Determining the relationship between depression and adiponectin levels in women with polycystic ovary syndrome and healthy

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This study was performed among women of reproductive age 18 to 45 years in two groups with polycystic ovary syndrome (n = 90) and healthy women (n = 90). First, the general demographic questionnaire and clinical signs of polycystic ovary syndrome were completed, then the Beck Depression Inventory was completed, blood samples were taken and serum adiponectin levels were measured using ELISA method and specialized kit with relevant specifications In inferential statistics, independent Mann-Whitney tests were used to analyze the research hypotheses using SPSS software version 16, it was shown that there is a weak and negative correlation between depression and adiponectin in women with polycystic ovary syndrome (PCOS), which is statistically significant (p = 0.016), there was no significant correlation between depression and adiponectin in healthy women (non-PCOS) (p = 0.470) and also the mean scores of variable depression score and adiponectin level in women with ovarian syndrome. There was a statistically significant difference between polycystic ovary and healthy women (p < 0001).complementary drug in the treatment of these patients by measuring adiponectin levels. Health sciences/Biomarkers Health sciences/Diseases Health sciences/Endocrinology Health sciences/Medical research Adiponectin Depression Polycystic Ovary Syndrome Figures Figure 1 Figure 2 Introduction Polycystic ovary syndrome (PCOS) is a multifaceted, polygenic pathology characterized by numerous signs and symptoms associated with dysfunction, endocrine and metabolic disorders [1]. PCOS includes genetic predisposition, increased insulin secretion, insulin resistance, obesity, and various environmental and chemical contaminations [2]. Obesity and insulin resistance are fundamental physiological features of PCOS patients. PCOS is a reproductive endocrine disorder that affects 5–10% of women of childbearing age. Hirsutism, acne, menstrual irregularities, and infertility are the most common problems in adults with PCOS. However, weight gain is considered the most worrisome symptom in adolescents and young women with PCOS [1]. The prevalence of PCOS has been estimated between 2.2% and 26% in different countries according to different population studies [3]. In the studies conducted in Iran, the prevalence of PCOS has been reported as 6.8% − 7.1% (NIH criteria), 19.5% − 14.6% (Rotterdam criteria) and 11.7% (AES criteria) [3,4]. Considering the importance of this disease on the fertility of Iranian women, plans should be made to diagnose this disease [5]. A recent study found that 56.9% of women with PCOS have at least one psychiatric disorder [6]. The main psychological and social consequences of PCOS are anxiety and depression, social problems, body image and weight, eating disorders, hirsutism, and decreased quality of life. Depression and anxiety are the most common psychiatric symptoms in PCOS [7]. Depression and psychological anxiety have been identified in women with PCOS due to physical symptoms of hyperandrogenism, including: Obesity, hirsutism, cystic acne, seborrhea, and hair loss can affect a woman's identity [1]. Depressive symptoms are a significant psychological problem in PCOS. Among women with PCOS, those who are heavier, have more children, and are less educated are at risk of mild to moderate depressive symptoms [8]. It is a state that affects our sense of health, thoughts, actions and emotions. Depression can produce many emotions such as fear, sadness, worry, disorder, and worthlessness. Depressed patients may lose activities they used to enjoy. Other symptoms include loss of appetite and weight gain, concentration problems, difficulty remembering details or making decisions, suicidal thoughts or decisions, insomnia, fatigue, excessive sleep, loss of energy, Pain, digestive problems, etc [9]. Among physical and mental illnesses, depression is a major problem worldwide and one of the most common mental illnesses, with an annual prevalence of 10–20% in the general population. 15% of the general population will experience a period of depression at some point in their lives [10]. It is estimated that by 2020, depression will be the second leading cause of disability [11]. Depression is one of the most common mental illnesses. Depression is her third health problem in the country, according to the National Survey of Illnesses and Injuries in Iran. The lowest and highest prevalence of depression in Iran varies between 14.29% and 45.7% [12]. The prevalence of depression in women with PCOS is high worldwide, varying between 28% and 64%, and is higher in Iran than in healthy individuals (non-PCOS) [13]. Material and methods Study design 180 women aged 18 to 45 with polycystic ovary syndrome and healthy (non-PCOS) referred to the women's clinic of Alborz Hospital in 2020–2021. This study was conducted after informed consent was obtained from available sampling among women of reproductive age between 18 and 45 years in two groups with polycystic ovary syndrome (90 people) and healthy (non-PCOS) women (90 people). First, general demographic questionnaire and clinical symptoms of polycystic ovary syndrome, then Beck depression questionnaire was completed. After these steps, a blood sample was taken and the amount of serum Adiponectin was measured using the ELISA method and a specialized kit with relevant specifications. Data collection tools include Plasma adiponectin diagnostic kit, The specific kit for human adiponectin, which is based on the ELISA method, was prepared by Behin Tashkhis Teb with the specifications of Elisa Kit 96t Zellbio, General demographic questionnaire, Beck depression questionnaire, second version, Table of clinical symptoms of polycystic ovary syndrome, Modified Freeman Galloway system to diagnose the severity of hirsutism, Visual analogue pain measure for the diagnosis of dysmenorrhea severity. the PCOS diagnostics criteria used in this study are listed in Table 1 . Table 1 presents the diagnostic criteria used for PCOS classification. Table 1 clinical symptoms of polycystic ovary syndrome NIH 1990 1 (1) Rotterdam 2003 2 (1,3) AES 2006 3 (2,3) Hyperandrogenism * * * Decreased or absent ovulation * * * or Polycystic ovary morphology * * 1 NIH: National Institutes of Health. 2 Rotterdam: ESHRE/ASRM-sponsored PCOS consensus workshop group. 