Skip to content
2000
image of Unraveling the Complexity of Polycystic Ovary Syndrome: Biomarkers for Diagnosis, Prognosis, and Treatment

Abstract

Polycystic ovary syndrome is distinguished by alterations in ovarian morphology, ovulatory failure, and increased androgen levels. The National Institutes of Health (NIH) defines it as ovulatory dysfunction accompanied by hyperandrogenism. Women with PCOS may have obesity, type 2 diabetes, anxiety, hypertension, insulin resistance, and pregnancy-related complications. PCOS is additionally linked with a greater chance of cardiovascular and metabolic disorders. Several factors, including LH/FSH ratio, FAI levels, and ovarian USG, should be considered when diagnosing PCOS. The Rotterdam criterion is employed to determine the condition when two of the three features are present and other etiologies are eliminated. Biomarkers have developed as a means of optimizing PCOS diagnosis and treatment results. This review has examined a number of biomarkers associated with PCOS, such as insulin, anti-Mullerian hormone, oxidative stress markers, inflammatory markers, and others. Controlling these disease-related markers may aid in lessening the symptoms of PCOS.

Loading

Article metrics loading...

/content/journals/cpd/10.2174/0113816128382284250822045319
2025-09-09
2026-02-27
Loading full text...

Full text loading...

References

  1. Xu Y. Qiao J. Association of insulin resistance and elevated androgen levels with polycystic ovarian syndrome (PCOS): A review of literature. J. Healthc. Eng. 2022 2022 1 1 13 10.1155/2022/9240569 35356614
    [Google Scholar]
  2. Rosenfield R.L. Ehrmann D.A. The pathogenesis of Polycystic Ovary Syndrome (PCOS): The hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr. Rev. 2016 37 5 467 520 10.1210/er.2015‑1104 27459230
    [Google Scholar]
  3. Kamenov Z. Gateva A. Inositols in PCOS. Molecules 2020 25 23 5566 10.3390/molecules25235566 33260918
    [Google Scholar]
  4. Crespo R.P. Bachega T.A.S.S. Mendonça B.B. Gomes L.G. An update of genetic basis of PCOS pathogenesis. Arch. Endocrinol. Metab. 2018 62 3 352 361 10.20945/2359‑3997000000049 29972435
    [Google Scholar]
  5. Rudnicka E. Suchta K. Grymowicz M. Chronic low grade inflammation in pathogenesis of PCOS. Int. J. Mol. Sci. 2021 22 7 3789 10.3390/ijms22073789 33917519
    [Google Scholar]
  6. Barber T.M. Franks S. Obesity and polycystic ovary syndrome. Clin. Endocrinol. (Oxf.) 2021 95 4 531 541 10.1111/cen.14421 33460482
    [Google Scholar]
  7. Hoeger K.M. Oberfield S.E. Do women with PCOS have a unique predisposition to obesity? Fertil. Steril. 2012 97 1 13 17 10.1016/j.fertnstert.2011.11.026 22192136
    [Google Scholar]
  8. Wang Z. Groen H. Cantineau A.E.P. Dietary intake, eating behavior, physical activity, and quality of life in infertile women with PCOS and obesity compared with non-PCOS obese controls. Nutrients 2021 13 10 3526 10.3390/nu13103526 34684528
    [Google Scholar]
  9. Osibogun O. Ogunmoroti O. Michos E.D. Polycystic ovary syndrome and cardiometabolic risk: Opportunities for cardiovascular disease prevention. Trends Cardiovasc. Med. 2020 30 7 399 404 10.1016/j.tcm.2019.08.010 31519403
    [Google Scholar]
  10. Diamanti-Kandarakis E. Papavassiliou A.G. Kandarakis S.A. Chrousos G.P. Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol. Metab. 2007 18 7 280 285 10.1016/j.tem.2007.07.004 17692530
    [Google Scholar]
  11. Wekker V. van Dammen L. Koning A. Long-term cardiometabolic disease risk in women with PCOS: A systematic review and meta-analysis. Hum. Reprod. Update 2020 26 6 942 960 10.1093/humupd/dmaa029 32995872
    [Google Scholar]
  12. Gomez J.M.D. VanHise K. Stachenfeld N. Chan J.L. Merz N.B. Shufelt C. Subclinical cardiovascular disease and polycystic ovary syndrome. Fertil. Steril. 2022 117 5 912 923 10.1016/j.fertnstert.2022.02.028 35512975
    [Google Scholar]
  13. Ollila M-M. Arffman R.K. Korhonen E. Women with PCOS have an increased risk for cardiovascular disease regardless of diagnostic criteria—a prospective population-based cohort study. Eur. J. Endocrinol. 2023 189 1 96 105 10.1093/ejendo/lvad077 37436934
    [Google Scholar]
  14. Patel S.S. Truong U. King M. Obese adolescents with polycystic ovarian syndrome have elevated cardiovascular disease risk markers. Vasc. Med. 2017 22 2 85 95 10.1177/1358863X16682107 28095749
    [Google Scholar]
