POLİKİSTİK OVER SENDROMUNDA YEME BOZUKLUKLARI

Yıl 2022, , 113 - 119, 28.03.2022

Büşra Çolak , Seda Çiftçi

https://doi.org/10.34108/eujhs.895085

Öz

Polikistik over sendromu (PKOS), kadın infertilitesinin en önemli nedeni sayılabilen ve vücutta birçok metabolik durumu etkileyen endokrin bir hastalıktır. Dünyada ve ülkemizde üreme çağındaki kadınların büyük bir kısmında görünmekteyken, hala tanı almamış birçokkadınbulunmaktadır. Vücutta oluşan belirtiler ve tanı kriterleri, androjen hormon varlığının artışıyla aynı doğrultuda ilerlemektedir. Hormon dengesizlikleri sistemik bir inflamasyona ve çevresel dokularda insülin direncine neden olmaktadır. PKOS’lu bireylerde insülin direncine bağlı olarak obeziteye yatkınlık görülse de PKOS, normal vücut ağırlığında ya da zayıf olan kişilerde de görülmektedir. Hormonların dengesiz bir şekilde artış göstermesi sonucu klinik ve psikolojik belirtilerin gelişmesi, PKOS’lu kadınlarda hem duygu durum bozukluklarına hem de buna bağlı gelişen yeme bozukluklarına yol açmaktadır. PKOS ile başa çıkabilmek için öncelikle bireylerin erken teşhis edilmesi, sonrasında da psikolojik sorunlar ve yeme bozukluğu açısından taranması gerekmektedir. Bütün belirtilerin asıl kaynağı olan hormon dengesizliklerini gidermek amacıyla çeşitli tedavi seçenekleribulunmakta olsa da en etkili öneri, beslenme davranışı değişikliğini de içeren kalıcı yaşam tarzı değişikliğidir.Bu derlemede PKOS’lu bireylerde yeme bozukluğu gelişiminin nedenlerinden ve bu durumun önlenebilmesinde beslenme tedavisinin öneminden bahsedilecektir.

Anahtar Kelimeler

PKOS, yeme bozukluğu, duygudurum, infertilite, diyet

EATING DISORDERS IN POLYCYSTIC OVARY SYNDROME

Öz

Polycystic ovary syndrome is an endocrin edisease that can be considered the most important cause of female infertility and affects many body metabolic conditions. While PCOS is more common in women of reproductive age in the world and our country, there are more women stil undiagnosed. Symptoms and diagnostic criteria in the body go in line with the increase in androgen hormone. Hormone imbalances cause systemic inflammation and insulin resistance in peripheral tissues. Although individuals with PCOS are prone to obesity due to insulin resistance, it can also be found in people with normal body weight or under weight. The development of clinical and psychological symptoms resulting from the unbalanced increase of hormones causes mood disorders and eating behavior disorders related to these women. To cope with PCOS, individuals must be diagnosed early and screened for psychological problems and eating disorders. Although exercise, nutrition, and pharmacological treatment are among the options in treating PCOS disease to eliminate the hormone imbalances that are the main source of all symptoms, the most effective suggestion is a permanent life style change, including nutritional behavior change. In this article, were viewed the reasons for developing eating disorders in individuals with PCOS. Moreover, the importance of nutritional therapy in preventing this situation was mentioned.

Anahtar Kelimeler

Diet, eating disorder, infertility, mood, PCOS.

