Dietetic Department, Faculty of Physical Culture, Poznan University of Physical Education, 66-400 Gorzów Wielkopolski, Poland.
Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany.
Nutrients. 2021 Dec 24;14(1):73. doi: 10.3390/nu14010073.
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.).
膳食宏量营养素和体力活动（PA）在 PCOS 患者中的作用尚未得到充分报道，尤其是在青春期少女中。为了弥补这一知识空白，我们评估了血清总睾酮（tT）、游离睾酮（fT）、雄烯二酮（A）、脱氢表雄酮硫酸酯（DHEA-S）、性激素结合球蛋白（SHBG）与膳食宏量营养素摄入以及不同类型和水平的 PA 之间的关联。研究人群由 96 名白种人血统的 14-18 岁女孩组成：61 名参与者患有多囊卵巢综合征（PCOS），35 名健康对照者。空腹采血测定血清 tT、fT、A、DHEA-S 和 SHBG。使用三天食物记录法和信念与饮食习惯问卷（KomPAN）评估宏量营养素摄入和 PA 水平。我们发现整个队列和健康女孩的膳食宏量营养素（如总脂肪、饱和脂肪酸（SFA）、单不饱和脂肪酸（MUFA）和多不饱和脂肪酸（PUFA））与激素参数之间存在多种正相关关系。SHBG 与总蛋白摄入呈正相关，与碳水化合物摄入呈负相关。在 PCOS 组中未发现雄激素与宏量营养素之间的相关性。相反，我们仅在 PCOS 患者中观察到雄激素浓度（除 DHEA-S 外）与“工作/学校”和/或“休闲时间”PA 之间的负相关。此外，激素水平根据 PA 强度而有所不同。总之，饮食和 PA 的影响在患有和不患有 PCOS 的青少年中差异显著。这些发现表明，PCOS 中的激素稳态紊乱，至少在最年轻的患者中，可能“压倒”了饮食的影响，否则，PA 提供了一种治疗潜力，需要进一步评估随机研究中的长期效果。（ClinicalTrial.gov 标识符：NCT04738409）。