  15. Chen T. Yu Y. Jia F. Luan P. Liu X. The relationship between polycystic ovary syndrome and insulin resistance from 1983 to 2022: A bibliometric analysis. Front. Public Health 2022 10 960965 10.3389/fpubh.2022.960965 35968428
    [Google Scholar]
  16. Luo Y. Cui C. Han X. Wang Q. Zhang C. The role of miRNAs in polycystic ovary syndrome with insulin resistance. J. Assist. Reprod. Genet. 2021 38 2 289 304 10.1007/s10815‑020‑02019‑7 33405004
    [Google Scholar]
  17. Stepto N.K. Hiam D. Gibson-Helm M. Exercise and insulin resistance in PCOS: muscle insulin signalling and fibrosis. Endocr. Connect. 2020 9 4 346 359 10.1530/EC‑19‑0551 32229703
    [Google Scholar]
  18. Li M. Chi X. Wang Y. Setrerrahmane S. Xie W. Xu H. Trends in insulin resistance: Insights into mechanisms and therapeutic strategy. Signal Transduct. Target. Ther. 2022 7 1 216 10.1038/s41392‑022‑01073‑0 35794109
    [Google Scholar]
  19. Batista T.M. Haider N. Kahn C.R. Defining the underlying defect in insulin action in type 2 diabetes. Diabetologia 2021 64 5 994 1006 10.1007/s00125‑021‑05415‑5 33730188
    [Google Scholar]
  20. Chang K.J. Chen J.H. Chen K.H. The pathophysiological mechanism and clinical treatment of polycystic ovary syndrome: A molecular and cellular review of the literature. Int. J. Mol. Sci. 2024 25 16 9037 10.3390/ijms25169037 39201722
    [Google Scholar]
  21. Rachdaoui N. Insulin: the friend and the foe in the development of type 2 diabetes mellitus. Int. J. Mol. Sci. 2020 21 5 1770 10.3390/ijms21051770 32150819
    [Google Scholar]
  22. Świderska E. Strycharz J. Wróblewski A. Szemraj J. Drzewoski J. Śliwińska A. Role of PI3K/AKT pathway in insulin-mediated glucose uptake. Blood glucose levels. Intechopen 2018 10.5772/intechopen.80402
    [Google Scholar]
  23. Khalid M. Alkaabi J. Khan M.A.B. Adem A. Insulin signal transduction perturbations in insulin resistance. Int. J. Mol. Sci. 2021 22 16 8590 10.3390/ijms22168590 34445300
    [Google Scholar]
  24. Akhtar A. Sah S.P. Insulin signaling pathway and related molecules: Role in neurodegeneration and Alzheimer’s disease. Neurochem. Int. 2020 135 104707 10.1016/j.neuint.2020.104707 32092326
    [Google Scholar]
  25. Silva Rosa S.C. Nayak N. Caymo A.M. Gordon J.W. Mechanisms of muscle insulin resistance and the cross‐talk with liver and adipose tissue. Physiol. Rep. 2020 8 19 e14607 10.14814/phy2.14607 33038072
    [Google Scholar]
  26. Calcaterra V. Verduci E. Cena H. Polycystic ovary syndrome in insulin-resistant adolescents with obesity: the role of nutrition therapy and food supplements as a strategy to protect fertility. Nutrients 2021 13 6 1848 10.3390/nu13061848 34071499
    [Google Scholar]
  27. Gangadharan C. Ahluwalia R. Sigamani A. Diabetes and COVID-19: Role of insulin resistance as a risk factor for COVID-19 severity. World J. Diabetes 2021 12 9 1550 1562 10.4239/wjd.v12.i9.1550 34630907
    [Google Scholar]
  28. Kostov K. Effects of magnesium deficiency on mechanisms of insulin resistance in type 2 diabetes: focusing on the processes of insulin secretion and signaling. Int. J. Mol. Sci. 2019 20 6 1351 10.3390/ijms20061351 30889804
    [Google Scholar]
  29. Tong Y. Xu S. Huang L. Chen C. Obesity and insulin resistance: Pathophysiology and treatment. Drug Discov. Today 2022 27 3 822 830 10.1016/j.drudis.2021.11.001 34767960
    [Google Scholar]
  30. Saltiel A.R. Insulin signaling in health and disease. J. Clin. Invest. 2021 131 1 e142241 10.1172/JCI142241 33393497
    [Google Scholar]
  31. Barazzoni R. Gortan Cappellari G. Ragni M. Nisoli E. Insulin resistance in obesity: An overview of fundamental alterations. Eat. Weight Disord. 2018 23 2 149 157 10.1007/s40519‑018‑0481‑6 29397563
    [Google Scholar]
  32. Tagi V.M. Giannini C. Chiarelli F. Insulin resistance in children. Front. Endocrinol. (Lausanne) 2019 10 342 10.3389/fendo.2019.00342 31214120
    [Google Scholar]
  33. Petersen M.C. Shulman G.I. Mechanisms of insulin action and insulin resistance. Physiol. Rev. 2018 98 4 2133 2223 10.1152/physrev.00063.2017 30067154
    [Google Scholar]
  34. Herman R. Sikonja J. Jensterle M. Janez A. Dolzan V. Insulin metabolism in polycystic ovary syndrome: secretion, signaling, and clearance. Int. J. Mol. Sci. 2023 24 4 3140 10.3390/ijms24043140 36834549
    [Google Scholar]
  35. Bharti A. Kushwaha A. Metabolic syndrome: Pathophysiology and consequences. Int. J. Curr. Microbiol. Appl. Sci. 2020 9 9 3723 3728 10.20546/ijcmas.2020.909.459
