Readdressing Pathophysiology of Polycystic Ovary Syndrome in Post-COVID New Normal Era - A Pilot Study

Abstract

Background: Polycystic ovary syndrome or PCOS is a complex endocrinopathy in women of reproductive age. The diversified expression pattern of this multigenic syndrome and its complex association with modulation in nutritional status, anthropometric indices, and biochemical parameters are still in puzzle. The COVID-19 pandemic has worsened the existing crosstalk by changing lifestyle toward more home confinement as well as sedentary. Aims and objectives: This study aimed to understand the effect of altered dietary patterns, anthropometric parameters like various adiposity indices, and biochemical parameters related to hyperandrogenism (HA) on the penetrance of PCOS in a new normal situation. Design: PCOS individuals (n = 50) and their age and gender (18–36 years)-matched healthy control (n = 50) were recruited in this study. Materials and methods: Food frequency questionnaire (FFQ), bioimpedance analyzer (BIA), and biochemical assays were used to estimate different indices of the participants. Statistical analysis: IBM SPSS (Statistical Package for the Social Sciences), Version 20.0, Armonk, NY, was applied for analyzing quantitative variables (P < 0.05 and P < 0.01 indicate significance level). Results: Consumption of dietary fat (P < 0.01) and carbohydrates (P < 0.05) were significantly higher in PCOS individuals compared to the control one; 94% of PCOS patients were found to be under oligomenorrhea+polycystic ovaries (O+PCO) category. The body fat content (P < 0.01 and 0.05) along with intrauterine androgen exposure (digit ratio-2D:4D, P = 0.000) were significantly higher and lower respectively, in PCOS individuals relative to the control group. HA was highly prevalent in the PCOS group where 100% of them manifested alopecia, and significant (P < 0.01) correlation between free testosterone (free T) and free sex-hormone-binding-globulin (FSHBG) was also found. Low-density lipoprotein (LDL) was strongly associated with waist-to-height ratio (WHtR, P = 0.02) and body mass index (BMI, P = 0.041) in the same way as homeostatic model assessment for insulin resistance (HOMA-IR) with visceral adiposity index (VAI, P = 0.002) and lipid accumulation product (LAP, P = 0.014) index in PCOS individuals. Additionally, the triglyceride glucose (TyG) index was normally distributed (Kolmogorov–Smirnov test = 0.20) in PCOS individuals. Conclusion: Abnormal alternation in dietary patterns, and anthropometric and biochemical indices could be promising indicators for early detection and better prognosis of this multifaceted syndrome.