Department of Clinical Therapeutics, School of Medicine, National & Kapodistrian University of Athens, "Alexandra" General Hospital, Athens, Greece.
Academic Department of Gastroenterology, School of Medicine, National & Kapodistrian University of Athens, "Laiko" General Hospital, Athens, Greece.
Endocrine. 2023 Oct;82(1):201-208. doi: 10.1007/s12020-023-03436-1. Epub 2023 Jun 30.
PCOS is associated with mood/eating disorders. Negative body image due to obesity, acne, hirsutism seems to play significant role, but hormonal derangements are probably implicated.
To investigate the relation between insulin resistance (IR), obesity and hyperandrogenism with mood and eating disorders in women with PCOS.
Forty-nine (60.5%) PCOS women and 32(39.5%) age- and BMI-matched healthy controls were enrolled. Emotional/food disorders were evaluated by using self-administered questionnaires: Eating Attitudes Test (EAT)-26, Beck Depression Inventory-II (BDI-II), Hamilton anxiety scale (HAS) and Food Craving Questionnaire-Trait (FCQ-T).
The two groups had no significant differences regarding age, BMI and HOMA2-IR. PCOS women had significantly higher DHEA-S (p < 0.0001), Δ4Α (p < 0.0001) and Testosterone (p < 0.0001). When the two groups were subclassified according to the BMI, in lean (BMI < 25 kg/m) or overweight (BMI ≥ 25 kg/m), no significant differences were found with respect to EAT-26 and HAS. BDI-II was associated with obesity (overweight vs lean PCOS: 20.5 ± 6.4 vs 9.8 ± 3.9; p = 0.037) and hyperandrogenism (overweight PCOS vs overweight controls: 20.5 ± 6.4 vs 14.8 ± 8.1; p < 0.0001; lean PCOS vs overweight controls: 16.7 ± 4.7 vs 14.8 ± 8.1; p = 0.01). Additionally, a significant correlation between BDI-II and DHEA-S (rho = 0.305; p = 0.006), Δ4Α (rho = 0.259; p = 0.02) and Testosterone (rho = 0.328; p = 0.003) was reported. FCQ-T was associated with obesity (overweight PCOS vs lean PCOS: 47.6 ± 9.9 vs 29.3 ± 8.9; p < 0.0001; overweight controls vs lean PCOS: 45.5 ± 15.7 vs 29.3 ± 8.9; p < 0.0001), whereas a correlation between FCQ-T and BMI (rho = 0.593; p = 0.0001), waist circumference (rho = 0.554; p = 0.0001) and HOMA2-IR (rho = 0.328; p = 0.003) was documented.
Obesity and hyperandrogenism increase the risk of depression and food cravings in women with PCOS, leading to a vicious circle of further aggravation of obesity and metabolic syndrome.
多囊卵巢综合征（PCOS）与情绪/饮食障碍有关。肥胖、痤疮、多毛症导致的负面身体形象似乎起着重要作用，但荷尔蒙失调也可能与此有关。
研究胰岛素抵抗（IR）、肥胖和高雄激素血症与多囊卵巢综合征女性情绪和饮食障碍之间的关系。
共纳入 49 名（60.5%）PCOS 女性和 32 名（39.5%）年龄和 BMI 匹配的健康对照组。采用自我管理问卷评估情绪/饮食障碍：饮食态度测试（EAT-26）、贝克抑郁量表 II（BDI-II）、汉密尔顿焦虑量表（HAS）和食物渴望问卷特质（FCQ-T）。
两组在年龄、BMI 和 HOMA2-IR 方面无显著差异。PCOS 女性的 DHEA-S（p<0.0001）、Δ4Α（p<0.0001）和睾酮（p<0.0001）明显升高。当根据 BMI 将两组分为瘦（BMI<25kg/m）或超重（BMI≥25kg/m）时，EAT-26 和 HAS 无显著差异。BDI-II 与肥胖（超重与瘦 PCOS：20.5±6.4 vs 9.8±3.9；p=0.037）和高雄激素血症（超重 PCOS 与超重对照组：20.5±6.4 vs 14.8±8.1；p<0.0001；瘦 PCOS 与超重对照组：16.7±4.7 vs 14.8±8.1；p=0.01）相关。此外，BDI-II 与 DHEA-S（rho=0.305；p=0.006）、Δ4Α（rho=0.259；p=0.02）和睾酮（rho=0.328；p=0.003）之间存在显著相关性。FCQ-T 与肥胖（超重 PCOS 与瘦 PCOS：47.6±9.9 vs 29.3±8.9；p<0.0001；超重对照组与瘦 PCOS：45.5±15.7 vs 29.3±8.9；p<0.0001）相关，而 FCQ-T 与 BMI（rho=0.593；p=0.0001）、腰围（rho=0.554；p=0.0001）和 HOMA2-IR（rho=0.328；p=0.003）之间存在相关性。
肥胖和高雄激素血症增加了 PCOS 女性抑郁和食物渴望的风险，导致肥胖和代谢综合征进一步恶化的恶性循环。