    [Google Scholar]
  36. Armanini D. Boscaro M. Bordin L. Sabbadin C. Controversies in the pathogenesis, diagnosis and treatment of PCOS: Focus on insulin resistance, inflammation, and hyperandrogenism. Int. J. Mol. Sci. 2022 23 8 4110 10.3390/ijms23084110 35456928
    [Google Scholar]
  37. Rosenfield R.L. Current concepts of polycystic ovary syndrome pathogenesis. Curr. Opin. Pediatr. 2020 32 5 698 706 10.1097/MOP.0000000000000945 32889963
    [Google Scholar]
  38. Vatier C. Christin-Maitre S. Vigouroux C. Role of insulin resistance on fertility-Focus on polycystic ovary syndrome. Ann. Endocrinol. (Paris) 2022 83 199 10.1016/j.ando.2022.04.004
    [Google Scholar]
  39. Ding H. Zhang J. Zhang F. Resistance to the insulin and elevated level of androgen: A major cause of polycystic ovary syndrome. Front. Endocrinol. (Lausanne) 2021 12 741764 10.3389/fendo.2021.741764 34745009
    [Google Scholar]
  40. Morgante G. Darino I. Spanò A. PCOS physiopathology and vitamin D deficiency: Biological insights and perspectives for treatment. J. Clin. Med. 2022 11 15 4509 10.3390/jcm11154509 35956124
    [Google Scholar]
  41. Witchel S.F. Oberfield S.E. Peña A.S. Polycystic ovary syndrome: Pathophysiology, presentation, and treatment with emphasis on adolescent girls. J. Endocr. Soc. 2019 3 8 1545 1573 10.1210/js.2019‑00078 31384717
    [Google Scholar]
  42. Yao Q. Zou X. Liu S. Wu H. Shen Q. Kang J. Oxidative stress as a contributor to insulin resistance in the skeletal muscles of mice with polycystic ovary syndrome. Int. J. Mol. Sci. 2022 23 19 11384 10.3390/ijms231911384 36232686
    [Google Scholar]
  43. Hussein K. Karami M. Association between insulin resistance and abnormal menstrual cycle in Saudi females with polycystic ovary syndrome. Saudi Pharm. J. 2023 31 6 1104 1108 10.1016/j.jsps.2023.03.021 37293383
    [Google Scholar]
  44. Zheng Y. Yin G. Chen F. Lin L. Chen Y. Evaluation of triglyceride glucose index and homeostasis model of insulin resistance in patients with polycystic ovary syndrome. Int. J. Womens Health 2022 14 1821 1829 10.2147/IJWH.S387942 36582617
    [Google Scholar]
  45. Bahadur A. Verma N. Mundhra R. Correlation of homeostatic model assessment-insulin resistance, anti-Mullerian hormone, and BMI in the characterization of polycystic ovary syndrome. Cureus 2021 13 6 e16047 10.7759/cureus.16047 34336524
    [Google Scholar]
  46. Pereira-Eshraghi C.F. Chiuzan C. Zhang Y. Obesity and insulin resistance, not polycystic ovary syndrome, are independent predictors of bone mineral density in adolescents and young women. Horm. Res. Paediatr. 2019 92 6 365 371 10.1159/000507079 32348991
    [Google Scholar]
  47. Chen Y. Zheng X. Ma D. Neck circumference is a good predictor for insulin resistance in women with polycystic ovary syndrome. Fertil. Steril. 2021 115 3 753 760 10.1016/j.fertnstert.2020.07.027 32917381
    [Google Scholar]
  48. Liu R. Bai S. Zheng S. Identification of the metabolomics signature of human follicular fluid from PCOS women with insulin resistance. Dis. Markers 2022 2022 1 1 10 10.1155/2022/6877541 35465261
    [Google Scholar]
  49. Mokou M. Yang S. Zhan B. Elevated circulating Fetuin-B levels are associated with insulin resistance and reduced by GLP-1RA in newly diagnosed PCOS women. Mediators Inflamm. 2020 2020 1 1 12 10.1155/2020/2483435 33061822
    [Google Scholar]
  50. Bayramoğlu E. Çetinkaya S. Özalkak S. Evaluation of the pathophysiological role of Fetuin A levels in adolescents with polycystic ovary syndrome. J. Pediatr. Endocrinol. Metab. 2021 34 7 911 916 10.1515/jpem‑2020‑0524 33887129
    [Google Scholar]
  51. Amisi C.A. Markers of insulin resistance in Polycystic ovary syndrome women: An update. World J. Diabetes 2022 13 3 129 149 10.4239/wjd.v13.i3.129 35432749
    [Google Scholar]
  52. Kanafchian M. Mahjoub S. Esmaeilzadeh S. Rahsepar M. Mosapour A. Status of serum selenium and zinc in patients with the polycystic ovary syndrome with and without insulin resistance. Middle East Fertil. Soc. J. 2018 23 3 241 245 10.1016/j.mefs.2017.11.003
    [Google Scholar]
  53. Borzan V. Lerchbaum E. Missbrenner C. Risk of insulin resistance and metabolic syndrome in women with hyperandrogenemia: A comparison between PCOS phenotypes and beyond. J. Clin. Med. 2021 10 4 829 10.3390/jcm10040829 33670546
    [Google Scholar]
