; 39:537-546. [PMID: 31887072 DOI: 10.1080/07315724.2019.1705200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Obesity is a key contributor to metabolic and reproductive outcomes in polycystic ovary syndrome (PCOS). The role of the dietary glycemic index (GI) and load (GL), and adiposity has been debated and studies on PCOS are scarce. We aimed to compare the dietary GI and GL and several anthropometric measurements in PCOS and control women. The association between dietary GI and GL and adiposity indices was examined in this cross-sectional study.Methods and materials: A study population consisted of 65 previously diagnosed with PCOS and 65 healthy women. All participants underwent detailed anthropometric, dietary and physical activity evaluation and categorized based on GI and GL tertiles.Results: When dietary GL was adjusted for age, physical activity level (PAL), and duration of diagnosis, there was a statistically significant inverse association between dietary GL and waist/hip ratio (WHR) (OR: 0.136; 95% CI: 0.021-0.874; p = 0.036) in women with PCOS. Both dietary GI (OR: 8.869; 95% CI: 1.194-65.910; p = 0.033 for tertile 2 in adjustment model) and GL (OR: 7.200; 95% CI: 1.635-31.712; p = 0.009 for tertile 3 in crude model; OR: 5.801; 95% CI: 1.242-27.096; p = 0.025 for tertile 3 in adjustment model) positively associated with WHR in healthy subjects. Also, positive association was observed between dietary GI and waist/height ratio (WHtR) (OR: 0.229; 95% CI: 0.063-0.826; p = 0.024 for tertile 2; OR: 0.277; 95% CI: 0.078-0.988; p = 0.048 for tertile 3) in healthy controls, however after adjustment for age and PAL, statistical significance was lost (OR: 1.051; 95% CI: 0.152-7.261; p = 0.959 for tertile 2; OR: 1.522; 95% CI: 0.225-10.297; p = 0.667 for tertile 3).Conclusion: The results of this study consistent with the literature that PCOS is associated with increased adiposity indices. There was no association between dietary GI/GL and BMI, WC, WHtR, and ABSI but dietary GL was inversely associated WHR in PCOS patients.
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Affiliation(s)
- Ebru Melekoglu
- Nutrition and Dietetics Department, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Dincer Goksuluk
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emine Akal Yildiz
- Nutrition and Dietetics Department, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, Turkey
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18
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Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, Brown JE. Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis. Syst Rev 2019; 8:51. [PMID: 30755271 PMCID: PMC6371542 DOI: 10.1186/s13643-019-0962-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 01/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Typically, management of PCOS focuses on lifestyle changes (exercise and diet), aiming to alleviate symptoms, and lower the associated risk of type 2 diabetes and cardiovascular disease. Our objective was to analyse evidence on the effectiveness of exercise in the management of PCOS, when compared to (i) usual care, (ii) diet alone, and (iii) exercise combined with diet, and also exercise combined with diet, compared to (i) control or usual care and (ii) diet alone. METHODS Relevant databases were searched (June 2017) with no time limit for trial inclusion. Eligible trials employed a randomised or quasi-randomised design to measure the chronic effects of exercise, or exercise and diet in women with PCOS. RESULTS Searches returned 2390 articles; of those, 27 papers from 18 trials were included. Results are presented as mean difference (MD) and 95% confidence intervals (95% CI). Compared with control, exercise had a statistical effect on change from baseline fasting insulin (MD - 2.44 μIU/mL, 95% CIs - 4.24 to - 0.64; very low-quality evidence), HOMA-IR (- 0.57, - 0.99 to - 0.14; very low-quality evidence), total cholesterol (- 5.88 mg/dL, - 9.92 to - 1.83; low-quality evidence), LDL cholesterol (- 7.39 mg/dL, - 9.83 to - 4.95; low-quality evidence), and triglycerides (- 4.78 mg/dL, - 7.52 to - 2.05; low-quality evidence). Exercise also improved VO2 max (3.84 ml/kg/min, 2.87 to 4.81), waist circumference (- 2.62 cm, - 4.13 to - 1.11), and body fat percentage (- 1.39%, - 2.61 to - 0.18) when compared with usual care. No effect was found for change value systolic/diastolic blood pressure, fasting glucose, HDL cholesterol (all low-quality evidence), or waist-to-hip ratio. Many favourable change score findings were supported by post-intervention value analyses: fasting insulin (- 2.11 μIU/mL, - 