3 AES: The Androgen Excess and PCOS Society To compare the average score of depression and adiponectin level in two groups, T-test was used when they were normal, otherwise Mann-Whitney U test was used. The chi-square test was used to compare the relationship between qualitative variables in two groups. To investigate the relationship between depression and adiponectin in each group, Pearson's or Sperman's correlation coefficient was used, and multiple regression method was used to analyze the relationship between individual characteristics and depression and adiponectin. After coding, raw data was collected by SPSS16 statistical software and analyzed using appropriate statistical tests. Results For inferential statistics, independent Mann-Whitney tests were used to analyze study hypotheses using SPSS version 16. Based on the results of Spearman's correlation coefficient test, a weak negative correlation was shown between depression and adiponectin in women with polycystic ovary syndrome (PCOS). This is statistically significant (p = 0.016). Spearman's correlation coefficient test results showed no significant correlation between depression and adiponectin in healthy women (non-PCOS) (p = 0.470), and variable depression scores in women with ovaries. Mean adiponectin levels are also shown syndrome. There was a statistically significant difference between polycystic ovaries and healthy women (p < 0.001). Table 2 Comparison of demographic variables of research samples in two groups of PCOS and non-PCOS Variable PCOC non-PCOS P-value Mean ± SD Mean ± SD age (years) 28.72 ± 5.62 33.40 ± 5.14 P < 0.001 * Marriage age (years) 21.24 ± 3.95 18.31 ± 4.37 P < 0.001 * puberty age (years) 12.90 ± 1.46 12.45 ± 1.21 P = 0.028 * Marriage duration (years) 8.4 ± 6.01 16.75 ± 5.82 P < 0.001 * Waist (cm) 85.06 ± 7.66 85.02 ± 6.31 P = 0.813 * Waist to hip percentage 0.812 ± 0.048 0.829 ± 6.31 P = 0.014 ⸶ * = Mann-Whitney test, ⸶= T-test The demographic characteristics of the participants in the two study groups are summarized in the Table 2 .Table 2 showed that the mean ± standard deviation of the age of people in the PCOS group was 28.72 ± 5.62 and in the non-PCOS group was 33.40 ± 5.14 years. Puberty age in PCOS group was 12.90 ± 1.46 years and in non-PCOS group it was 12.45 ± 1.21 years. Also, the duration of marriage was 8.40 ± 6.01 years in the PCOS group and 16.75 ± 5.82 years in the non-PCOS group. According to independent t-test and Mann-Whitney, there was a statistically significant difference between the two groups in terms of women's age, age of marriage and age of puberty and duration of marriage, and the percentage of waist to hip circumference, and the two groups were not homogeneous. 159 of the 180 women participating in the study were married. Table 3 Clinical variables of research samples in women with polycystic ovary syndrome Variable Mean ± SD Modified hirsutism score 11.15 ± 2.21 Iranian hirsutism score 6.73 ± 2.14 Adiponectin hormone levels (µg/ml) 12.75 ± 4.63 Period interval to next period (days) 71.66 ± 44.78 Duration of menstrual bleeding (days) 7.18 ± 2.02 Bleeding volume (number of pads used monthly) 15.40 ± 6.46 Table 3 displays clinical characteristics among women with polycystic ovary syndrome, including hirsutism scores, adiponectin levels ,and menstrual data. Table 3 showed that the mean ± standard deviation of Iranian modified hirsutism score of women with polycystic ovary syndrome was 11.15 ± 2.21 and 6.73 ± 2.14, respectively. On average, the interval between the period and the next period, the duration of menstrual bleeding was on average 71.66 and 7.18 days. 70 people (77.8%) of women with polycystic ovary syndrome had menstrual disorders and 20 people (22.2%) did not have menstrual disorders. Also, in terms of spotting status, 26 people (28.9%) had spotting and 64 (71.1%) women did not have spotting. Table 4 Variable comparison of Adiponectin level in two groups of depressed and non-depressed people Variable PCOS p-value depressed non-depressed Mean ± SD Mean ± SD Adiponectin levels 12.03 ± 4.20 14.12 ± 5.14 P = 0.042 ⸶ Variable non-PCOS p-value depressed non-depressed Mean ± SD Mean ± SD Adiponectin levels 9.73 ± 6.03 14.85 ± 4.14 P = 0.001 ⸶ ⸶= T test Table 4 presents a comparasion of adiponectin levels between depressed and non_depressed individuals in both the PCOS and non_PCOS groups.The results of Table 4 showed that the average variable score of Adiponectin level in two groups of depressed and non-depressed people among women with polycystic ovary syndrome had a statistically significant difference. It also showed that the mean variable score of Adiponectin level in two groups of depressed and non-depressed people among healthy women (non-PCOS) had a statistically significant difference. Table 5 Comparison of variables of adiponectin level and depression and overweight based on BMI in women with polycystic ovary syndrome Variable Overweight according to BMI P value Yes No Mean ± SD Mean ± SD Depression 22.44 ± 12.21 13.66 ± 8.55 P = 0.001 ⸶ Adiponectin levels 12.46 ± 4.70 13.42 ± 4.47 P = 0.373 ⸶ ⸶= T test Table 5 compares depression scores and adiponectin levels in overweight versus non_overweight women with PCOS.The results of Table 5 showed that the average score of adiponectin level variables among women with polycystic ovary syndrome who are overweight or not had no statistically significant difference. On the other hand, there was a statistically significant difference in the depression variable among women with polycystic ovary syndrome who are overweight or not, so that the average score of depression in women who are overweight [22,24] is higher than It is women who are not overweight [13]. Discussion Polycystic ovary syndrome is a common endocrine disorder that occurs in women of reproductive age. This disease manifests as a wide range of symptoms including hirsutism, amenorrhea, oligomenorrhea, obesity, acne vulgaris, infertility, alopecia, and insulin resistance. The incidence of depression in the PCOS population is increasing compared to the general population. Increased depression in PCOS significantly changes the quality of life (QOL) of affected women. Also, self-esteem is low in depression and PCOS. Decreased self-esteem in such patients can be largely attributed to related factors such as obesity, acne, androgenic alopecia and hirsutism [14]. The mechanism of adiponectin production and secretion Adiponectin extravasation into the circulation shown in Fig. 1. Adiponectin is a protein with 244 amino acids that is encoded by the Adipo Q gene located on chromosome Cq27 [19]. Adiponectin with a high molecular weight is the main and dominant form in the blood circulation. Adiponectin in the blood circulation is approximately one hundred percent of all plasma proteins, its serum level is 2–20 micrograms per milliliter and in some studies 30 micrograms per milliliter. The half-life of adiponectin in humans is 2.5 hours. be Its signaling is through three separate receptors called AdipoQ1, AdipoQ2 and T-cadherin [19]. Biosynthesis and secretion of adiponectin in fat cells is controlled by ERP44, Lα-Ero1 and DSbA-L molecules in the endoplasmic reticulum [20]. ERP44 inhibits the secretion of high molecular weight adiponectin from the endoplasmic reticulum [20]. In contrast, Lα-Ero1 releases adiponectin, which is inhibited by ERP44, and L-DsbA also increases the intracellular formation of HMV adiponectin and its secretion [21]. Adiponectin has two receptors that are expressed in almost all body tissues, but their expression varies in different tissues. Adipo1 is expressed in the liver and mainly in skeletal muscles, while Adipo2 is expressed in skeletal muscles and abundantly in the liver. Like the other two receptors, T-cadherin is expressed in all parts of the body except the liver, but it is abundant in the cardiovascular system [22]. (see Fig. 1) (see Fig. 2) Effects of adiponectin on insulin sensitivity Adiponectin