  54. Sanchez-Garrido M.A. Tena-Sempere M. Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Mol. Metab. 2020 35 100937 10.1016/j.molmet.2020.01.001 32244180
    [Google Scholar]
  55. Naamneh Elzenaty R. du Toit T. Flück C.E. Basics of androgen synthesis and action. Best Pract. Res. Clin. Endocrinol. Metab. 2022 36 4 101665 10.1016/j.beem.2022.101665 35595638
    [Google Scholar]
  56. Kempegowda P. Melson E. Manolopoulos K.N. Arlt W. O’Reilly M.W. Implicating androgen excess in propagating metabolic disease in polycystic ovary syndrome. Ther. Adv. Endocrinol. Metab. 2020 11 2042018820934319 10.1177/2042018820934319 32637065
    [Google Scholar]
  57. Cussen L. McDonnell T. Bennett G. Thompson C.J. Sherlock M. O’Reilly M.W. Approach to androgen excess in women: Clinical and biochemical insights. Clin. Endocrinol. (Oxf.) 2022 97 2 174 186 10.1111/cen.14710 35349173
    [Google Scholar]
  58. Ye W. Xie T. Song Y. Zhou L. The role of androgen and its related signals in PCOS. J. Cell. Mol. Med. 2021 25 4 1825 1837 10.1111/jcmm.16205 33369146
    [Google Scholar]
  59. Lawrence B.M. O’Donnell L. Smith L.B. Rebourcet D. New insights into testosterone biosynthesis: Novel observations from HSD17B3 deficient mice. Int. J. Mol. Sci. 2022 23 24 15555 10.3390/ijms232415555 36555196
    [Google Scholar]
  60. Traish A.M. Vignozzi L. Simon J.A. Goldstein I. Kim N.N. Role of androgens in female genitourinary tissue structure and function: implications in the genitourinary syndrome of menopause. Sex. Med. Rev. 2018 6 4 558 571 10.1016/j.sxmr.2018.03.005 29631981
    [Google Scholar]
  61. Mohamad N.V. Soelaiman I.N. Chin K.Y. A concise review of testosterone and bone health. Clin. Interv. Aging 2016 11 1317 1324 10.2147/CIA.S115472 27703340
    [Google Scholar]
  62. Davis S.R. Wahlin-Jacobsen S. Testosterone in women—the clinical significance. Lancet Diabetes Endocrinol. 2015 3 12 980 992 10.1016/S2213‑8587(15)00284‑3 26358173
    [Google Scholar]
  63. Celec P. Ostatníková D. Hodosy J. On the effects of testosterone on brain behavioral functions. Front. Neurosci. 2015 9 12 10.3389/fnins.2015.00012 25741229
    [Google Scholar]
  64. Kanakis G.A. Tsametis C.P. Goulis D.G. Measuring testosterone in women and men. Maturitas 2019 125 41 44 10.1016/j.maturitas.2019.04.203 31133215
    [Google Scholar]
  65. Dadachanji R. Shaikh N. Mukherjee S. Genetic variants associated with hyperandrogenemia in PCOS pathophysiology. Genet. Res. Int. 2018 2018 1 1 12 10.1155/2018/7624932 29670770
    [Google Scholar]
  66. Shabbir S. Khurram E. Moorthi V.S. Eissa Y.T.H. Kamal M.A. Butler A.E. The interplay between androgens and the immune response in polycystic ovary syndrome. J. Transl. Med. 2023 21 1 259 10.1186/s12967‑023‑04116‑4 37062827
    [Google Scholar]
  67. Alviggi C. Conforti A. De Rosa P. The distribution of stroma and antral follicles differs between insulin-resistance and hyperandrogenism-related polycystic ovarian syndrome. Front. Endocrinol. 2017 8 117 10.3389/fendo.2017.00117
    [Google Scholar]
  68. Huang-Doran I. Kinzer A.B. Jimenez-Linan M. Ovarian hyperandrogenism and response to gonadotropin-releasing hormone analogues in primary severe insulin resistance. J. Clin. Endocrinol. Metab. 2021 106 8 2367 2383 10.1210/clinem/dgab275 33901270
    [Google Scholar]
  69. Pateguana N.B. Janes A. The contribution of hyperinsulinemia to the hyperandrogenism of polycystic ovary syndrome. J Metabolic Health 2019 4 1 1 3 10.4102/jir.v4i1.50
    [Google Scholar]
  70. Garzia E. Galiano V. Marfia G. Navone S. Grossi E. Marconi A.M. Hyperandrogenism and menstrual imbalance are the best predictors of metformin response in PCOS patients. Reprod. Biol. Endocrinol. 2022 20 1 6 10.1186/s12958‑021‑00876‑0 34983571
    [Google Scholar]
  71. Ashraf S. Nabi M. Rasool S.A. Rashid F. Amin S. Hyperandrogenism in polycystic ovarian syndrome and role of CYP gene variants: a review. Egypt. J. Med. Hum. Genet. 2019 20 1 25 10.1186/s43042‑019‑0031‑4
    [Google Scholar]
  72. Azziz R. Carmina E. Dewailly D. The androgen excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil. Steril. 2009 91 2 456 488 10.1016/j.fertnstert.2008.06.035 18950759
    [Google Scholar]
  73. Elhassan Y.S. Idkowiak J. Smith K. Causes, patterns, and severity of androgen excess in 1205 consecutively recruited women. J. Clin. Endocrinol. Metab. 2018 103 3 1214 1223 10.1210/jc.2017‑02426 29342266
    [Google Scholar]
