Obesity, Insulin Resistance, and Hyperandrogenism Mediate the Link between Poor Diet Quality and Ovarian Dysmorphology in Reproductive-Aged Women
Obesity, Insulin Resistance, and Hyperandrogenism Mediate the Link between Poor Diet Quality and Ovarian Dysmorphology in Reproductive-Aged Women
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DOI：
10.3390/nu12071953
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发表时间：
2020-07-01
期刊：
影响因子：
5.9
通讯作者：
Lujan, Marla E.
中科院分区：
文献类型：
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作者：
Kazemi, Maryam;Jarrett, Brittany Y.;Lujan, Marla E.
饮食质量和卵巢形态之间的关系具有生物学合理性，但仍不清楚，因此进行了评估。在一项多中心横断面分析中，使用 (1) 健康饮食指数 (HEI-2015) 对 111 名连续育龄女性（18-45 岁）的四种饮食模式进行评分； (2)替代HEI-2010； (3) 替代地中海饮食（aMED）； (4) 和控制高血压的饮食方法 (DASH) 指数。通过经阴道超声检查评估卵巢体积（OV）和每个卵巢卵泡数（FNPO）。通过线性回归和中介分析评估饮食和卵巢形态指数之间的关系。 aMED 和 DASH 评分与 OV/FNPO 之间的关联完全由肥胖、胰岛素抵抗和高雄激素血症介导（全部：p < 0.05），与直接关联不同（全部：p >= 0.89）。也就是说，aMED 评分每增加 1 个标准差 [SD]，就会通过减小腰围来降低 OV（0.09 SD；0.4 mL）。同样，aMED 和 DASH 评分每增加 1 个 SD，就会减少对 75 g 葡萄糖耐量测试的葡萄糖反应，从而导致 OV（0.07 SD；0.3 mL）降低。 DASH 评分增加 1 SD 与游离雄激素指数降低导致 FNPO 降低（0.07 SD；2 个卵泡）相关（全部：p < 0.05）。遵守 aMED 和 DASH 饮食计划与卵巢形态的显着改善间接相关，为未来饮食质量对卵巢功能影响的干预措施提供了新的机制见解。
The relationship between diet quality and ovarian morphology has biological plausibility yet remains unclear and was therefore evaluated. In a multicenter cross-sectional analysis, four dietary patterns were scored for 111 consecutive reproductive-aged women (18-45 years) using (1) Healthy Eating Index (HEI-2015); (2) alternative HEI-2010; (3) alternate Mediterranean Diet (aMED); (4) and Dietary Approaches to Stop Hypertension (DASH) indices. Ovarian volume (OV) and follicle number per ovary (FNPO) were evaluated on transvaginal ultrasonography. Relationships between dietary and ovarian morphology indices were evaluated by linear regression and mediation analyses. Associations between aMED and DASH scores and OV/FNPO were completely mediated by obesity, insulin resistance, and hyperandrogenism (All:p< 0.05), unlike direct associations (All:p >= 0.89). Namely, a 1-standard deviation [SD] increase in aMED score was associated with decreases in OV (0.09 SD; 0.4 mL) through reducing waist circumference. Likewise, a 1 SD increase in aMED and DASH score was associated with decreases in OV (0.07 SD; 0.3 mL) by reducing glucose response to a 75 g glucose tolerance test. A 1 SD increase in DASH score was associated with decreased FNPO (0.07 SD; 2 follicles) by reducing free androgen index (All:p< 0.05). Adherence to aMED and DASH eating plans was indirectly associated with significant improvements in ovarian form, providing novel mechanistic insights for future interventions about contributions of diet quality on ovarian function.