Kaynakça

• 1. Bednarska S, Siejka A. The pathogenesis and treatment of polycystic ovary syndrome: What's new? Adv Clin Exp Med. 2017; 26(2): 359-67.
• 2. Tata B, Mimouni NEH, Barbotin AL, Malone SA, Loyens A, Pigny P, et al. Elevated prenatal anti-Mullerian hormone reprograms the fetus and induces polycystic ovary syndrome in adulthood. Nat Med. 2018; 24(6): 834-46.
• 3. Bellver J, Rodriguez-Tabernero L, Robles A, Munoz E, Martinez F, Landeras J, et al. Polycystic ovary syndrome throughout a woman's life. J Assist Reprod Genet. 2018; 35(1): 25-39.
• 4. Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, et al. Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis. Syst Rev. 2019; 8(1): 51.
• 5. Steegers-Theunissen RP, Wiegel RE, Jansen PW, Laven JS, Sinclair KD. Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence. Int J Mol Sci. 2020; 21(21): 8211.
• 6. Larsson I, Hulthen L, Landen M, Palsson E, Janson P, Stener-Victorin E. Dietary intake, resting energy expenditure, and eating behavior in women with and without polycystic ovary syndrome. Clin Nutr. 2016; 35(1): 213-8.
• 7. Pirotta S, Barillaro M, Brennan L, Grassi A, Jeanes YM, Joham AE, et al. Disordered Eating Behaviours and Eating Disorders in Women in Australia with and without Polycystic Ovary Syndrome: A Cross-Sectional Study. J Clin Med. 2019; 8(10).
• 8. Alkoudsi KT, Basheti IA. Prevalence of anxiety and depression among women with Polycystic Ovary Syndrome living in war versus non-war zone countries: A randomized controlled trial assessing a pharmacist intervention. Res Social Adm Pharm. 2020; 16(5): 689-98.
• 9. Anagnostis P, Tarlatzis BC, Kauffman RP. Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism. 2018; 86: 33-43. 10. Krug I, Giles S, Paganini C. Binge eating in patients with polycystic ovary syndrome: prevalence, causes, and management strategies. Neuropsychiatr Dis Treat. 2019; 15: 1273-85.
• 11. Delitala AP, Capobianco G, Delitala G, Cherchi PL, Dessole S. Polycystic ovary syndrome, adipose tissue and metabolic syndrome. Arch Gynecol Obstet. 2017; 296(3): 405-19.
• 12. Franik G, Maksym M, Owczarek AJ, Chudek J, Madej P, Olszanecka-Glinianowicz M. Estradiol/testosterone and estradiol/androstenedione indexes and nutritional status in PCOS women - A pilot study. Eur J Obstet Gynecol Reprod Biol. 2019; 242: 166-9.
• 13. Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2017; 102(2): 604-12.
• 14. De Leo V, Musacchio M, Cappelli V, Massaro M, Morgante G, Petraglia F. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol. 2016; 14(1): 38.
• 15. de Melo AS, Dias SV, de Carvalho Cavalli R, Cardoso VC, Bettiol H, Barbieri MA, et al. Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause. Reproduction. 2015 ;150(1): R11-R24.
• 16. Scaruffi E, Franzoi IG, Civilotti C, Guglielmucci F, La Marca L, Tomelini M, et al. Body image, personality profiles and alexithymia in patients with polycystic ovary syndrome (PCOS). J Psychosom Obstet Gynaecol. 2019; 40(4): 294-303.
• 17. Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction. 2015; 149(5): R219-27.
• 18. Lin T, Li S, Xu H, Zhou H, Feng R, Liu W, et al. Gastrointestinal hormone secretion in women with polycystic ovary syndrome: an observational study. Hum Reprod. 2015; 30(11): 2639-44.
• 19. Brennan L, Teede H, Skouteris H, Linardon J, Hill B, Moran L. Lifestyle and Behavioral Management of Polycystic Ovary Syndrome. J Womens Health (Larchmt). 2017; 26(8): 836-48.
• 20. Ilie IR. Neurotransmitter, neuropeptide and gut peptide profile in PCOS-pathways contributing to the pathophysiology, food intake and psychiatric manifestations of PCOS. Adv Clin Chem. 2020; 96: 85-135.
• 21. Cooney LG, Dokras A. Depression and Anxiety in Polycystic Ovary Syndrome: Etiology and Treatment. Curr Psychiatry Rep. 2017; 19(11): 83. 22. Brutocao C, Zaiem F, Alsawas M, Morrow AS, Murad MH, Javed A. Psychiatric disorders in women with polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine. 2018; 62(2): 318-25.
• 23. Lee I, Cooney LG, Saini S, Smith ME, Sammel MD, Allison KC, et al. Increased risk of disordered eating in polycystic ovary syndrome. Fertil Steril. 2017; 107(3): 796-802.
• 24. Kogure GS, Ribeiro VB, Lopes IP, Furtado CLM, Kodato S, Silva de Sa MF, et al. Body image and its relationships with sexual functioning, anxiety, and depression in women with polycystic ovary syndrome. J Affect Disord. 2019; 253: 385-93.