  74. Pace L. Kummer N. Wallace M. Azziz R. The value of androgen measures for diagnosing Polycystic Ovary Syndrome (PCOS) in an unselected population. Reprod. Sci. 2024 1 8 10.1007/s43032‑024‑01702‑9 39419927
    [Google Scholar]
  75. Vitku J. Varausova A. Skodova T. The role of 11-oxygenated androgens and endocrine disruptors in androgen excess disorders in women. Int. J. Mol. Sci. 2024 25 17 9691 10.3390/ijms25179691 39273637
    [Google Scholar]
  76. Moran C. Arriaga M. Arechavaleta-Velasco F. Moran S. Adrenal androgen excess and body mass index in polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2015 100 3 942 950 10.1210/jc.2014‑2569 25514100
    [Google Scholar]
  77. Sucquart I.E. Coyle C. Rodriguez Paris V. Investigating GABA neuron-specific androgen receptor knockout in two hyperandrogenic models of PCOS. Endocrinology 2024 165 7 bqae060 10.1210/endocr/bqae060 38788194
    [Google Scholar]
  78. Teede H. Misso M. Tassone E.C. Anti-Müllerian hormone in PCOS: A review informing international guidelines. Trends Endocrinol. Metab. 2019 30 7 467 478 10.1016/j.tem.2019.04.006 31160167
    [Google Scholar]
  79. Rudnicka E. Kunicki M. Calik-Ksepka A. Anti-Müllerian hormone in pathogenesis, diagnostic and treatment of PCOS. Int. J. Mol. Sci. 2021 22 22 12507 10.3390/ijms222212507 34830389
    [Google Scholar]
  80. Pierre A. Taieb J. Giton F. Dysregulation of the anti-Müllerian hormone system by steroids in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2017 102 11 3970 3978 10.1210/jc.2017‑00308 28938480
    [Google Scholar]
  81. Kim J.Y. Tfayli H. Michaliszyn S.F. Lee S. Nasr A. Arslanian S. Anti-Müllerian hormone in obese adolescent girls with polycystic ovary syndrome. J. Adolesc. Health 2017 60 3 333 339 10.1016/j.jadohealth.2016.10.015 27998701
    [Google Scholar]
  82. di Clemente N. Racine C. Rey R.A. Anti-Müllerian hormone and polycystic ovary syndrome in women and its male equivalent. Biomedicines 2022 10 10 2506 10.3390/biomedicines10102506 36289767
    [Google Scholar]
  83. di Clemente N. Racine C. Pierre A. Taieb J. Anti-Müllerian hormone in female reproduction. Endocr. Rev. 2021 42 6 753 782 10.1210/endrev/bnab012 33851994
    [Google Scholar]
  84. Jacob S.L. Field H.P. Calder N. Picton H.M. Balen A.H. Barth J.H. Anti-Müllerian hormone reflects the severity of polycystic ovary syndrome. Clin. Endocrinol. (Oxf.) 2017 86 3 395 400 10.1111/cen.13269 27805276
    [Google Scholar]
  85. Qi X. Pang Y. Qiao J. The role of anti-Müllerian hormone in the pathogenesis and pathophysiological characteristics of polycystic ovary syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol. 2016 199 82 87 10.1016/j.ejogrb.2016.01.029 26914398
    [Google Scholar]
  86. Caanen M.R. Peters H.E. van de Ven P.M. Anti-Müllerian hormone levels in adolescence in relation to long-term follow-up for presence of polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 2021 106 3 e1084 e1095 10.1210/clinem/dgaa949 33351079
    [Google Scholar]
  87. Łebkowska A. Kowalska I. Anti-Müllerian hormone and polycystic ovary syndrome. Endokrynol. Pol. 2017 68 1 74 78 10.5603/EP.a2016.0065 27918066
    [Google Scholar]
  88. Lv P.P. Jin M. Rao J.P. Role of anti-Müllerian hormone and testosterone in follicular growth: A cross-sectional study. BMC Endocr. Disord. 2020 20 1 101 10.1186/s12902‑020‑00569‑6 32641160
    [Google Scholar]
  89. Abbara A. Eng P.C. Phylactou M. Anti-Müllerian hormone (AMH) in the diagnosis of menstrual disturbance due to polycystic ovarian syndrome. Front. Endocrinol. (Lausanne) 2019 10 656 10.3389/fendo.2019.00656 31616381
    [Google Scholar]
  90. Matsuzaki T. Munkhzaya M. Iwasa T. Relationship between serum anti-Mullerian hormone and clinical parameters in polycystic ovary syndrome. Endocr. J. 2017 64 5 531 541 10.1507/endocrj.EJ16‑0501 28381699
    [Google Scholar]
  91. Bhattacharya K. Saha I. Sen D. Role of anti-Mullerian hormone in polycystic ovary syndrome. Middle East Fertil. Soc. J. 2022 27 1 32 10.1186/s43043‑022‑00123‑5
    [Google Scholar]
  92. Butt M.S. Saleem J. Aiman S. Zakar R. Sadique I. Fischer F. Serum anti-Müllerian hormone as a predictor of polycystic ovarian syndrome among women of reproductive age. BMC Womens Health 2022 22 1 199 10.1186/s12905‑022‑01782‑2 35643521
    [Google Scholar]
