Abstract
The results of epidemiological studies involving omega-3 polyunsaturated fatty acids (PUFAs) and polycystic ovary syndrome (PCOS) are scarce. This matched case-control study assessed the associations between omega-3 PUFAs and PCOS prevalence in 325 pairs of PCOS cases and healthy controls. Dietary information was assessed using a 102-item food frequency questionnaire. Fatty acids in serum phospholipids were measured with a gas chromatography method. We found that omega-3 PUFAs in serum phospholipids were inversely associated with PCOS prevalence, including total, long-chain and individual PUFAs (e.g., docosapentaenoic acid (DPA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)). Compared to the lowest tertile (T1), the adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for the highest tertile (T3) were 0.63 (0.40, 0.93) for total omega-3 PUFAs, 0.60 (0.38, 0.92) for long-chain omega-3 PUFAs, 0.68 (0.45, 1.01) for DHA, 0.70 (0.45, 1.05) for EPA and 0.72 (0.45, 1.08) for DPA. For dietary intake of omega-3 PUFAs, significant inverse associations were found only for long-chain omega-3 PUFAs (p trend = 0.001), EPA (p trend = 0.047) and DHA (p trend = 0.030). Both dietary and serum omega-3 PUFAs, mainly EPA and DPA, were negatively correlated with PCOS-related parameters, such as BMI, fasting insulin, total testosterone and high-sensitivity C-reactive protein (hs-CRP), but positively correlated with follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG). These results indicated inverse associations between omega-3 PUFAs, especially long-chain omega-3 PUFAs, and PCOS prevalence. Higher intakes of omega-3 PUFAs might be considered a protective factor for PCOS among Chinese females.
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Key Points
Polycystic ovary syndrome (PCOS) is a common endocrine disease that is characterized by hyperandrogenism, ovulation disorder and ovarian polycystic change. Omega-3 polyunsaturated fatty acids (PUFAs) may exert beneficial effects on PCOS, including enhancement of endothelial function, anti-obesity effects, glycaemic and hormonal homeostasis, and anti-inflammatory effects. The purpose of this study was to explore the relationship between omega-3 PUFAs from a normal diet and from serum phospholipids and PCOS prevalence among Chinese women to provide evidence for the strategic relevance of nutritional assessment in the management of patients with PCOS. This matched case-control study assessed the associations between omega-3 PUFAs and PCOS prevalence in 325 pairs of PCOS cases and healthy controls. The results suggest that omega-3 PUFAs in serum phospholipids were inversely associated with PCOS prevalence, including total, long-chain and individual PUFAs (e.g., docosapentaenoic acid (DPA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)). Both dietary and serum omega-3 PUFAs, mainly EPA and DPA, were negatively correlated with PCOS-related parameters, such as BMI, fasting insulin, total testosterone and high-sensitivity C-reactive protein (hs-CRP), but positively correlated with follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG). These results indicate inverse associations between omega-3 PUFAs, especially long-chain omega-3 PUFAs, and PCOS prevalence. The researchers concluded that higher intakes of omega-3 PUFAs might be considered a protective factor for PCOS among Chinese females. Omega-3 PUFAs may also have effects on the hormone levels of PCOS patients. Omega-3 PUFAs inhibited the arachidonic acid-induced activation of acute regulatory protein factor and also regulate the expression of LH. In addition, omega-3 can regulate testosterone activity in PCOS patients, inhibit testosterone production and produce intervention effects.