ARTICLE INFO | ABSTRACT | |
ORIGINAL ARTICLE | Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. It is linked to genetic and environmental factors such as nutrition. Insulin resistance (IR) is one of the major pathological changes in PCOS. This study aimed to determine the relationship between IR and macronutrient intake in PCOS subgroups. Methods: This case-control study was performed on 151 women with PCOS and were divided into four groups according to the Rotterdam diagnostic criteria: A=41, B=33, C=40, and D=37, and 31 women were also in the control group and did not have this syndrome. All macronutrients were assessed with a 168-item food frequency questionnaire (FFQ). Results: There was a significant relationship between HOMA-IR and some dietary components (Increased calorie in group A, increased total fat intake in group C, lower intake of unsaturated fats (PUFA and MUFA) in group D and higher intake of saturated fat (SFA) and protein intake in the control group). There was no correlation in subgroup B (ovulatory phenotype). Conclusion: Due to the significant relationship between IR and some dietary components in PCOS subtypes, it is recommended to maintain a balance in carbohydrate and fatty acids intake, and increase dietary fiber to improve health parameters in PCOS subjects. Keywords: Macronutrient; PCOS; Insulin resistance |
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Article history: Received: 5 Oct 2021 Revised: 9 Jan 2022 Accepted: 15 Feb 2022 |
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*Corresponding author maryam.movahedinezhad@ modares.ac.ir Department of Midwifery, Faculty of Medical Sciences, Tehran Tarbiat Modares University, Tehran, Iran. Postal code: 14115-111 Tel: +98 915 9516438 |
Table 1. Comparison of demographic variables at baseline between groups. | ||||||
Variables | Phenotype A N=41 |
Phenotype B N=33 |
Phenotype C N=40 |
Phenotype D N=37 |
Control N=31 |
P-value |
Age (y) | 28.07 ± 4.70 | 27.00 ± 5.44 | 29.70 ± 6.44 | 29.83 ± 5.93 | 28.07 ± 4.70 | 0.09a |
Body mass index (kg/m2) | 25.48 ± 5.23 | 25.06 ± 4.28 | 25.08 ± 3.93 | 24.98 ± 4.80 | 25.48 ± 5.23 | 0.99a |
Educational status | ||||||
Under diploma | 4 (9.8) | 3 (9.1 ) | 4 (10.0 ) | 2 ( 5.4) | 2 (6.5 ) | 0.30b |
Diploma | 9 (22.0) | 5 ( 15.2) | 10 (25.0 ) | 15 (43.2 ) | 14 (45.2 ) | |
Bachelor | 19 (46.3) | 16 (48.5 ) | 20 ( 50.0) | 16 ( 40.5) | 10 (32.3 ) | |
Master’s degree and higher | 9 (22.0) | 9 (27.3 ) | 6 (15.0 ) | 4 (10.8 ) | 5 (16.1 ) | |
The economic situation | ||||||
Poor | 16 (39.0 ) | 23 ( 69.7) | 23 (57.5 ) | 21 ( 56.8) | 17 ( 54.8) | 0.27b |
Medium | 16 (39.0 ) | 5 ( 15.2) | 11 ( 27.5) | 7 ( 18.9) | 7 ( 22.6) | |
Good | 9 (22.0 ) | 5 ( 15.2) | 6 (15.0 ) | 9 ( 24.3) | 7 ( 22.6) | |
Physical activity status | ||||||
Level 1 | 23 (56.1 ) | 20 ( 60.6) | 25 ( 62.5) | 25 (67.6 ) | 20 ( 67.6) | 0.87b |
Level 2 | 6 (14.6 ) | 6 ( 18.2) | 7 (17.5 ) | 5 (13.5 ) | 5 (13.5 ) | |
Level 3 | 12 ( 29.3) | 7 (21.2 ) | 8 ( 20.0) | 7 ( 18.9) | 6 ( 18.9) | |
a: Kruskal Wallis test; b: Chi-square test; Level 1: Normal daily activities without exercise. Level 2: Moderate physical activity: (1 to 2 times a week, each time for at least 20 minutes). Level 3: High physical activity: (3 or more 3 times a week, Each time for at least 20 minutes). |
Table 2. Comparison of insulin resistance status in PCOS subgroups and control group. | ||||||||||
Insulin resistance statusa | Phenotype A | Phenotype B | Phenotype C | Phenotype D | Control group | |||||
n | % | n | % | n | % | n | % | n | % | |
NO | 16 | 39.5 | 16 | 48.5 | 25 | 62.5 | 19 | 51.4 | 29 | 93.5 |
Yes | 25 | 61.0 | 17 | 51.5 | 15 | 37.5 | 18 | 48.6 | 2 | 6.5 |
Total | 41 | 100 | 33 | 100 | 40 | 100 | 37 | 100 | 31 | 100 |
a: Yes is HOMA-IR >2.5 and No is less than 2.5; P<0.001 Chi-square test. |
Table 3. Correlation between dietary components and HOMA IR index in four subgroups of PCOS and control group | |||||||
Phenotype A | |||||||
Calories | Total fiber | Soluble fiber | Total fat | PUFA | MUFA | SFA | Protein |
0.334a | -0.188 | -0.139 | 0.195 | 0181 | -0.151 | 0.010 | 0.017 |
0.033b | 0.240 | 0.385 | 0.227 | 0.264 | 0.352 | 0.952 | 0.916 |
Phenotype B | |||||||
0.019 | 0.309 | 0.288 | -0.173 | 0.094 | -0.069 | -0.051 | -0.037 |
0.915 | 0.080 | 0.104 | 0.337 | 0.604 | 0.705 | 0.776 | 0.836 |
Phenotype C | |||||||
0.074 | 0.036 | -0.035 | 0.341 | 0.226 | 0.256 | 0.053 | -0.063 |
0.649 | 0.824 | 0.830 | 0.031 | 0.161 | 0.110 | 0.747 | 0.697 |
Phenotype D | |||||||
-0.028 | -0.288 | -0.132 | 0.124 | -0.404 | -0.473 | 0.062 | -0.311 |
0.033 | 0.240 | 0.385 | 0.227 | 0.013 | 0.003 | 0.004 | 0.061 |
Control group | |||||||
0.139 | 0.247 | 0.522 | 0.202 | 0.482 | 0.512 | 0.366 | 0.443 |
0.455 | 0181 | 0.066 | 0.275 | 0.067 | 0.052 | 0.043 | 0.012 |
a: Correlation coefficient; b: P-value; PUFA: Polyunsaturated fatty acid; MUFA: Monounsaturated fatty acid; SFA: Saturated fatty acid |
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