can activate AMPK and PPARα in liver and skeletal muscle. The effects of adiponectin on insulin action in liver and muscle are shown in Fig. 2. In skeletal muscle, globular and full-length adiponectin activates AMPK, thereby stimulating ACC phosphorylation, fatty acid oxidation, and glucose uptake. Adiponectin activates PPARα, thereby stimulating fatty acid oxidation and reducing tissue TG content in muscle. In the liver, only full-length adiponectin activates AMPK, thereby reducing molecules involved in gluconeogenesis and increasing ACC phosphorylation and fatty acid oxidation. Adiponectin activates PPARα, thereby stimulating fatty acid oxidation and reducing tissue TG content in the liver [23]. (see Fig. 2) In a study conducted by Hu et al. (2014) in China, it was found that there is a relationship between the decrease in adiponectin levels and depression in the European population [9]. In study by [15]. (2019) in Taiwan, they concluded that the chance of depression in the PCOS group was higher than in the comparison group [15]. In a study conducted by [16]. (2015) in Pakistan, it showed that women with a family history of polycystic ovary syndrome were significantly more susceptible to this syndrome [16]. al-Faqi et al (2018) showed that the serum levels of adiponectin in PCOS women were significantly lower compared to women with normal menstruation. The findings indicated that polycystic ovary syndrome is independent of age and body mass index with low levels. Serum adiponectin is related [17]. The results of Chen et al.'s (2013) study in China indicate that adipose tissue insufficiency and dysregulation of adipokine expression, including adiponectin, play an important role in the pathophysiology of PCOS and ovulation. Finally, they concluded that the level of serum adiponectin decreases in people with PCOS compared to healthy people (non-PCOS) [18]. According to the previous studies and the present study, it was shown that adiponectin probably plays a role in PCOS, and probably by controlling and regulating this hormone in the body, it is possible to help treat people with PCOS or prevent it, and the economic burden on reduced family and community. Considering the effects of adiponectin on insulin sensitivity and its lower level in obesity and that the amount of adiponectin is reduced by testosterone, it seems reasonable to assume that the level of adiponectin is lower in women with PCOS. What is important in obtaining these results is to consider that depression does not occur directly in patients with polycystic ovary syndrome, but it occurs due to changes in adiponectin (an inflammatory marker) in these patients. According to the data obtained in this research, tracking the common relationship between depression and PCOS helps to find potential drug treatments and improve the quality of life of women suffering from PCOS depression. Conclusion In conclusion, our findings indicate a statistically significant inverse association between serum adiponectin levels and depression scores among women with PCOS. This relationship was not observed in healthy controls, suggesting a potential pathophysiological link between metabolic and psychological aspects of PCOS. Adiponectin may serve as a promising biomarker for identifying women with PCOS at higher risk for depression, thereby guiding integrated management strategies. Further longitudinal and interventional studies are needed to confirm these associations and explore the mechanistic pathways involved. Declarations Data availability The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request but we do not have the link to the data availability statements page. Acknowledgment: The present study is the result of a dissertation for a master's degree in midwifery approved by the Tarbiat Modares University with an ethics code of IR.MODARES.REC.1398.152, approved. The author would like to thank and appreciate all the professors and research vice counselor of the Tarbiat Modares University, the officials at Alborz hospital maternity ward, and dear women who participated in this study. Funding None. Contributions El. Ka, and Na.Te, contributed to the conception and design of the study; Za.Adj contributed to clinical sampelling and An.Ka, performed the statistical analysis; El. Ka, and Na.Te, contributed to the wrote of the first draft of the manuscript. All authors contributed to the manuscript revision and read and approved the submitted version. Corresponding author Ethics declarations Competing interests The authors declare no competing interests. The study protocol was approved by the Ethics Committee of Tarbiat Modares University (code: IR.MODARES.REC.1398.152). All procedures were in accordance with the ethical standards of the Regional Research Committee and with the Declaration of Helsinki 1964 and its later amendments. After explaining the study’s purposes, informed written consent and verbal assent were obtained from all participants. They were informed that their participation was voluntary, confidential and anonymous, and that they had the right to withdraw from the research at any time. References Subhalakshmi TVarghese PJJIjopm. A cross-sectional study on the proportion of anxiety and depression and determinants of quality of life in polycystic ovarian disease. 2018;40(3):257. Ramezani Tehrani FSimbar MTehran MAli R Jijoe EMetabolism. Concerns of women with polycystic ovary syndrome: A qualitative study. 2013;15(1):41-51. Kiani F[5][5]Khodaee ZAkbari MJIjorm. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis. 2015;13(10):591. Simbar MTohidi MHosseinpanah F[7]Endocrinology. The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. 2011;9(1):39. Kiani F[5]Maleki FAhmadi MShohani M,. Prevalence Of Polycystic Ovary Syndrome In Iranian Women: A Systematic Review and Meta-analysis. 2014. IJOGIVol. 17No. 115pp. 11-21, Hu LYTsai SJYang ACHuang MWChen PMet al. Risk of psychiatric disorders following polycystic ovary syndrome: a nationwide population-based cohort study. PloS one. 2014;9(5):e97041. Elyasi FJIJoPSciences B. Psychosomatic Aspects of Polycystic Ovarian Syndrome: A Review. 2017;11(2). Talbott EOSong MKBromberger JWilson J. Associations between psychologic symptoms and life satisfaction in women with polycystic ovary syndrome. Journal of women's health (2002). 2012;21(2):179-87. [18]et al. Association of serum adiponectin with depression and metabolic parameters in women with polycystic ovary syndrome. BMC Women's Health. 2023;23(1):123. https://doi.org/10.1186/s12905-023-02465-1 Ebrahimi AOmidi RHedayati ARanjbar HHosseinpour SJPSJ. Depressionanxietystress and related demographic variables in nurses of Valiasr hospital in Fasa University of Medical Sciences in 2014. 2015;13(4):51-9. Moradi Aet al. The role of adiponectin in mental health and metabolic disorders: A comprehensive review. Psychiatry Res. 2022;315:114746. https://doi.org/10.1016/j.psychres.2022.114746 Mousavi SJOmidvari STavousi MHashemi ARostami T. Depression in Iran: a systematic review of the literature (2000-2010). Payesh 2013; 12 (6) :567-594 URL: Roy Set al. Prevalence and correlates of psychiatric disorders among women with polycystic ovary syndrome: A systematic review and meta-analysis. Sci Rep. 2023;13:12234. https://doi.org/10.1038/s41598-023-32620-9 Chhipa ASButani SChavda VPatel SSJRS. PCOS and Depression: Common Links and Potential Targets. 