Insulin Resistance is Associated with Depression Risk in Polycystic Ovary Syndrome
Open accessAbstract
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.
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Depression can lead to poor adherence to healthy lifestyle behaviors, such as maintaining a balanced diet and regular physical activity, which are crucial for managing PCOS symptoms.
“On the other hand, depression can lead to poor adherence to healthy lifestyle behaviors, such as maintaining a balanced diet and regular physical activity, which are crucial for managing PCOS symptoms [31,32]”
From Dietary Patterns and Metabolic and Hormonal Parameters in Women with Suspected PCOS (2025) · cites this paper as [31]
The Introduction says depression in women with PCOS may negatively affect self-care and compound metabolic consequences. It does not specifically address adherence to a balanced diet or regular physical activity, or establish that depression causes poor adherence to either behavior. (LLM, conf=0.84)
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- Authors
- Greenwood, E. A., Pasch, L. A., Cedars, M. I., Legro, R. S., Eisenberg, E., & Huddleston, H. G.
- Affiliations
- University of California, San Francisco (US)
- Pennsylvania State University (US)
- National Institutes of Health (US)
- Corresponding author
- Greenwood, Eleni A.
- ORCID
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 110
- Issue
- 1
- Pages
- 27-34
- ISSN
- 0015-0282 (ISSN-L)
- PMC
- PMC6392023
- OpenAlex
- W2808547776
- Cited by
- 88
- References
- 48
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 17 · 2023: 19 · 2022: 9 · 2021: 10 · 2020: 6 · 2019: 4 · 2018: 2
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U10 HD055936, U10 HD055942, U10 HD055944, U10 HD27049, U10 HD38992, U10 HD38998, U10 HD39005, U10HD055925, U54-HD29834)
- National Institutes of Health (UL1 TR000127)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- insulin resistance, depression, polycystic ovary syndrome, HOMA-IR, clomiphene citrate, letrozole, body mass index
- MeSH terms
- Letrozole, Adult, Clomiphene, Depression, Female, Humans, Infertility, Female, Insulin Resistance, Polycystic Ovary Syndrome, Retrospective Studies, Risk Factors, Young Adult
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