Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome

Abstract

Background: Stress is an invisible factor affecting modern day living and is strongly associated with many disease pathogenesis including polycystic ovarian syndrome (PCOS) in women. PCOS is the most frequent endocrinological disorder that affects women of reproductive age, leading to metabolic dysfunction and body composition alterations. Salivary amylase and cortisol are major stress mediators that have been implicated in PCOS. However, their role in altering body composition in PCOS is yet to be deciphered.

Aim: The present study aimed at understanding the relation between stress-associated factors and alterations in body composition among PCOS patients.

Design: This study enrolled a total of 100 patients (PCOS) and 60 age-matched controls. The female patients were of ages between 13 and 30 years.

Materials and methods: Standard assay kits were used to evaluate the α-amylase activity and cortisol level in saliva. The participants were chosen on the basis of the Rotterdam American Society for Reproductive Medicine/European Society of Human Reproduction criteria. Saliva was collected from each participant as per the protocol of Salimetrics, USA.

Statistical analysis: Statistical analysis was performed using SPSS version 20 for Windows. The quantitative variables are described as mean ± standard deviation. P < 0.05 was considered significant.

Results: Increased salivary cortisol level and α-amylase activity were seen in the PCOS population as compared to age-matched controls suggesting patients a sustained stress scenario in their system. Moreover, overweight PCOS participants reflected higher amylase activity than the lean patients participants. Pulse rate, body mass index (BMI), visceral adiposity, and waist-hip ratio (WHR) was considerably higher in the PCOS patients participants compared to controls. A significant correlation could be drawn between the α-amylase activity and BMI or WHR, respectively, among PCOS patients. These observations indicate a strong link between the stress marker and alterations in the body composition parameters of PCOS patients participants.

Conclusion: Higher prevalence of stress in PCOS patients participants has a critical role in their altered body composition.

Keywords: Polycystic ovarian syndrome; salivary cortisol; salivary α-amylase; stress.

Figure 1

Hemoglobin concentration of (a) controls and (b) polycystic ovarian syndrome patients

Figure 2

Salivary α-amylase activity (a) control and polycystic ovarian syndrome women (b) lean and obese polycystic ovarian syndrome patients. The box plot represents 25%, 50%(median), and 75% quartile values, and the error bar represents the standard deviation. **Significant change with respect to control at P < 0.01 level

Figure 3

Activation of hypothalamic–pituitary–adrenal axis along with heart rate in polycystic ovarian syndrome patients in comparison to age-matched control (a) salivary cortisol level (b) heart rate. All values in the respective box plots show 25%, 50% (median), and 75% quartile values, and the error bar indicates the standard deviation. **The significant change with respect to control at P < 0.01 level

Figure 4

Altered body composition in polycystic ovarian syndrome patients (a) body mass index (b) visceral fat (c) waist-hip ratio. The respective box plots are representing the 25%, 50% (median), and 75% quartiles, whereas the error bars indicate the standard deviation. **Significant change with respect to control at P < 0.01 level

Figure 5

Correlation plots of association between (a) body mass index and visceral fat (b) body mass index and waist-hip ratio

Figure 6

Correlation plots of association between (a) salivary α-amylase activity and body mass index (b) salivary α-amylase activity and waist.hip ratio (c) salivary α-amylase activity and visceral fat