3.49 to - 0.73), total cholesterol (- 6.66 mg/dL, - 11.14 to - 2.17), LDL cholesterol (- 6.91 mg/dL, - 12.02 to - 1.80), and VO2 max (5.01 ml/kg/min, 3.48 to 6.54). Statistically lower BMI (- 1.02 kg/m2, - 1.81 to - 0.23) and resting heart rate (- 3.26 beats/min - 4.93 to - 1.59) were also revealed in post-intervention analysis. Subgroup analyses revealed the greatest improvements in overweight/obese participants, and more outcomes improved when interventions were supervised, aerobic in nature, or of a shorter duration. Based on limited data, we found no differences for any outcome between the effects of exercise and diet combined, and diet alone. It was not possible to compare exercise vs diet or exercise and diet combined vs diet. CONCLUSION Statistically beneficial effects of exercise were found for a range of metabolic, anthropometric, and cardiorespiratory fitness-related outcomes. However, caution should be adopted when interpreting these findings since many outcomes present modest effects and wide CIs, and statistical effects in many analyses are sensitive to the addition/removal of individual trials. Future work should focus on rigorously designed, well-reported trials that make comparisons involving both exercise and diet. SYSTEMATIC REVIEW REGISTRATION This systematic review was prospectively registered on the Prospero International Prospective Register of Systematic Reviews ( CRD42017062576 ).
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Affiliation(s)
- Chris Kite
- School of Life and Health Sciences, Cell and Tissue Biomedical Research Group, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.,Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, SY3 8HQ, UK
| | - Ian M Lahart
- Faculty of Education Health and Wellbeing, University of Wolverhampton, Walsall Campus, Gorway Road, Walsall, WS1 3BD, UK
| | - Islam Afzal
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK
| | - David R Broom
- Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Harpal Randeva
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK.,Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.,Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry, CV1 5FB, UK
| | - Ioannis Kyrou
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK.,Division of Translational and Experimental Medicine, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.,Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry, CV1 5FB, UK
| | - James E Brown
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK. .,School of Life and Health Sciences, Cell and Tissue Biomedical Research Group, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
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19
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Rubin KH, Andersen MS, Abrahamsen B, Glintborg D. Socioeconomic status in Danish women with polycystic ovary syndrome: A register-based cohort study. Acta Obstet Gynecol Scand 2018; 98:440-450. [PMID: 30516823 DOI: 10.1111/aogs.13514] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/01/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Low socioeconomic status (SES) may be associated with increased risk of polycystic ovary syndrome (PCOS) and vice versa. Possible associations between SES, obesity and ethnicity in PCOS are undetermined. MATERIAL AND METHODS National register-based study including women with PCOS aged 25 years or above (PCOS Denmark and an embedded cohort; PCOS Odense University Hospital [OUH]) and one control population. PCOS Denmark (n = 13 891) included women with PCOS in the Danish National Patient Register. Women in PCOS OUH underwent clinical examination (n = 814). Three age-matched controls were included per patient (n = 41 584). The main outcome measure was SES (personal income, occupational status and education). RESULTS The median (Q1; Q3) age of women in PCOS Denmark and controls was 33 (29; 39) years. Women with personal income in the lower tertile had a higher probability of a PCOS diagnosis than women in the high-income tertile (adjusted odds ratio [aOR] 1.5, 95% confidence interval [CI] 1.4-1.6). Women who were unemployed or on welfare payment (aOR 1.5, 95% CI 1.4-1.6), or who retired early (OR 1.8, 95% CI 1.7-2.0) had a higher probability of a PCOS diagnosis than women affiliated to the labor market. Women originating from the Middle East more often had PCOS (aOR 3.2, 95% CI 2.8-3.7) compared with women originating from Europe. In PCOS OUH, SES was lower in obese than in normal weight women. CONCLUSIONS A diagnosis of PCOS was associated with lower SES. In PCOS, women of foreign origin and women with obesity more often had low SES.