2021:1-18. Chen WWang J-HLin S-ZDing D-CJHR. Association between depression risk and polycystic ovarian syndrome in young women: a retrospective nationwide population-based cohort study (1998–2013). 2019;34(9):1830-7. Shafique KShaikh ARKhan NAAnwar Qureshi M. Association between circulating adiponectin levels and polycystic ovarian syndrome. Journal of Ovarian Research. 2014;7:18. Khader YSAl-Dwairi ANAlzoubi AAl-Shboul OHatim AJKjofm. Lower levels of serum adiponectin and the T allele of rs1501299 of the ADIPOQ gene are protective against polycystic ovarian syndrome in Jordan. 2018;39(2):108. et al. Adiponectin as a potential biomarker for polycystic ovary syndrome: a meta-analysis. Reprod Biol Endocrinol. 2023;21(1):45. https://doi.org/10.1186/s12958-023-01057-3 Kanety HPariente CHemi RWiser ASchiff Eet al. Maternal serum adiponectin levels during human pregnancy. 2007;27(2):77-81. Prasad NRet al. Adiponectin and inflammation: Insights for managing PCOS. J Endocrinol Invest. 2022;45(3):527–535. https://doi.org/10.1007/s40618-021-01606-w Wang HFarmer SRJMbiology c. Adiponectin secretion is regulated by SIRT1 and the endoplasmic reticulum oxidoreductase Ero1-Lα. 2007;27(13):4698- 07. Bashtrykov PIvanov DIuG AIl'inskaia OTararak Eet al. Expression of T-cadherin in the rat carotid artery wall after balloon injury and in different rat organs. 2002;44(3):285-95. Yamauchi TJEr. Adiponectin and adiponectin receptors. 2005;26(3):439-51 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7029787","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":519822935,"identity":"54b2c892-7e1e-471e-a3f2-831d1dbc28a0","order_by":0,"name":"Elaheh Kamarei","email":"","orcid":"","institution":"Tarbiat Modares University","correspondingAuthor":false,"prefix":"","firstName":"Elaheh","middleName":"","lastName":"Kamarei","suffix":""},{"id":519822937,"identity":"1d8349c7-23a1-4073-8ac9-61f2a1ffc3f9","order_by":1,"name":"Najmeh 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01:18:09","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":71863,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7029787/v1/443c880fb65e4cb3614b7d0f.html"},{"id":92681668,"identity":"1e2d00a5-8e2e-4850-8cf7-1824e8c82665","added_by":"auto","created_at":"2025-10-03 01:10:09","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":34248,"visible":true,"origin":"","legend":"\u003cp\u003eAdiponectin extravasation into the circulation\u003cem\u003eA\u003c/em\u003e: paracellular and transcellular movement. \u003cem\u003eB\u003c/em\u003e: adiponectin extravasation from circulation into interstitial space on target tissue. Process mediated through paracellular movement across the endothelium. Decreased tightness of junctions allows higher amounts of fulllength adiponectin extravasation into the interstitial space [Figure 1]. This figure was created using Servier Medical Art (available at https://smart.servier.com/) and PAGES software.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7029787/v1/35ef84973e27e6efc7851014.jpeg"},{"id":92681663,"identity":"11e03aec-a513-45c0-90a7-838353cc3af5","added_by":"auto","created_at":"2025-10-03 01:10:09","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":42341,"visible":true,"origin":"","legend":"\u003cp\u003eEffects of adiponectin on insulin sensitivity\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7029787/v1/9e36ae91af81b8cc8ebb5e41.jpeg"},{"id":92682553,"identity":"9cdd1054-9e3a-41ed-b6a6-c70113644d3f","added_by":"auto","created_at":"2025-10-03 01:18:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":655044,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7029787/v1/96783a39-e1b5-4cfb-bcb4-112a7cb99d3e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Determining the relationship between depression and adiponectin levels in women with polycystic ovary syndrome and healthy","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePolycystic ovary syndrome (PCOS) is a multifaceted, polygenic pathology characterized by numerous signs and symptoms associated with dysfunction, endocrine and metabolic disorders [1]. PCOS includes genetic predisposition, increased insulin secretion, insulin resistance, obesity, and various environmental and chemical contaminations [2]. Obesity and insulin resistance are fundamental physiological features of PCOS patients. PCOS is a reproductive endocrine disorder that affects 5\u0026ndash;10% of women of childbearing age. Hirsutism, acne, menstrual irregularities, and infertility are the most common problems in adults with PCOS. However, weight gain is considered the most worrisome symptom in adolescents and young women with PCOS [1].\u003c/p\u003e\u003cp\u003eThe prevalence of PCOS has been estimated between 2.2% and 26% in different countries according to different population studies [3]. In the studies conducted in Iran, the prevalence of PCOS has been reported as 6.8% \u0026minus;\u0026thinsp;7.1% (NIH criteria), 19.5% \u0026minus;\u0026thinsp;14.6% (Rotterdam criteria) and 11.7% (AES criteria) [3,4]. Considering the importance of this disease on the fertility of Iranian women, plans should be made to diagnose this disease [5]. A recent study found that 56.9% of women with PCOS have at least one psychiatric disorder [6]. The main psychological and social consequences of PCOS are anxiety and depression, social problems, body image and weight, eating disorders, hirsutism, and decreased quality of life. Depression and anxiety are the most common psychiatric symptoms in PCOS [7]. Depression and psychological anxiety have been identified in women with PCOS due to physical symptoms of hyperandrogenism, including: Obesity, hirsutism, cystic acne, seborrhea, and hair loss can affect a woman's identity [1].\u003c/p\u003e\u003cp\u003eDepressive symptoms are a significant psychological problem in PCOS. Among women with PCOS, those who are heavier, have more children, and are less educated are at risk of mild to moderate depressive symptoms [8]. It is a state that affects our sense of health, thoughts, actions and emotions. Depression can produce many emotions such as fear, sadness, worry, disorder, and worthlessness. Depressed patients may lose activities they used to enjoy. Other symptoms include loss of appetite and weight gain, concentration problems, difficulty remembering details or making decisions, suicidal thoughts or decisions, insomnia, fatigue, excessive sleep, loss of energy, Pain, digestive problems, etc [9].\u003c/p\u003e\u003cp\u003eAmong physical and mental illnesses, depression is a major problem worldwide and one of the most common mental illnesses, with an annual prevalence of 10\u0026ndash;20% in the general population. 15% of the general population will experience a period of depression at some point in their lives [10]. It is estimated that by 2020, depression will be the second leading cause of disability [11]. Depression is one of the most common mental illnesses. Depression is her third health problem in the country, according to the National Survey of Illnesses and Injuries in Iran. The lowest and highest prevalence of depression in Iran varies between 14.29% and 45.7% [12]. The prevalence of depression in women with PCOS is high worldwide, varying between 28% and 64%, and is higher in Iran than in healthy individuals (non-PCOS) [13].