背景:多囊卵巢综合征(PCOS)与饮食紊乱有关,但先前的荟萃分析受到数量少的限制。
目的:为了通知2023年国际PCOS指南,我们进行了系统评价和荟萃分析,评估了有和没有PCOS的女性中饮食失调/饮食失调的患病率.
方法:OvidMEDLINE,EMBASE,PsycInfo,从开始到2024年2月1日,对所有EMB进行了搜索,以比较青春期或成年女性饮食失调/饮食失调的患病率。使用随机效应荟萃分析来估计PCOS女性与对照组的结果的合并比值比(OR)或标准化平均差异(SMD)。方法质量通过建议分级来评估,评估,开发和评估(等级)系统,并对纳入研究的偏倚风险进行评估.
结果:在确定的1352篇文章中,包括20个,共有28922名PCOS女性和258619名对照。PCOS患者患饮食失调的几率更高(OR:1.53[1.29,1.82],8项研究),在根据鹿特丹标准诊断为PCOS的研究中仍然存在(OR:2.88[1.55,5.34],4项研究)。神经性贪食症的几率,暴饮暴食症,和无序的饮食,但不是神经性厌食症,在PCOS中增加。PCOS患者的平均饮食紊乱评分较高(SMD:0.52[0.28,0.77],13项研究),包括按正常体重和较高体重体重指数分层时。大多数纳入的研究质量中等,没有发表偏倚的证据。
结论:我们的研究为2023年PCOS指南提供了建议,以考虑PCOS女性患者饮食失调/饮食失调的风险。不管重量,尤其是在提供生活方式咨询期间。
BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with disordered eating/eating disorders, but prior meta-analyses are limited by small numbers.
OBJECTIVE: To inform the 2023 International PCOS Guideline, we performed a systematic review and meta-analysis evaluating the prevalence of disordered eating/eating disorders among women with and without PCOS.
METHODS: Ovid MEDLINE, EMBASE, PsycInfo, and All EMB were searched from inception through February 1, 2024, for studies that compared prevalences of eating disordered/disordered eating in adolescent or adult women. Random effects meta-analyses were used to estimate the pooled odds ratios (OR) or standardized mean differences (SMD) of outcomes in women with PCOS compared to controls. Methodological quality was assessed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system, and included studies were assessed for risk of bias.
RESULTS: Of 1352 articles identified, 20 were included, with a total of 28 922 women with PCOS and 258 619 controls. Individuals with PCOS had higher odds of any eating disorder (OR: 1.53 [1.29, 1.82], 8 studies), which persisted in studies where PCOS was diagnosed by Rotterdam criteria (OR: 2.88 [1.55, 5.34], 4 studies). Odds of
bulimia nervosa, binge eating disorder, and disordered eating, but not anorexia nervosa, were increased in PCOS. Mean disordered eating scores were higher in PCOS (SMD: 0.52 [0.28, 0.77], 13 studies), including when stratified by normal and higher weight body mass index. Most included studies were of moderate quality, with no evidence of publication bias.
CONCLUSIONS: Our study informs the 2023 PCOS Guideline recommendations for consideration of the risk of disordered eating/ eating disorders in care of women with PCOS, regardless of weight, especially during providing lifestyle counseling.