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Affiliation(s)
- Katrine H Rubin
- Odense Patient data Explorative Network-OPEN, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | | | - Bo Abrahamsen
- Odense Patient data Explorative Network-OPEN, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark.,Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
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20
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Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev 2018; 31:291-301. [PMID: 30033891 DOI: 10.1017/s0954422418000136] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
High carbohydrate intake and low-grade inflammation cooperate with insulin resistance and hyperandrogenism to constitute an interactive continuum acting on the pathophysiology of polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age characterised by oligo-anovulatory infertility and cardiometabolic disorders. The role of insulin in PCOS is pivotal both in regulating the activity of ovarian and liver enzymes, respectively involved in androgen production and in triggering low-grade inflammation usually reported to be associated with an insulin resistance, dyslipidaemia and cardiometabolic diseases. Although an acute hyperglycaemia induced by oral glucose loading may increase inflammation and oxidative stress by generating reactive oxygen species through different mechanisms, the postprandial glucose increment, commonly associated with the Western diet, represents the major contributor of chronic sustained hyperglycaemia and pro-inflammatory state. Together with hyperinsulinaemia, hyperandrogenism and low-grade inflammation, unhealthy diet should be viewed as a key component of the 'deadly quartet' of metabolic risk factors associated with PCOS pathophysiology. The identification of a tight diet-inflammation-health association makes the adoption of healthy nutritional approaches a primary preventive and therapeutic tool in women with PCOS, weakening insulin resistance and eventually promoting improvements of reproductive life and endocrine outcomes. The intriguing nutritional-endocrine connections operating in PCOS underline the role of expert nutritionists in the management of this syndrome. The aim of the present review is to provide an at-a-glance overview of the possible bi-directional mechanisms linking inflammation, androgen excess and carbohydrate intake in women with PCOS.
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Dokras A, Stener-Victorin E, Yildiz BO, Li R, Ottey S, Shah D, Epperson N, Teede H. Androgen Excess- Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome. Fertil Steril 2018; 109:888-899. [PMID: 29778388 DOI: 10.1016/j.fertnstert.2018.01.038] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To formulate clinical consensus recommendations for screening depression, anxiety, health-related quality of life (HRQoL), and disordered eating symptoms in women with polycystic ovary syndrome (PCOS) and review prevalence based on phenotypes and ethnicity, changes over time, etiology, and impact of treatment. DESIGN Systematic reviews and preparation of position statement. SETTING Not applicable. PATIENT(S) Women with PCOS and controls screened using validated tools. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Depressive symptoms, anxiety symptoms, disordered eating, and HRQoL scores. RESULT(S) Several studies demonstrate that women with PCOS have an increased prevalence of higher depression and anxiety scores and higher odds of moderate and severe depressive and anxiety symptoms compared with controls. Obesity, hyperandrogenism, and fertility have a weak association with these symptoms. HRQoL scores are consistently reduced in PCOS, with infertility and weight concerns having the most significant impact. Some studies suggest an increased prevalence of disordered eating in women with PCOS compared with controls. The few studies that have evaluated the impact of PCOS-related treatments (lifestyle interventions and pharmacotherapy) show no detrimental effect or some improvement in depressive and anxiety symptoms and HRQoL scores. CONCLUSION(S) In women with PCOS, screening for depressive and anxiety symptoms should be offered at the time of diagnosis and screening for disordered eating should be considered. Further research is required across PCOS phenotypes, in longitudinal cohorts and on impact of therapy on depressive and anxiety syptoms, HRQOL, and disordered eating.