\u003c/p\u003e"},{"header":"Material and methods","content":"\u003cp\u003e\u003cb\u003eStudy design\u003c/b\u003e\u003c/p\u003e\u003cp\u003e180 women aged 18 to 45 with polycystic ovary syndrome and healthy (non-PCOS) referred to the women's clinic of Alborz Hospital in 2020\u0026ndash;2021. This study was conducted after informed consent was obtained from available sampling among women of reproductive age between 18 and 45 years in two groups with polycystic ovary syndrome (90 people) and healthy (non-PCOS) women (90 people). First, general demographic questionnaire and clinical symptoms of polycystic ovary syndrome, then Beck depression questionnaire was completed. After these steps, a blood sample was taken and the amount of serum Adiponectin was measured using the ELISA method and a specialized kit with relevant specifications.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData collection tools include\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePlasma adiponectin diagnostic kit, The specific kit for human adiponectin, which is based on the ELISA method, was prepared by Behin Tashkhis Teb with the specifications of Elisa Kit 96t Zellbio, General demographic questionnaire, Beck depression questionnaire, second version, Table of clinical symptoms of polycystic ovary syndrome, Modified Freeman Galloway system to diagnose the severity of hirsutism, Visual analogue pain measure for the diagnosis of dysmenorrhea severity. the PCOS diagnostics criteria used in this study are listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the diagnostic criteria used for PCOS classification.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eclinical symptoms of polycystic ovary syndrome\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNIH 1990\u003csup\u003e1\u003c/sup\u003e (1)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRotterdam 2003\u003csup\u003e2\u003c/sup\u003e (1,3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAES 2006\u003csup\u003e3\u003c/sup\u003e (2,3)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHyperandrogenism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDecreased or absent ovulation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e* or\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePolycystic ovary morphology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e1\u003c/sup\u003eNIH: National Institutes of Health. \u003csup\u003e2\u003c/sup\u003eRotterdam: ESHRE/ASRM-sponsored PCOS consensus workshop group. \u003csup\u003e3\u003c/sup\u003eAES: The Androgen Excess and PCOS Society\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTo compare the average score of depression and adiponectin level in two groups, T-test was used when they were normal, otherwise Mann-Whitney U test was used. The chi-square test was used to compare the relationship between qualitative variables in two groups. To investigate the relationship between depression and adiponectin in each group, Pearson's or Sperman's correlation coefficient was used, and multiple regression method was used to analyze the relationship between individual characteristics and depression and adiponectin. After coding, raw data was collected by SPSS16 statistical software and analyzed using appropriate statistical tests.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eFor inferential statistics, independent Mann-Whitney tests were used to analyze study hypotheses using SPSS version 16. Based on the results of Spearman's correlation coefficient test, a weak negative correlation was shown between depression and adiponectin in women with polycystic ovary syndrome (PCOS). This is statistically significant (p\u0026thinsp;=\u0026thinsp;0.016). Spearman's correlation coefficient test results showed no significant correlation between depression and adiponectin in healthy women (non-PCOS) (p\u0026thinsp;=\u0026thinsp;0.470), and variable depression scores in women with ovaries. Mean adiponectin levels are also shown syndrome. There was a statistically significant difference between polycystic ovaries and healthy women (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of demographic variables of research samples in two groups of PCOS and non-PCOS\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePCOC\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003enon-PCOS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eage (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e28.72\u0026thinsp;\u0026plusmn;\u0026thinsp;5.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e33.40\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarriage age (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e21.24\u0026thinsp;\u0026plusmn;\u0026thinsp;3.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e18.31\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003epuberty age (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e12.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e12.45\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.028\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarriage duration (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8.4\u0026thinsp;\u0026plusmn;\u0026thinsp;6.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e16.75\u0026thinsp;\u0026plusmn;\u0026thinsp;5.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWaist (cm)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e85.06\u0026thinsp;\u0026plusmn;\u0026thinsp;7.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e85.02\u0026thinsp;\u0026plusmn;\u0026thinsp;6.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.813\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWaist to hip percentage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e0.812\u0026thinsp;\u0026plusmn;\u0026thinsp;0.048\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e0.829\u0026thinsp;\u0026plusmn;\u0026thinsp;6.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.014\u003csup\u003e⸶\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e* = Mann-Whitney test, ⸶= T-test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe demographic characteristics of the participants in the two study groups are summarized in the Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e showed that the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation of the age of people in the PCOS group was 28.72\u0026thinsp;\u0026plusmn;\u0026thinsp;5.62 and in the non-PCOS group was 33.40\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14 years. Puberty age in PCOS group was 12.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.46 years and in non-PCOS group it was 12.45\u0026thinsp;\u0026plusmn;\u0026thinsp;1.21 years. Also, the duration of marriage was 8.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.01 years in the PCOS group and 16.75\u0026thinsp;\u0026plusmn;\u0026thinsp;5.82 years in the non-PCOS group. According to independent t-test and Mann-Whitney, there was a statistically significant difference between the two groups in terms of women's age, age of marriage and age of puberty and duration of marriage, and the percentage of waist to hip circumference, and the two groups were not homogeneous. 