Association of Macronutrients Composition, Physical Activity and Serum Androgen Concentration in Young Women with Polycystic Ovary Syndrome

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.)

Effects of AIDiet intervention to improve diet quality, immuno-metabolic health in normal and overweight PCOS girls: a pilot study

“…This is important because our previous research showed certain correlations between macronutrients in the diet and the tested androgens in the PCOS and/or control group. In the girls studied, we revealed a positive correlation between the serum concentration of androstenedione and the supply of total fats and MUFA, as well as a negative correlation between the above-mentioned androgen, and the supply of total protein, vegetable protein, and fibre 40 . Intervention studies by other authors showed a beneficial effect of dietary interventions on insulin resistance in PCOS patients and the normalization of hyperandrogenemia 55 .…”

“…Unfortunately, in contrast to these findings, our previous studies did not show any significant correlations between fibre intake and androgen levels in girls with PCOS. However, the entire study cohort showed a negative correlation between fibre intake and testosterone and androstenedione concentrations 40 .…”

“…The dietary intervention we conducted with the participation of teenage PCOS patients was based on our previous research findings 4 , 8 , 12 , 40 . We observed negative but, at the same time, favourable correlations between the concentration of IL-6 and TNF-α, markers of inflammation, and MDA—oxidative stress marker, and the supply of proteins, including plant proteins, carbohydrates, and fibre in overweight and obese PCOS teenagers.…”

“…Intervention studies by other authors showed a beneficial effect of dietary interventions on insulin resistance in PCOS patients and the normalization of hyperandrogenemia 55 . By inducing compensatory hyperinsulinemia, insulin resistance induces several pathways, ultimately leading to subsequent excess of circulating androgens 40 , 56 . Moreover, a beneficial effect of a 3-month high-protein diet with a low glycaemic load in women with PCOS and excessive body weight on the concentration of CRP, testosterone, and insulin, as well as the HOMA-IR value, was observed 59 .…”

“…Moreover, the dietary checklist does not examine all food types with anti-inflammatory potential. Nevertheless, the choice was based on our previous research findings 4 , 8 , 12 , 40 . In the next follow-up trials, the list should be expanded.…”