Relation between dietary advanced glycation end (AGE)products and polycystic ovary syndrome (PCOS) – evidencefrom a case-control study

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders among women of reproductive age. Advanced glycation end(AGEs) products are highly reactive molecules that are formed by non-enzymatic reactions of sugars with proteins, nucleic acids, and lipids. AGEs are also present in a variety of diet. A substantial increase in AGEs can result due to thermal processing (deep frying, Grill cooking etc.) and modifications of food (cheese, butter etc.)and in high sugar and carbonated beverages.Elevated serum AGEs levels have been observed in patients with hyperglycaemia, insulin resistance, diabetes and recently PCOS.

In this study we will assess the role of dietary AGEsamong patients with PCOS. Additionally, the role of (low AGE) diet modification and exercise in reducing PCOS symptoms will also be studied along with the sociodemographic profile of women with PCOS.

Materials and methods

A retrospective case-control study was conducted among patients and their attenders visiting obstetrics and gynaecology department of tertiary care teaching hospital for a period of two months in June – July 2019. Sample size calculated was 156 with 95% confidence and 80% power and ratio of unexposed to exposed as 2:1 using OpenEpi software.

Inclusion criteria for cases – Women of reproductive age group (15-45years), diagnosed and on treatment for PCOS.

Exclusion criteria – Women with thyroid disorders (acts as confounding factor)and who refused to be a part of the study.

Controls were women attenders in age group 15-45 years without PCOS or thyroid disorders. Data was collected in a pre-tested semi-structured questionnaire to know their sociodemographic details, gynaecological history, consumption pattern of advanced glycation end products (AGEs) and physical activity using google forms. Data was analysed using SPSS v17.0.

Results

The study participants majorly were in age group 20-22yrs (79%). Mean age of study participants was 22.05±3.31years. Majority were educated up to PUC / 12th std.Multivariate analysis showed that the risk factors of PCOS included increased with dietary AGE (OR=4.2842) and lack of physical activity (OR=4.9150).

Discussion

On comparing the results with those of similar studies carried out on relation between AGE and PCOS, the following have been observed 1) Increased dietary exposure and elevated serum AGE level is related to PCOS. 2) decreased physical activity adds on to the risk of developing PCOS. 3) A change in the diet pattern by including low AGE and reducing high AGE along with adequate physical activity reduced the severity of PCOS.

Conclusion

Women who include high AGE in their diet and do not include physical activity in their routine have 4 times higher chances of developing PCOS than women who consume low AGE diet and do physical activity routinely (min 150 minutes per week).