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Open AccessArticle

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

1
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
2
Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL 60611, USA
3
Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14623, USA
4
Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(7), 1953; https://doi.org/10.3390/nu12071953
Received: 30 May 2020 / Revised: 25 June 2020 / Accepted: 29 June 2020 / Published: 30 June 2020
(This article belongs to the Section Nutrition Methodology & Assessment)
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. View Full-Text
Keywords: Mediterranean Diet; Dietary Approaches to Stop Hypertension; ovary; fertility; metabolism Mediterranean Diet; Dietary Approaches to Stop Hypertension; ovary; fertility; metabolism
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Kazemi, M.; Jarrett, B.Y.; Vanden Brink, H.; Lin, A.W.; Hoeger, K.M.; Spandorfer, S.D.; Lujan, M.E. Obesity, Insulin Resistance, and Hyperandrogenism Mediate the Link between Poor Diet Quality and Ovarian Dysmorphology in Reproductive-Aged Women. Nutrients 2020, 12, 1953.

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