Mindfulness in Women with Polycystic Ovary Syndrome

Nazia Raja-Khan博士是一名内分泌学家，她的长期职业目标是建立一个多囊卵巢综合征（PCOS）的综合医学研究项目，旨在将基于证据的非常规补充疗法与PCOS的传统医学疗法相结合，以优化PCOS患者的心理和心脏代谢健康。多囊卵巢综合征是一种常见的内分泌紊乱，影响5-10%的育龄妇女。患有多囊卵巢综合征的女性患心理困扰的风险增加，这可能导致她们患糖尿病和心血管疾病的风险增加。然而，对多囊卵巢综合征患者的心理困扰缺乏有效的管理策略。正念减压法（MBSR）减轻了不同患者群体的心理困扰，一项初步研究表明，正念减压法可以降低血糖和血压。因此，正念减压疗法可以通过减少心理困扰和心脏代谢风险来显著影响PCOS；然而，正念减压在多囊卵巢综合征中的作用尚未得到研究。正念减压疗法对超重或肥胖但没有多囊卵巢综合征（非多囊卵巢综合征）的女性也有类似的好处，因为压力也被认为是肥胖的主要原因。我们的目标是开展一项随机对照试验，调查正念减压疗法在多囊卵巢综合征和非多囊卵巢综合征超重或肥胖女性中的可行性和效果。98名妇女将被随机分为8周的正念减压或健康教育控制组，并随访16周。总体假设是，正念减压会降低多囊卵巢综合征和非多囊卵巢综合征妇女的心脏代谢风险和心理困扰，并改善生活质量。具体目的是：1)确定正念减压与健康教育对照对正念变化的影响，主要采用多伦多正念量表进行评估；2)初步评价正念减压与健康教育对照对糖化血红蛋白、平均动脉压（MAP）、生活质量、整体心理困扰的影响；3)探讨MBSR可能介导的生理机制，包括通过稳态模型评估（HOMA-IR）测量唾液皮质醇和胰岛素抵抗。该职业发展奖将为Raja-Khan博士提供技能、经验和初步数据，以制定有竞争力的R01提案，更全面地研究MBSR在多囊卵巢综合征中的作用和机制。这项研究将为多囊卵巢综合征、糖尿病和心血管疾病的新型综合身心方法的发展提供信息。

Nazia Raja-Khan, M.D. is an endocrinologist with a long-term career goal of establishing an integrative medicine research program for Polycystic Ovary Syndrome (PCOS) aimed at integrating evidence-based non-conventional complementary therapies with conventional medical therapies for PCOS to optimize psychological and cardiometabolic health in PCOS. PCOS is a common endocrine disorder that affects 5-10% of reproductive-aged women. Women with PCOS are at increased risk for psychological distress, which may contribute to their increased risk for diabetes and cardiovascular disease. However, there is a lack of effective strategies for managing psychological distress in PCOS. Mindfulness-Based Stress Reduction (MBSR) reduces psychological distress in various patient populations and a pilot study showed that MBSR lowers glucose and blood pressure. Therefore, MBSR could significantly impact PCOS by reducing psychological distress and cardiometabolic risk; however, MBSR has not been investigated in PCOS. MBSR may have similar benefits for overweight or obese women who do not have PCOS (non-PCOS) as stress is also believed to play a major role in obesity. Our objective is to conduct a pilot randomized controlled trial investigating the feasibility and effects of MBSR in PCOS and non-PCOS women who are overweight or obese. Ninety eight (98) women will be randomized to 8-weeks of MBSR or health education control and followed for 16 weeks. The overall hypothesis is that MBSR will reduce cardiometabolic risk and psychological distress and improve quality of life in PCOS and non-PCOS women. Specific Aims are to: 1) Determine the effects of MBSR compared to health education control on changes in mindfulness, primarily assessed with the Toronto Mindfulness Scale; 2) Conduct a preliminary evaluation of the effects of MBSR compared to health education control on hemoglobin A1c, mean arterial pressure (MAP), quality of life, and overall psychological distress; 3) Explore physiologic mechanisms potentially mediating the effects of MBSR, including salivary cortisol and insulin resistance measured by homeostasis model assessment (HOMA-IR). This career development award will provide Dr. Raja-Khan with the skills, experience, and preliminary data to develop a competitive R01 proposal to more comprehensively investigate the effects and mechanisms of MBSR in PCOS. This research will inform the development of novel integrative mind-body approaches for PCOS, diabetes, and cardiovascular disease.