159 of the 180 women participating in the study were married.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eClinical variables of research samples in women with polycystic ovary syndrome\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModified hirsutism score\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e11.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.21\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIranian hirsutism score\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdiponectin hormone levels (\u0026micro;g/ml)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e12.75\u0026thinsp;\u0026plusmn;\u0026thinsp;4.63\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePeriod interval to next period (days)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e71.66\u0026thinsp;\u0026plusmn;\u0026thinsp;44.78\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of menstrual bleeding (days)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7.18\u0026thinsp;\u0026plusmn;\u0026thinsp;2.02\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBleeding volume (number of pads used monthly)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e15.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.46\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e displays clinical characteristics among women with polycystic ovary syndrome, including hirsutism scores, adiponectin levels ,and menstrual data. Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e showed that the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation of Iranian modified hirsutism score of women with polycystic ovary syndrome was 11.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.21 and 6.73\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14, respectively. On average, the interval between the period and the next period, the duration of menstrual bleeding was on average 71.66 and 7.18 days. 70 people (77.8%) of women with polycystic ovary syndrome had menstrual disorders and 20 people (22.2%) did not have menstrual disorders. Also, in terms of spotting status, 26 people (28.9%) had spotting and 64 (71.1%) women did not have spotting.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eVariable comparison of Adiponectin level in two groups of depressed and non-depressed people\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003ePCOS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003edepressed\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003enon-depressed\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdiponectin levels\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12.03\u0026thinsp;\u0026plusmn;\u0026thinsp;4.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.12\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.042\u003csup\u003e⸶\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e\u003cb\u003enon-PCOS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003edepressed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003enon-depressed\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdiponectin levels\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9.73\u0026thinsp;\u0026plusmn;\u0026thinsp;6.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.85\u0026thinsp;\u0026plusmn;\u0026thinsp;4.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.001\u003csup\u003e⸶\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e⸶= T test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents a comparasion of adiponectin levels between depressed and non_depressed individuals in both the PCOS and non_PCOS groups.The results of Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e showed that the average variable score of Adiponectin level in two groups of depressed and non-depressed people among women with polycystic ovary syndrome had a statistically significant difference. It also showed that the mean variable score of Adiponectin level in two groups of depressed and non-depressed people among healthy women (non-PCOS) had a statistically significant difference.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of variables of adiponectin level and depression and overweight based on BMI in women with polycystic ovary syndrome\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eOverweight according to BMI\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDepression\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e22.44\u0026thinsp;\u0026plusmn;\u0026thinsp;12.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e13.66\u0026thinsp;\u0026plusmn;\u0026thinsp;8.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.001\u003csup\u003e⸶\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAdiponectin levels\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e12.46\u0026thinsp;\u0026plusmn;\u0026thinsp;4.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e13.42\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.373\u003csup\u003e⸶\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e⸶= T test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e compares depression scores and adiponectin levels in overweight versus non_overweight women with PCOS.The results of Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e showed that the average score of adiponectin level variables among women with polycystic ovary syndrome who are overweight or not had no statistically significant difference. On the other hand, there was a statistically significant difference in the depression variable among women with polycystic ovary syndrome who are overweight or not, so that the average score of depression in women who are overweight [22,24] is higher than It is women who are not overweight [13].\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003ePolycystic ovary syndrome is a common endocrine disorder that occurs in women of reproductive age. This disease manifests as a wide range of symptoms including hirsutism, amenorrhea, oligomenorrhea, obesity, acne vulgaris, infertility, alopecia, and insulin resistance. The incidence of depression in the PCOS population is increasing compared to the general population. Increased depression in PCOS significantly changes the quality of life (QOL) of affected women. Also, self-esteem is low in depression and PCOS. Decreased self-esteem in such patients can be largely attributed to related factors such as obesity, acne, androgenic alopecia and hirsutism [14].