Moslehi Nazanin, Mirmiran Parvin, Tehrani Fahimeh Ramezani, Azizi Fereidoun
Nutrition and Endocrine Research Center.
Department of Nutrition and Clinical Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Adv Nutr. 2017 Jul 14;8(4):597-612. doi: 10.3945/an.116.014647. Print 2017 Jul.
Ovarian aging is thought to be influenced by environmental factors, including nutrition. The aim of this study was to systematically review current evidence on the associations between nutritional factors, ovarian reserve, and age at menopause. PubMed and Scopus were structurally searched until May 2016. Original studies, with either observational or interventional designs, that examined the associations of nutritional factors (serum or dietary nutrients, food groups, and/or dietary patterns) with different ovarian reserve markers and/or timing of menopause were considered eligible. Twenty-six studies met the inclusion criteria: 17 studies on ovarian reserve markers and 9 studies on menopausal age. Significant diversity was observed in nutritional factors examined across studies. In the study of nutritional factors, associations of serum 25-hydroxyvitamin D [25(OH)D] concentration and intakes of soy or soy products with ovarian reserve have been the most investigated. For associations with menopausal age, intakes of total fat, fiber, and soy products have been mainly examined. Significant associations with ovarian reserve markers were found in 4 of 7 studies on serum 25(OH)D, 2 of 6 studies on soy or soy products, 1 of 2 studies on fiber intake, 1 study on serum zinc and copper concentrations, and 1 study on serum antioxidant concentrations. Studies on nutritional factors and menopausal age provided inconsistent findings, some of which suggested modest associations. Although there is some promising evidence on the influential role of nutrition in ovarian aging, a limited number of studies, heterogeneous in their design and study of nutritional factors, makes it difficult to draw definite conclusions. To better understand this issue, examination of associations of dietary intakes or dietary patterns with more precise markers of ovarian reserve, such as anti-mullerian hormone and antral follicle count, with age at menopause is needed. In addition, to explore whether nutritional factors alter the process of ovarian aging, an examination of changes in ovarian reserve markers should be considered.
卵巢衰老被认为受包括营养在内的环境因素影响。本研究的目的是系统综述当前关于营养因素、卵巢储备和绝经年龄之间关联的证据。截至2016年5月，对PubMed和Scopus进行了结构化检索。纳入的原始研究需具有观察性或干预性设计，研究营养因素（血清或膳食营养素、食物类别和/或膳食模式）与不同卵巢储备标志物和/或绝经时间的关联。26项研究符合纳入标准：17项关于卵巢储备标志物的研究和9项关于绝经年龄的研究。各项研究中所考察的营养因素存在显著差异。在营养因素研究中，血清25-羟维生素D[25(OH)D]浓度以及大豆或大豆制品摄入量与卵巢储备的关联研究最多。对于与绝经年龄的关联，主要考察了总脂肪、纤维和大豆制品的摄入量。在7项关于血清25(OH)D的研究中，有4项发现与卵巢储备标志物存在显著关联；在6项关于大豆或大豆制品的研究中，有2项；在2项关于纤维摄入量的研究中，有1项；在1项关于血清锌和铜浓度的研究中；以及在1项关于血清抗氧化剂浓度的研究中均有发现。关于营养因素和绝经年龄的研究结果并不一致，其中一些显示存在适度关联。尽管有一些证据表明营养在卵巢衰老中具有重要作用，但研究数量有限，且在营养因素的设计和研究方面存在异质性，难以得出明确结论。为更好地理解这一问题，需要研究膳食摄入量或膳食模式与更精确的卵巢储备标志物（如抗苗勒管激素和窦卵泡计数）以及绝经年龄之间的关联。此外，为探究营养因素是否改变卵巢衰老过程，应考虑对卵巢储备标志物的变化进行研究。
