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Obesity and hyperandrogenism are implicated with anxiety, depression and food cravings in women with polycystic ovary syndrome

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Abstract

Introduction

PCOS is associated with mood/eating disorders. Negative body image due to obesity, acne, hirsutism seems to play significant role, but hormonal derangements are probably implicated.

Aim

To investigate the relation between insulin resistance (IR), obesity and hyperandrogenism with mood and eating disorders in women with PCOS.

Methods

Forty-nine (60.5%) PCOS women and 32(39.5%) age- and BMI-matched healthy controls were enrolled. Emotional/food disorders were evaluated by using self-administered questionnaires: Eating Attitudes Test (EAT)-26, Beck Depression Inventory-II (BDI-II), Hamilton anxiety scale (HAS) and Food Craving Questionnaire-Trait (FCQ-T).

Results

The two groups had no significant differences regarding age, BMI and HOMA2-IR. PCOS women had significantly higher DHEA-S (p < 0.0001), Δ4Α (p < 0.0001) and Testosterone (p < 0.0001). When the two groups were subclassified according to the BMI, in lean (BMI < 25 kg/m2) or overweight (BMI ≥ 25 kg/m2), no significant differences were found with respect to EAT-26 and HAS. BDI-II was associated with obesity (overweight vs lean PCOS: 20.5 ± 6.4 vs 9.8 ± 3.9; p = 0.037) and hyperandrogenism (overweight PCOS vs overweight controls: 20.5 ± 6.4 vs 14.8 ± 8.1; p < 0.0001; lean PCOS vs overweight controls: 16.7 ± 4.7 vs 14.8 ± 8.1; p = 0.01). Additionally, a significant correlation between BDI-II and DHEA-S (rho = 0.305; p = 0.006), Δ4Α (rho = 0.259; p = 0.02) and Testosterone (rho = 0.328; p = 0.003) was reported. FCQ-T was associated with obesity (overweight PCOS vs lean PCOS: 47.6 ± 9.9 vs 29.3 ± 8.9; p < 0.0001; overweight controls vs lean PCOS: 45.5 ± 15.7 vs 29.3 ± 8.9; p < 0.0001), whereas a correlation between FCQ-T and BMI (rho = 0.593; p = 0.0001), waist circumference (rho = 0.554; p = 0.0001) and HOMA2-IR (rho = 0.328; p = 0.003) was documented.

Conclusions

Obesity and hyperandrogenism increase the risk of depression and food cravings in women with PCOS, leading to a vicious circle of further aggravation of obesity and metabolic syndrome.

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Abbreviations

PCOS:

Polycystic ovary syndrome

IR:

Insulin Resistance

BMI:

Body Mass Index

WC:

Waist Circumference

HOMA2-IR:

Homeostatic Model Assessment 2-Insulin Resistance

Δ4Α:

Δ4-Androstenedione

DHEA-S:

Dehydroepiandrosterone Sulfate

SHBG:

Sex Hormone Binding Globulin

EAT-26:

Eating Attitudes Test-26

FCQ-T:

Food Craving Questionnaire-Trait

HAS:

Ηamilton Anxiety Scale (HAS)

BDI-II:

Beck Depression Inventory-II.

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Author information

Author notes

  1. These authors contributed equally: Katerina Stefanaki, Dimitrios S. Karagiannakis

Authors and Affiliations

  1. Department of Clinical Therapeutics, School of Medicine, National & Kapodistrian University of Athens, “Alexandra” General Hospital, Athens, Greece

    Katerina Stefanaki, Theodora Psaltopoulou & Stavroula A. Paschou

  2. Academic Department of Gastroenterology, School of Medicine, National & Kapodistrian University of Athens, “Laiko” General Hospital, Athens, Greece

    Dimitrios S. Karagiannakis

  3. Diabetes Unit, “Athens Medical Center”, Athens, Greece

    Marina Raftopoulou

  4. Department of Endocrinology, Diabetes and Metabolism, “Elena Venizelou” General Hospital, Athens, Greece

    Ioannis Ilias

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  1. Katerina Stefanaki
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  2. Dimitrios S. Karagiannakis
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Correspondence to Dimitrios S. Karagiannakis.

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The study was performed according to the principles of the declaration of Helsinki as revised in 1983 and approval was obtained by the Ethics Committee of Alexandra General Hospital of Athens, Greece.

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Stefanaki, K., Karagiannakis, D.S., Raftopoulou, M. et al. Obesity and hyperandrogenism are implicated with anxiety, depression and food cravings in women with polycystic ovary syndrome. Endocrine 82, 201–208 (2023). https://doi.org/10.1007/s12020-023-03436-1

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