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe mechanism of adiponectin production and secretion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdiponectin extravasation into the circulation shown in Fig. 1. Adiponectin is a protein with 244 amino acids that is encoded by the \u003cem\u003eAdipo\u003c/em\u003eQ gene located on chromosome Cq27 [19]. Adiponectin with a high molecular weight is the main and dominant form in the blood circulation. Adiponectin in the blood circulation is approximately one hundred percent of all plasma proteins, its serum level is 2\u0026ndash;20 micrograms per milliliter and in some studies 30 micrograms per milliliter. The half-life of adiponectin in humans is 2.5 hours. be Its signaling is through three separate receptors called AdipoQ1, AdipoQ2 and T-cadherin [19]. Biosynthesis and secretion of adiponectin in fat cells is controlled by ERP44, L\u0026alpha;-Ero1 and DSbA-L molecules in the endoplasmic reticulum [20]. ERP44 inhibits the secretion of high molecular weight adiponectin from the endoplasmic reticulum [20]. In contrast, L\u0026alpha;-Ero1 releases adiponectin, which is inhibited by ERP44, and L-DsbA also increases the intracellular formation of HMV adiponectin and its secretion [21].\u003c/p\u003e\n\u003cp\u003eAdiponectin has two receptors that are expressed in almost all body tissues, but their expression varies in different tissues. Adipo1 is expressed in the liver and mainly in skeletal muscles, while Adipo2 is expressed in skeletal muscles and abundantly in the liver. Like the other two receptors, T-cadherin is expressed in all parts of the body except the liver, but it is abundant in the cardiovascular system [22].\u003c/p\u003e\n\u003cp\u003e(see Fig. 1)\u003c/p\u003e\n\u003cp\u003e(see Fig.\u0026nbsp;2)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEffects of adiponectin on insulin sensitivity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdiponectin can activate AMPK and PPAR\u0026alpha; in liver and skeletal muscle.\u003c/p\u003e\n\u003cp\u003eThe effects of adiponectin on insulin action in liver and muscle are shown in Fig.\u0026nbsp;2. In skeletal muscle, globular and full-length adiponectin activates AMPK, thereby stimulating ACC phosphorylation, fatty acid oxidation, and glucose uptake. Adiponectin activates PPAR\u0026alpha;, thereby stimulating fatty acid oxidation and reducing tissue TG content in muscle. In the liver, only full-length adiponectin activates AMPK, thereby reducing molecules involved in gluconeogenesis and increasing ACC phosphorylation and fatty acid oxidation. Adiponectin activates PPAR\u0026alpha;, thereby stimulating fatty acid oxidation and reducing tissue TG content in the liver [23].\u003c/p\u003e\n\u003cp\u003e(see Fig. 2)\u003c/p\u003e\n\u003cp\u003eIn a study conducted by Hu et al. (2014) in China, it was found that there is a relationship between the decrease in adiponectin levels and depression in the European population [9]. In study by [15]. (2019) in Taiwan, they concluded that the chance of depression in the PCOS group was higher than in the comparison group [15]. In a study conducted by [16]. (2015) in Pakistan, it showed that women with a family history of polycystic ovary syndrome were significantly more susceptible to this syndrome [16]. al-Faqi et al (2018) showed that the serum levels of adiponectin in PCOS women were significantly lower compared to women with normal menstruation. The findings indicated that polycystic ovary syndrome is independent of age and body mass index with low levels. Serum adiponectin is related [17]. The results of Chen et al.\u0026apos;s (2013) study in China indicate that adipose tissue insufficiency and dysregulation of adipokine expression, including adiponectin, play an important role in the pathophysiology of PCOS and ovulation. Finally, they concluded that the level of serum adiponectin decreases in people with PCOS compared to healthy people (non-PCOS) [18].\u003c/p\u003e\n\u003cp\u003eAccording to the previous studies and the present study, it was shown that adiponectin probably plays a role in PCOS, and probably by controlling and regulating this hormone in the body, it is possible to help treat people with PCOS or prevent it, and the economic burden on reduced family and community. Considering the effects of adiponectin on insulin sensitivity and its lower level in obesity and that the amount of adiponectin is reduced by testosterone, it seems reasonable to assume that the level of adiponectin is lower in women with PCOS. What is important in obtaining these results is to consider that depression does not occur directly in patients with polycystic ovary syndrome, but it occurs due to changes in adiponectin (an inflammatory marker) in these patients. According to the data obtained in this research, tracking the common relationship between depression and PCOS helps to find potential drug treatments and improve the quality of life of women suffering from PCOS depression.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, our findings indicate a statistically significant inverse association between serum adiponectin levels and depression scores among women with PCOS. This relationship was not observed in healthy controls, suggesting a potential pathophysiological link between metabolic and psychological aspects of PCOS. Adiponectin may serve as a promising biomarker for identifying women with PCOS at higher risk for depression, thereby guiding integrated management strategies. Further longitudinal and interventional studies are needed to confirm these associations and explore the mechanistic pathways involved.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request but we do not have the link to the data availability statements page.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study is the result of a dissertation for a master\u0026apos;s degree in midwifery approved by the Tarbiat Modares University with an ethics code of IR.MODARES.REC.1398.152, approved. The author would like to thank and appreciate all the professors and research vice counselor of the Tarbiat Modares University, the officials at Alborz hospital maternity ward, and dear women who participated in this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEl. Ka, and Na.Te, contributed to the conception and design of the study; Za.Adj contributed to clinical sampelling and An.Ka, performed the statistical analysis; El. Ka, and Na.Te, contributed to the wrote of the first draft of the manuscript. All authors contributed to the manuscript revision and read and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by the Ethics Committee of Tarbiat Modares University (code: IR.MODARES.REC.1398.152). All procedures were in accordance with the ethical standards of the Regional Research Committee and with the Declaration of Helsinki 1964 and its later amendments. After explaining the study\u0026rsquo;s purposes, informed written consent and verbal assent were obtained from all participants. They were informed that their participation was voluntary, confidential and anonymous, and that they had the right to withdraw from the research at any time.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSubhalakshmi TVarghese PJJIjopm. A cross-sectional study on the proportion of anxiety and depression and determinants of quality of life in polycystic ovarian disease. 2018;40(3):257.\u003c/li\u003e\n\u003cli\u003eRamezani Tehrani FSimbar MTehran MAli R Jijoe EMetabolism. Concerns of women with polycystic ovary syndrome: A qualitative study. 2013;15(1):41-51.\u003c/li\u003e\n\u003cli\u003eKiani F[5][5]Khodaee ZAkbari MJIjorm. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis. 2015;13(10):591.\u003c/li\u003e\n\u003cli\u003eSimbar MTohidi MHosseinpanah F[7]Endocrinology. The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. 