  93. Sivanandy M.S. Ha S.K. The role of serum anti-mullerian hormone measurement in the diagnosis of polycystic ovary syndrome. Diagnostics 2023 13 5 907 10.3390/diagnostics13050907 36900051
    [Google Scholar]
  94. Ran Y. Yi Q. Li C. The relationship of anti-Mullerian hormone in polycystic ovary syndrome patients with different subgroups. Diabetes Metab. Syndr. Obes. 2021 14 1419 1424 10.2147/DMSO.S299558 33790608
    [Google Scholar]
  95. Javedani Masroor M. Sheybani H. Sheybani S. Abolghasem N. Anti-mullerian hormone levels before and after ovarian drilling in polycystic ovary syndrome: has this an effect on fertility? Reprod. Biol. Endocrinol. 2022 20 1 129 10.1186/s12958‑022‑01002‑4 36042475
    [Google Scholar]
  96. Li X.J. Wang H. Lu D.Y. Anti-Müllerian hormone accelerates pathological process of insulin resistance in polycystic ovary syndrome patients. Horm. Metab. Res. 2021 53 8 504 511 10.1055/a‑1499‑7718 34384107
    [Google Scholar]
  97. Robin G. Deknuydt M. Barbotin A.L. Pigny P. Catteau-Jonard S. Dewailly D. Anti-Müllerian hormone as a driving force of polycystic ovary syndrome, independently from insulin resistance. Reprod. Biomed. Online 2021 42 5 1023 1031 10.1016/j.rbmo.2021.01.012 33632656
    [Google Scholar]
  98. Ramezani Tehrani F. Rahmati M. Mahboobifard F. Firouzi F. Hashemi N. Azizi F. Age-specific cut-off levels of anti-Müllerian hormone can be used as diagnostic markers for polycystic ovary syndrome. Reprod. Biol. Endocrinol. 2021 19 1 76 10.1186/s12958‑021‑00755‑8 34022904
    [Google Scholar]
  99. Yang H. Di J. Pan J. The association between prolactin and metabolic parameters in PCOS women: A retrospective analysis. Front. Endocrinol. (Lausanne) 2020 11 263 10.3389/fendo.2020.00263 32477263
    [Google Scholar]
  100. Davoudi Z. Araghi F. Vahedi M. Mokhtari N. Gheisari M. Prolactin level in Polycystic Ovary Syndrome (PCOS): An approach to the diagnosis and management. Acta Biomed. 2021 92 5 e2021291 10.23750/abm.v92i5.9866 34738596
    [Google Scholar]
  101. Szosland K. Pawłowicz P. Lewiński A. Prolactin secretion in polycystic ovary syndrome (PCOS). Neuroendocrinol. Lett. 2015 36 1 53 58 25789595
    [Google Scholar]
  102. Delcour C. Robin G. Young J. Dewailly D. PCOS and Hyperprolactinemia: What do we know in 2019? Clin. Med. Insights Reprod. Health 2019 13 1179558119871921 10.1177/1179558119871921 31523136
    [Google Scholar]
  103. Yilmaz Ö. Calan M. Kume T. Temur M. Yesil P. Senses M.Y. The effect of prolactin levels on MPV in women with PCOS. Clin. Endocrinol. (Oxf.) 2015 82 5 747 752 10.1111/cen.12647 25359296
    [Google Scholar]
  104. Saei Ghare Naz M. Mousavi M. Mahboobifard F. Niknam A. Ramezani Tehrani F. A meta-analysis of observational studies on prolactin levels in women with polycystic ovary syndrome. Diagnostics 2022 12 12 2924 10.3390/diagnostics12122924 36552931
    [Google Scholar]
  105. Lavanya K. Palaniappan N. Vinodhini V.M. Kumar M. Silambanan S. Association of prolactin and insulin with obesity in women with polycystic ovarian syndrome. Biomedicine (Taipei) 2022 42 6 1166 1171 10.51248/.v42i6.1613
    [Google Scholar]
  106. Sadaria R.G. Ravi B.V. Assessment of leptin and prolactin in women with polycystic ovarian syndrome. Int. J. Biochem. Res. Rev. 2019 27 1 1 7 10.9734/ijbcrr/2019/v27i130112
    [Google Scholar]
  107. Cera N. Pinto J. Pignatelli D. What do we know about abnormally low prolactin levels in polycystic ovary syndrome? A narrative review. Rev. Endocr. Metab. Disord. 2024 25 6 1127 1138 10.1007/s11154‑024‑09912‑x 39425884
    [Google Scholar]
  108. Kyritsi E.M. Dimitriadis G.K. Angelousi A. The value of prolactin in predicting prolactinοma in hyperprolactinaemic polycystic ovarian syndrome. Eur. J. Clin. Invest. 2018 48 7 e12961 10.1111/eci.12961 29845629
    [Google Scholar]
  109. Yang H. Lin J. Li H. Liu Z. Chen X. Chen Q. Prolactin is associated with insulin resistance and beta-cell dysfunction in infertile women with polycystic ovary syndrome. Front. Endocrinol. (Lausanne) 2021 12 571229 10.3389/fendo.2021.571229 33716958
    [Google Scholar]
  110. Selzer C. Ott J. Dewailly D. Marculescu R. Steininger J. Hager M. Prolactin levels in functional hypothalamic amenorrhea: A retrospective case-control study. Arch. Gynecol. Obstet. 2023 309 2 651 658 10.1007/s00404‑023‑07277‑1 37957366
    [Google Scholar]
  111. Mastnak L. Herman R. Ferjan S. Janež A. Jensterle M. Prolactin in polycystic ovary syndrome: Metabolic effects and therapeutic prospects. Life 2023 13 11 2124 10.3390/life13112124 38004264