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Affiliation(s)
- Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
| | | | - Bulent O Yildiz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey
| | - Rong Li
- Department of Obstetrics and Gyneocology, Reproductive Medical Center, Peking University Third Hosptal, Bejing, People's Republic of China
| | | | | | - Neill Epperson
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University and Monash Health, Clayton, Victoria, Australia
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Abstract
The prevalence of obesity is high among reproductive-age women and is associated with impaired reproductive function. Obesity is multifactorial in origin, yet many cases of obesity result from overconsumption of a diet high in fat. Excess dietary fat increases both adipose and nonadipose tissue lipid content and, through lipotoxicity, leads to cell dysfunction and death. High dietary fat intake, with or without the development of obesity, impairs female hypothalamic-pituitary-ovarian (HPO) axis functionality and fertility. Based on the current evidence, it appears the reproductive dysfunction involves increased leptin and insulin signaling at the various levels of the HPO axis, as well as changes in peroxisome proliferator-activated receptor γ actions and increased inflammation, yet other mechanisms may also be involved. This review summarizes the current body of knowledge on impaired female reproductive function after high-fat diet exposure, as well as discusses proposed mechanisms through which this may occur.
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Affiliation(s)
- Natalie M Hohos
- Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado 80045
| | - Malgorzata E Skaznik-Wikiel
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado 80045
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Chen TS, Chen YT, Liu CH, Sun CC, Mao FC. Effect of Chromium Supplementation on Element Distribution in a Mouse Model of Polycystic Ovary Syndrome. Biol Trace Elem Res 2015; 168:472-80. [PMID: 26041153 DOI: 10.1007/s12011-015-0384-6] [Citation(s) in RCA: 9] [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] [Received: 03/13/2015] [Accepted: 05/26/2015] [Indexed: 01/01/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder and one of the most common causes of anovulatory infertility. In addition, insulin resistance is commonly associated with PCOS and contributed to pathophysiology connected to dietary minerals including chromium (Cr), copper (Cu), iron (Fe), and zinc (Zn). The aims of this study were to explore whether PCOS in mice alters levels of these elements and determine if Cr supplementation resolves changes. Twenty-four female BALB/c mice were divided into three groups of eight mice [normal control (NC), PCOS+placebo milk (PP), and PCOS+Cr-containing milk (PCr)]. Each group received a high-fat diet for 4 weeks. Our results show significantly higher levels of dehydroepiandrosterone (DHEA) (p<0.001), fasting glucose (p<0.05), and fasting insulin (p<0.05) in the PP group compared with both NC and PCr group. However, Cr levels were significantly lower in muscle, bone, and serum in the PP group (p<0.05) compared with NC and PCr groups. In liver, bone, and serum, Fe levels were significantly higher in the PP group compared with the NC group (p<0.05). In addition, we found significant correlations between Cu/Zn ratio and fasting insulin in all mice (r=0.61; p=0.002). Given that significant research shows that Cr supplementation improves fasting glucose, fasting insulin, and metal metabolism disorders for PCOS mice, our data suggest that trace element levels can serve as biomarkers to prescribe therapeutic supplementation to maintain a healthy metabolic balance and treat disease conditions.
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Affiliation(s)
- Tsung-Sheng Chen
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, 402, Taiwan
| | - Yi-Ting Chen
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, 402, Taiwan
| | - Chia-Hsin Liu
- Department of Research and Development, Maxluck Biotechnology Corporation, Taichung, 402, Taiwan
| | - Chi-Ching Sun
- Department of Research and Development, Maxluck Biotechnology Corporation, Taichung, 402, Taiwan
| | - Frank Chiahung Mao
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, 402, Taiwan.