• 25. Sanchez-Ferrer ML, Adoamnei E, Prieto-Sanchez MT, Mendiola J, Corbalan-Biyang S, Monino-Garcia M, et al. Health-related quality of life in women with polycystic ovary syndrome attending to a tertiary hospital in Southeastern Spain: a case-control study. Health Qual Life Outcomes. 2020; 18(1): 232.
• 26. Kaczmarek C, Haller DM, Yaron M. Health-Related Quality of Life in Adolescents and Young Adults with Polycystic Ovary Syndrome: A Systematic Review. J Pediatr Adolesc Gynecol. 2016; 29(6): 551-7.
• 27. Hewawasam E, Brennan L, Giles L, Hull ML, Short A, Norman R, et al. Assessing Whether Meditation Improves Quality of Life for Adolescent Girls With Polycystic Ovary Syndrome: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2020; 9(1): e14542.
• 28. Tay CT, Teede HJ, Hill B, Loxton D, Joham AE. Increased prevalence of eating disorders, low self-esteem, and psychological distress in women with polycystic ovary syndrome: a community-based cohort study. Fertil Steril. 2019; 112(2): 353-61.
• 29. Asdaq SMB, Jomah S, Hasan R, Al-Baroudi D, Alharbi M, Alsubaie S, et al. Impact of polycystic ovary syndrome on eating behavior, depression and health related quality of life: A cross-sectional study in Riyadh. Saudi Journal of Biological Sciences. 2020; 27(12): 3342-7.
• 30. Faghfoori Z, Fazelian S, Shadnoush M, Goodarzi R. Nutritional management in women with polycystic ovary syndrome: A review study. Diabetes Metab Syndr. 2017; 11 Suppl 1: S429-S32.
• 31. Jeanes YM, Reeves S, Gibson EL, Piggott C, May VA, Hart KH. Binge eating behaviours and food cravings in women with Polycystic Ovary Syndrome. Appetite. 2017; 109: 24-32.
• 32. Greenwood EA, Pasch LA, Cedars MI, Huddleston HG. Obesity and depression are risk factors for future eating disorder-related attitudes and behaviors in women with polycystic ovary syndrome. Fertil Steril. 2020; 113(5): 1039-49.
• 33. Lee I, Cooney LG, Saini S, Sammel MD, Allison KC, Dokras A. Increased odds of disordered eating in polycystic ovary syndrome: a systematic review and meta-analysis. Eat Weight Disord. 2019; 24(5): 787-97.
• 34. Thannickal A, Brutocao C, Alsawas M, Morrow A, Zaiem F, Murad MH, et al. Eating, sleeping and sexual function disorders in women with polycystic ovary syndrome (PCOS): A systematic review and meta-analysis. Clin Endocrinol (Oxf). 2020; 92(4): 338-49.
• 35. Jeanes YM, Reeves S. Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: diagnostic and methodological challenges. Nutr Res Rev. 2017; 30(1): 97-105.
• 36. Szczuko M, Zapałowska-Chwyć M, Maciejewska D, Drozd A, Starczewski A, Stachowska E. Significant improvement selected mediators of inflammation in phenotypes of women with PCOS after reduction and low GI diet. Mediators Inflamm. 2017; 2017.
• 37. Shishehgar F, Mirmiran P, Rahmati M, Tohidi M, Tehrani FR. Does a restricted energy low glycemic index diet have a different effect on overweight women with or without polycystic ovary syndrome? BMC Endocr Disord. 2019; 19(1): 1-11.
• 38. Barrea L, Marzullo P, Muscogiuri G, Di Somma C, Scacchi M, Orio F, et al. Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev. 2018; 31(2): 291-301.
• 39. Zhang X, Zheng Y, Guo Y, Lai Z. The effect of low carbohydrate diet on polycystic ovary syndrome: a meta-analysis of randomized controlled trials. Int J Endocr. 2019; 2019.
• 40. Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, et al. Adherence to the mediterranean diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients. 2019; 11(10): 2278.
• 41. Riley JK, Jungheim ES. Is there a role for diet in ameliorating the reproductive sequelae associated with chronic low-grade inflammation in polycystic ovary syndrome and obesity? Fertil Steril. 2016; 106(3): 520-7.
• 42. Rahmani E, Samimi M, Ebrahimi FA, Foroozanfard F, Ahmadi S, Rahimi M, et al. The effects of omega-3 fatty acids and vitamin E co-supplementation on gene expression of lipoprotein (a) and oxidized low-density lipoprotein, lipid profiles and biomarkers of oxidative stress in patients with polycystic ovary syndrome. Mol Cell Endocrinol. 2017; 439: 247-55.
• 43. Ostadmohammadi V, Jamilian M, Bahmani F, Asemi Z. Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome. J Ovarian Res. 2019; 12(1): 1-8.