    [Google Scholar]
  112. Kim S.I. Yoon J.H. Park D.C. Yang S.H. Kim Y.I. What is the optimal prolactin cutoff for predicting the presence of a pituitary adenoma in patients with polycystic ovary syndrome? Int. J. Med. Sci. 2023 20 4 463 467 10.7150/ijms.80891 37057215
    [Google Scholar]
  113. Majumdar A. Mangal N.S. Hyperprolactinemia. Principles and practice of controlled ovarian stimulation in ART. New Delhi, India Springer 2015 319 328 10.1007/978‑81‑322‑1686‑5_29
    [Google Scholar]
  114. Abdelsalam K.E.A. Ibrahim W. Relationship between TSH, T4, T3 and Prolactin in overweight and lean Sudanese PCOS Patients. Int. J. Biomed. Res. 2015 6 2 108 112 10.7439/ijbr.v6i2.1671
    [Google Scholar]
  115. van der Ham K. Stekelenburg K.J. Louwers Y.V. The prevalence of thyroid dysfunction and hyperprolactinemia in women with PCOS. Front. Endocrinol. (Lausanne) 2023 14 1245106 10.3389/fendo.2023.1245106 37854182
    [Google Scholar]
  116. Soni A. Satyanarayana P. Yadav B. Singh S. Serum PRL, TSH and insulin have any association with insulin resistance in females with polycystic ovary syndrome. Int. J. Health Sci. Res. 2024 14 2 332 338 10.52403/ijhsr.20240241
    [Google Scholar]
  117. Mustari M. Hasanat M.A. Hasan Q. Association of altered thyroid function and prolactin level in polycystic ovarian syndrome. Bangladesh Med. J. 2016 45 1 1 5 10.3329/bmj.v45i1.28957
    [Google Scholar]
  118. Paulson M. Norstedt G. Sahlin L. Hirschberg A.L. Association between prolactin receptor expression and proliferation in the endometrium of obese women with polycystic ovary syndrome. Gynecol. Endocrinol. 2020 36 3 226 232 10.1080/09513590.2019.1650343 31389293
    [Google Scholar]
  119. Kastrinakis K. Stavros S. Christodoulaki C. Correlation of serum prolactin levels with metabolic and cardiovascular risk in greek women with polycystic ovarian syndrome. Cureus 2024 16 5 e59430 10.7759/cureus.59430 38826895
    [Google Scholar]
  120. Amin M. Gragnoli C. The prolactin receptor gene (PRLR) is linked and associated with the risk of polycystic ovarian syndrome. J. Ovarian Res. 2023 16 1 222 10.1186/s13048‑023‑01280‑5 37993904
    [Google Scholar]
  121. Iancu M.E. Albu A.I. Albu D.N. Prolactin relationship with fertility and in vitro fertilization outcomes: A review of the literature. Pharmaceuticals 2023 16 1 122 10.3390/ph16010122 36678618
    [Google Scholar]
  122. Qu X. Donnelly R. Sex hormone-binding globulin (SHBG) as an early biomarker and therapeutic target in polycystic ovary syndrome. Int. J. Mol. Sci. 2020 21 21 8191 10.3390/ijms21218191 33139661
    [Google Scholar]
  123. Hisham R. Shehab A.F. Omair H.A.H. The Relation of the SHBG Gene Polymorphism (rs1799941) with PCOS in a Group of Iraqi Women. J Res Appl Sci Biotechnol 2022 1 4 124 128 10.55544/jrasb.1.4.16
    [Google Scholar]
  124. Xing C. Zhang J. Zhao H. He B. Effect of sex hormone-binding globulin on polycystic ovary syndrome: mechanisms, manifestations, genetics, and treatment. Int. J. Womens Health 2022 14 91 105 10.2147/IJWH.S344542 35140526
    [Google Scholar]
  125. Sun Y. Li S. Liu H. Oxidative stress promotes hyperandrogenism by reducing sex hormone-binding globulin in polycystic ovary syndrome. Fertil. Steril. 2021 116 6 1641 1650 10.1016/j.fertnstert.2021.07.1203 34433519
    [Google Scholar]
  126. Xing C. Zhao H. Zhang J. He B. The association of CYP17A1, CYP19A1, and SHBG gene polymorphisms in polycystic ovary syndrome susceptibility: A systematic review and meta-analysis. Front. Physiol. 2022 13 741285 10.3389/fphys.2022.741285 35615684
    [Google Scholar]
  127. Malini N. Roy G.K. Influence of insulin on LH, testosterone and SHBG in various PCOS categories based on the mode of secretion of LH in relation to FSH levels. Acta Endocrinol. (Bucur.) 2021 17 3 313 318 10.4183/aeb.2021.313 35342460
    [Google Scholar]
  128. Biernacka-Bartnik A. Kocełak P. Owczarek A.J. The cut-off value for HOMA-IR discriminating the insulin resistance based on the SHBG level in women with polycystic ovary syndrome. Front. Med. (Lausanne) 2023 10 1100547 10.3389/fmed.2023.1100547 36968815
    [Google Scholar]
  129. Giannouli A. Stefanaki C. Kouskoutis C. Hepatokine profile in adolescents with polycystic ovary syndrome: A case-control study. J. Clin. Med. 2023 12 17 5744 10.3390/jcm12175744 37685811
    [Google Scholar]