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Moran LJ, Grieger JA, Mishra GD, Teede HJ. The Association of a Mediterranean-Style Diet Pattern with Polycystic Ovary Syndrome Status in a Community Cohort Study. Nutrients 2015; 7:8553-64. [PMID: 26501318 PMCID: PMC4632439 DOI: 10.3390/nu7105419] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/12/2015] [Indexed: 01/08/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. While lifestyle management is first-line treatment in PCOS, the dietary intake of women with PCOS is unclear and there is no research assessing dietary patterns of women with and without PCOS. The aim of this study was to examine dietary patterns in a large cohort of women with and without PCOS. Data were from 7569 participants in the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health population assessed at 2009 (Survey 5) (n = 414 PCOS, n = 7155 non-PCOS). Dietary patterns were evaluated using factor analysis and multiple logistic regressions assessed their associations with PCOS status. Three dietary patterns were identified that explained 27% of the variance in food intake between women with and without PCOS: Non-core foods; Meats and take-away and Mediterranean-style. The Mediterranean-style dietary pattern was independently associated with PCOS status. On adjusted analysis for each 1 SD increase in the Mediterranean-style dietary pattern, there was a 26% greater likelihood that women had PCOS. This may indicate an improvement in the quality of dietary intake following a diagnosis of PCOS. Future research should examine the contribution of dietary patterns to the incidence and severity of PCOS and the potential for modification of dietary patterns in the lifestyle management of PCOS.
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Affiliation(s)
- Lisa J. Moran
- The Robinson Research Institute, University of Adelaide, 55 King William Road, North Adelaide, South Australia 5006, Australia;
- Monash Centre for Health Research Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia;
- Correspondence: ; Tel.: +61-8-313-1352; Fax: +61-8-3161-7652
| | - Jessica A. Grieger
- The Robinson Research Institute, University of Adelaide, 55 King William Road, North Adelaide, South Australia 5006, Australia;
| | - Gita D. Mishra
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;
| | - Helena J. Teede
- Monash Centre for Health Research Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia;
- Diabetes and Endocrine Unit, Monash Health, Clayton 3168, Australia
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Santos RR, Schoevers EJ, Roelen BAJ. Usefulness of bovine and porcine IVM/IVF models for reproductive toxicology. Reprod Biol Endocrinol 2014; 12:117. [PMID: 25427762 PMCID: PMC4258035 DOI: 10.1186/1477-7827-12-117] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 11/05/2014] [Indexed: 11/10/2022] Open
Abstract
Women presenting fertility problems are often helped by Assisted Reproductive Techniques (ART), such as in vitro fertilization (IVF) programs. However, in many cases the etiology of the in/subfertility remains unknown even after treatment. Although several aspects should be considered when assisting a woman with problems to conceive, a survey on the patients' exposure to contaminants would help to understand the cause of the fertility problem, as well as to follow the patient properly during IVF. Daily exposure to toxic compounds, mainly environmental and dietary ones, may result in reproductive impairment. For instance, because affects oocyte developmental competence. Many of these compounds, natural or synthetic, are endocrine disruptors or endocrine active substances that may impair reproduction. To understand the risks and the mechanism of action of such chemicals in human cells, the use of proper in vitro models is essential. The present review proposes the bovine and porcine models to evaluate toxic compounds on oocyte maturation, fertilization and embryo production in vitro. Moreover, we discuss here the species-specific differences when mice, bovine and porcine are used as models for human.
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Affiliation(s)
- Regiane R Santos
- />Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University,TD Utrecht,, P.O Box 80152, 3508 The Netherlands
- />Laboratory of Wild Animal Biology and Medicine, Federal University of Pará,, Rua Augusto Corrêa,Belém, CEP 66075-110 Pará Brazil
| | - Eric J Schoevers
- />Department of Farm Animal Health, Utrecht University,, Yalelaan, 104, 3584 CM Utrecht, The Netherlands
| | - Bernard AJ Roelen
- />Department of Farm Animal Health, Utrecht University,, Yalelaan, 104, 3584 CM Utrecht, The Netherlands
- />Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan, 104, 3584 CM Utrecht, The Netherlands
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