Abstract
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.)
Highlights
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy, affecting 5–13% of women of reproductive age [1,2,3]
Insulin resistance is estimated at 30% of lean and 70% of obese women with polycystic ovary syndrome (PCOS), whereas the prevalence of impaired glucose tolerance (IGT) and T2DM in PCOS patients is reported at 23–35% and 4–10%, respectively
While infertility associated with PCOS is often the most troublesome symptom in adult patients, the burden of disease in adolescents is mainly determined by clinical hyperandrogenism and overweight [14,15,16]
Summary
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy, affecting 5–13% of women of reproductive age [1,2,3]. In adolescents, depending on the criteria used, PCOS is diagnosed in 3.4%, 8% and 11% (based on criteria of the National Institutes of Health, Androgen Excess and Polycystic Ovary Syndrome Society, and Rotterdam, respectively) [1]. It is the most frequently diagnosed endocrine disorder in obese women [4,5]. PCOS comprises a much wider spectrum of endocrine and metabolic alterations, including insulin resistance (IR), disturbed gonadotropic and neuropeptide secretion, obesity, type 2 diabetes (T2DM), atherogenic dyslipidemia, and increased overall cerebrovascular morbidity [6]. While infertility associated with PCOS is often the most troublesome symptom in adult patients, the burden of disease in adolescents is mainly determined by clinical hyperandrogenism (seborrhea, acne, hirsutism) and overweight [14,15,16]
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