Ghavami Abed, Mehrabani Sanaz, Khodarahmi Mahdieh, Mokari-Yamchi Amin, Vajdi Mahdi, Ghasemi-Tehrani Hatav, Askari Gholamreza
Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Front Nutr. 2025 May 22;12:1559229. doi: 10.3389/fnut.2025.1559229. eCollection 2025.
Diminished ovarian reserve (DOR) occurs as a result of a decrease in the quantity and quality of oocytes, which can negatively affect fertility. Diet is one of the modifiable factors that plays an important role in preventing or exacerbating numerous diseases. As the effects of diet on the risk of DOR were not well-defined, this study was designed to investigate the association between DOR and dietary insulin index (DII) and dietary insulin load (DIL).
A total of 370 Iranian women participated in this case-control study: 120 individuals with DOR and 250 control subjects matched for age and body mass index. A validated semiquantitative 80-item food frequency questionnaire was used to assess the DII and DIL. Serum anti-Müllerian hormone levels were measured, the number of antral follicles was counted, and various anthropometric indices were evaluated. In addition, the relationship between the DII and DIL, and the risk of DOR was analyzed using multivariable logistic regression.
The unadjusted model of analysis found no significant relationship between the risk of developing DOR, and the DII and DIL. However, the findings showed that women who were in the highest quartile of the DII had a 1.29 times higher chance of having DOR (odds ratio: 1.29; 95% confidence interval: 1.07 to 3.93) when factors such as energy consumption and physical activity were considered. Furthermore, participants in the third and fourth quartiles of the DII and DIL had significantly higher odds of developing DOR when all possible confounders were taken into account.
The risk of DOR increased with an increase in the DII and DIL. However, further clinical trials and prospective cohort studies are needed to support this finding.
卵巢储备功能减退（DOR）是由于卵母细胞数量和质量下降所致，这会对生育能力产生负面影响。饮食是可改变的因素之一，在预防或加剧多种疾病方面起着重要作用。由于饮食对DOR风险的影响尚不明确，本研究旨在调查DOR与饮食胰岛素指数（DII）和饮食胰岛素负荷（DIL）之间的关联。
共有370名伊朗女性参与了这项病例对照研究：120名DOR患者和250名年龄及体重指数相匹配的对照受试者。使用经过验证的80项半定量食物频率问卷来评估DII和DIL。测量血清抗苗勒管激素水平，计数窦卵泡数量，并评估各种人体测量指标。此外，使用多变量逻辑回归分析DII和DIL与DOR风险之间的关系。
未经调整的分析模型未发现发生DOR的风险与DII和DIL之间存在显著关系。然而，研究结果表明，在考虑能量消耗和身体活动等因素时，DII处于最高四分位数的女性患DOR的几率高1.29倍（优势比：1.29；95%置信区间：1.07至3.93）。此外，当考虑所有可能的混杂因素时，DII和DIL处于第三和第四四分位数的参与者患DOR的几率显著更高。
DOR的风险随着DII和DIL的增加而增加。然而，需要进一步的临床试验和前瞻性队列研究来支持这一发现。
