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Fertil Steril. 2018 Jul 1;110(1):27-34. doi: 10.1016/j.fertnstert.2018.03.009. Epub 2018 Jun 13.

Insulin resistance is associated with depression risk in polycystic ovary syndrome.

Author information

1
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, San Francisco, California. Electronic address: eleni.greenwood@ucsf.edu.
2
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco, San Francisco, California.
3
Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, Pennsylvania.
4
Fertility and Infertility Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland.

Abstract

OBJECTIVE:

To test the hypothesis that insulin resistance is associated with depression risk in polycystic ovary syndrome (PCOS).

DESIGN:

Secondary analysis of data from a multicenter randomized trial.

SETTING:

Multicenter university-based clinical practices.

PATIENT(S):

Seven hundred thirty-eight women with PCOS by modified Rotterdam criteria seeking pregnancy enrolled in a randomized clinical trial comparing clomiphene citrate versus letrozole.

INTERVENTION(S):

The Primary Care Evaluation of Mental Disorders Patient Health Questionnaire was self-administered to identify depression using a validated algorithm at enrollment. Demographic and anthropometric data were collected, and serum assays were performed. Insulin resistance was estimated using the homeostatic model of insulin resistance (HOMA-IR), with a cutoff of >2.2 considered abnormal.

MAIN OUTCOME MEASURE(S):

Demographic, endocrine, and metabolic parameters associated with depression.

RESULT(S):

In a univariate logistic regression analysis, elevated HOMA-IR was associated with 2.3-fold increased odds of depression (odds ratio [OR] = 2.32; 95% confidence interval [CI], 1.28-4.21). This association remained significant after controlling for age and body mass index (adjusted OR [aOR] = 2.23; 95% CI, 1.11-4.46) and in a model including additional potential confounders (aOR = 2.03; 95% CI, 1.00-4.16).

CONCLUSION(S):

Insulin resistance has a strong and independent association with depression in PCOS and may serve as a physiologic mediator. Our findings corroborate a growing body of evidence linking insulin resistance to depressed mood. The association between insulin resistance and depressed mood warrants further investigation to elucidate mechanisms and identify potential therapeutic targets.

KEYWORDS:

Polycystic ovary syndrome (PCOS); depression; insulin resistance

PMID:
29908775
PMCID:
PMC6392023
DOI:
10.1016/j.fertnstert.2018.03.009
[Indexed for MEDLINE]
Free PMC Article

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