2011;9(1):39.\u003c/li\u003e\n\u003cli\u003eKiani F[5]Maleki FAhmadi MShohani M,. Prevalence Of Polycystic Ovary Syndrome In Iranian Women: A Systematic Review and Meta-analysis. 2014. IJOGIVol. 17No. 115pp. 11-21,\u003c/li\u003e\n\u003cli\u003eHu LYTsai SJYang ACHuang MWChen PMet al. Risk of psychiatric disorders following polycystic ovary syndrome: a nationwide population-based cohort study. PloS one. 2014;9(5):e97041.\u003c/li\u003e\n\u003cli\u003eElyasi FJIJoPSciences B. Psychosomatic Aspects of Polycystic Ovarian Syndrome: A Review. 2017;11(2).\u003c/li\u003e\n\u003cli\u003eTalbott EOSong MKBromberger JWilson J. Associations between psychologic symptoms and life satisfaction in women with polycystic ovary syndrome. Journal of women\u0026apos;s health (2002). 2012;21(2):179-87.\u003c/li\u003e\n\u003cli\u003e[18]et al. Association of serum adiponectin with depression and metabolic parameters in women with polycystic ovary syndrome. BMC Women\u0026apos;s Health. 2023;23(1):123. https://doi.org/10.1186/s12905-023-02465-1\u003c/li\u003e\n\u003cli\u003eEbrahimi AOmidi RHedayati ARanjbar HHosseinpour SJPSJ. Depressionanxietystress and related demographic variables in nurses of Valiasr hospital in Fasa University of Medical Sciences in 2014. 2015;13(4):51-9.\u003c/li\u003e\n\u003cli\u003eMoradi Aet al. The role of adiponectin in mental health and metabolic disorders: A comprehensive review. Psychiatry Res. 2022;315:114746. https://doi.org/10.1016/j.psychres.2022.114746\u003c/li\u003e\n\u003cli\u003eMousavi SJOmidvari STavousi MHashemi ARostami T. Depression in Iran: a systematic review of the literature (2000-2010). Payesh 2013; 12 (6) :567-594 URL:\u003c/li\u003e\n\u003cli\u003eRoy Set al. Prevalence and correlates of psychiatric disorders among women with polycystic ovary syndrome: A systematic review and meta-analysis. Sci Rep. 2023;13:12234. https://doi.org/10.1038/s41598-023-32620-9\u003c/li\u003e\n\u003cli\u003eChhipa ASButani SChavda VPatel SSJRS. PCOS and Depression: Common Links and Potential Targets. 2021:1-18.\u003c/li\u003e\n\u003cli\u003eChen WWang J-HLin S-ZDing D-CJHR. Association between depression risk and polycystic ovarian syndrome in young women: a retrospective nationwide population-based cohort study (1998\u0026ndash;2013). 2019;34(9):1830-7.\u003c/li\u003e\n\u003cli\u003eShafique KShaikh ARKhan NAAnwar Qureshi M. Association between circulating adiponectin levels and polycystic ovarian syndrome. Journal of Ovarian Research. 2014;7:18.\u003c/li\u003e\n\u003cli\u003eKhader YSAl-Dwairi ANAlzoubi AAl-Shboul OHatim AJKjofm. Lower levels of serum adiponectin and the T allele of rs1501299 of the ADIPOQ gene are protective against polycystic ovarian syndrome in Jordan. 2018;39(2):108.\u003c/li\u003e\n\u003cli\u003eet al. Adiponectin as a potential biomarker for polycystic ovary syndrome: a meta-analysis. Reprod Biol Endocrinol. 2023;21(1):45. https://doi.org/10.1186/s12958-023-01057-3\u003c/li\u003e\n\u003cli\u003eKanety HPariente CHemi RWiser ASchiff Eet al. Maternal serum adiponectin levels during human pregnancy. 2007;27(2):77-81.\u003c/li\u003e\n\u003cli\u003ePrasad NRet al. Adiponectin and inflammation: Insights for managing PCOS. J Endocrinol Invest. 2022;45(3):527\u0026ndash;535. https://doi.org/10.1007/s40618-021-01606-w\u003c/li\u003e\n\u003cli\u003eWang HFarmer SRJMbiology c. Adiponectin secretion is regulated by SIRT1 and the endoplasmic reticulum oxidoreductase Ero1-L\u0026alpha;. 2007;27(13):4698- 07.\u003c/li\u003e\n\u003cli\u003eBashtrykov PIvanov DIuG AIl\u0026apos;inskaia OTararak Eet al. Expression of T-cadherin in the rat carotid artery wall after balloon injury and in different rat organs. 2002;44(3):285-95.\u003c/li\u003e\n\u003cli\u003eYamauchi TJEr. Adiponectin and adiponectin receptors. 2005;26(3):439-51\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Adiponectin, Depression, Polycystic Ovary Syndrome","lastPublishedDoi":"10.21203/rs.3.rs-7029787/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7029787/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe aim of this study was to determine the relationship between depression and adiponectin levels in women with healthy polycystic ovary syndrome. This study was performed among women of reproductive age 18 to 45 years in two groups with polycystic ovary syndrome (n\u0026thinsp;=\u0026thinsp;90) and healthy women (n\u0026thinsp;=\u0026thinsp;90). First, the general demographic questionnaire and clinical signs of polycystic ovary syndrome were completed, then the Beck Depression Inventory was completed, blood samples were taken and serum adiponectin levels were measured using ELISA method and specialized kit with relevant specifications In inferential statistics, independent Mann-Whitney tests were used to analyze the research hypotheses using SPSS software version 16, it was shown that there is a weak and negative correlation between depression and adiponectin in women with polycystic ovary syndrome (PCOS), which is statistically significant (p\u0026thinsp;=\u0026thinsp;0.016), there was no significant correlation between depression and adiponectin in healthy women (non-PCOS) (p\u0026thinsp;=\u0026thinsp;0.470) and also the mean scores of variable depression score and adiponectin level in women with ovarian syndrome. There was a statistically significant difference between polycystic ovary and healthy women (p\u0026thinsp;\u0026lt;\u0026thinsp;0001).complementary drug in the treatment of these patients by measuring adiponectin levels.\u003c/p\u003e","manuscriptTitle":"Determining the relationship between depression and adiponectin levels in women with polycystic ovary syndrome and healthy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-03 01:10:04","doi":"10.21203/rs.3.rs-7029787/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-21T06:02:54+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-14T08:23:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89927867580878899067163973097412135667","date":"2025-10-21T16:32:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-05T17:02:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283699653742764704690491387920423998432","date":"2025-09-24T08:01:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-21T16:13:53+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-21T15:52:05+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-15T05:54:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-14T07:32:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-07-02T13:16:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bb0d3aad-f469-4201-882c-2c49c7247c5b","owner":[],"postedDate":"October 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[{"id":55245738,"name":"Health sciences/Biomarkers"},{"id":55245739,"name":"Health sciences/Diseases"},{"id":55245740,"name":"Health sciences/Endocrinology"},{"id":55245741,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-11-21T06:08:43+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-03 01:10:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7029787","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7029787","identity":"rs-7029787","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}