Obesity, Insulin Resistance, and Hyperandrogenism Mediate the Link between Poor Diet Quality and Ovarian Dysmorphology in Reproductive-Aged Women

• Published in: Nutrients Vol. 12; no. 7; p. 1953
• Main Authors: Kazemi, Maryam, Jarrett, Brittany Y, Vanden Brink, Heidi, Lin, Annie W, Hoeger, Kathleen M, Spandorfer, Steven D, Lujan, Marla E
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30-06-2020; MDPI
• Subjects: Adolescent; Adult; Androgens; Chronic illnesses; Clinical Trials as Topic; Cross-Sectional Studies; Diabetes; Diet; Diet - adverse effects; Diet, Healthy - statistics & numerical data; Diet, Mediterranean - statistics & numerical data; Dietary Approaches to Stop Hypertension; Dietary Approaches To Stop Hypertension - statistics & numerical data; Disease; Eating; Fasting; Female; fertility; Follicles; Glucose; Glucose tolerance; Humans; Hyperandrogenism - complications; Hypertension; Insulin; Insulin Resistance; Linear Models; Mediation Analysis; Mediterranean Diet; Menstruation; Metabolism; Middle Aged; Morphology; Obesity; Obesity - complications; Ovarian Diseases - etiology; Ovarian Follicle - growth & development; Ovaries; ovary; Ovary - pathology; Polycystic ovary syndrome; Pregnancy; Quality; Reproductive health; Reproductive status; Ultrasonic imaging; Womens health; Young Adult; New York; United States > US; ovary; metabolism; Dietary Approaches to Stop Hypertension; Mediterranean Diet; fertility
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12071953

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:
< 0.05), unlike direct associations (All:
≥ 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:
< 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.