  130. Chang H. Wu Q. Ge H. High baseline SHBG, as an independent predictor, was associated with high ovulation: A secondary analysis of PCOSAct. Research SQUARE 10.21203/rs.3.rs‑146920/v1
    [Google Scholar]
  131. Biernacka-Bartnik A. Kocełak P. Owczarek A.J. Prediction of insulin resistance and impaired fasting glucose based on sex Hormone-Binding Globulin (SHBG) levels in polycystic ovary syndrome. Int. J. Endocrinol. 2022 2022 1 1 6 10.1155/2022/6498768 35140785
    [Google Scholar]
  132. Deswal R. Yadav A. Dang A.S. Sex hormone binding globulin: An important biomarker for predicting PCOS risk: A systematic review and meta-analysis. Syst Biol Reprod Med 2018 64 1 12 24 10.1080/19396368.2017.1410591 29227165
    [Google Scholar]
  133. Tosi F. Bonora E. Moghetti P. Insulin resistance in a large cohort of women with polycystic ovary syndrome: a comparison between euglycaemic-hyperinsulinaemic clamp and surrogate indexes. Hum. Reprod. 2017 32 12 2515 2521 10.1093/humrep/dex308 29040529
    [Google Scholar]
  134. Tűű L. Nas K. Török M. Várbíró S. SHBG levels do not correlate with insulin levels in PCOS with appropriate fasting insulin sensitivity. J. Clin. Med. 2024 13 3 838 10.3390/jcm13030838 38337532
    [Google Scholar]
  135. Buyukyılmaz G. Koca S.B. Adıguzel K.T. Boyraz M. Gurbuz F. The role of the AMH, SHBG, free androgen index and LH/FSH ratio in the diagnosis of polycystic ovary syndrome in adolescent. Turkish J Pediatric Disease 2024 18 1 34 40 10.12956/tchd.1347807
    [Google Scholar]
  136. Di Stasi V. Maseroli E. Rastrelli G. SHBG as a marker of NAFLD and metabolic impairments in women referred for oligomenorrhea and/or hirsutism and in women with sexual dysfunction. Front. Endocrinol. (Lausanne) 2021 12 641446 10.3389/fendo.2021.641446 33854482
    [Google Scholar]
  137. Urbano F. Chiarito M. Lattanzio C. Sex hormone-binding globulin (SHBG) reduction: The alarm bell for the risk of non-alcoholic fatty liver disease in adolescents with polycystic ovary syndrome. Children 2022 9 11 1748 10.3390/children9111748 36421197
    [Google Scholar]
  138. Abdel-latif A. Al-Jarhi U.M. Hesham D. khozam M, Fathy SA. Sex hormone binding globulin (SHBG) as a predictor of liver fibrosis in subjects with nonalcoholic fatty liver disease (NAFLD). Egypt. J. Intern. Med. 2023 35 1 38 10.1186/s43162‑023‑00220‑5
    [Google Scholar]
  139. Ma H. Chen Y. Examining the causal relationship between sex hormone-binding globulin (SHBG) and infertility: A Mendelian randomization study. PLoS One 2024 19 6 e0304216 10.1371/journal.pone.0304216 38848344
    [Google Scholar]
  140. Emre O.Z. Demet T.A. Differentiating PCOS from anovulatory cycles in adolescents: A Comprehensive evaluation of FAI, SHBG, and LH/FSH Ratio. Research Square 2024 10.21203/rs.3.rs‑4945396/v1
    [Google Scholar]
  141. Liu Q. Xie Y. Qu L. Zhang M. Mo Z. Dyslipidemia involvement in the development of polycystic ovary syndrome. Taiwan. J. Obstet. Gynecol. 2019 58 4 447 453 10.1016/j.tjog.2019.05.003 31307731
    [Google Scholar]
  142. Guo F. Gong Z. Fernando T. Zhang L. Zhu X. Shi Y. The lipid profiles in different characteristics of women with PCOS and the interaction between dyslipidemia and metabolic disorder states: A retrospective study in Chinese population. Front. Endocrinol. (Lausanne) 2022 13 892125 10.3389/fendo.2022.892125 35860700
    [Google Scholar]
  143. Ollila M.M.E. Piltonen T. Puukka K. Weight gain and dyslipidemia in early adulthood associate with polycystic ovary syndrome: prospective cohort study. J. Clin. Endocrinol. Metab. 2016 101 2 739 747 10.1210/jc.2015‑3543 26652764
    [Google Scholar]
  144. Yang F. Lu J.C. Shen T. Jin Y.H. Liang Y.J. Effect of hyperlipidemia on the outcome of in vitro fertilization in non-obese patients with polycystic ovary syndrome. Front. Endocrinol. (Lausanne) 2023 14 1281794 10.3389/fendo.2023.1281794 38033994
    [Google Scholar]
  145. Blagojević I.P. Ignjatović S. Macut D. Evaluation of a summary score for dyslipidemia, oxidative stress and inflammation (the DOI score) in women with polycystic ovary syndrome and its relationship with obesity. J. Med. Biochem. 2018 37 4 476 485 10.2478/jomb‑2018‑0008 30584408
    [Google Scholar]
  146. Habib R. Rehman S.U. Zubair T. Tariq M. Association of dyslipidemia with anxiety and depression in patients of polycystic ovarian syndrome. Khyber Med Univ J 2021 13 2 113 117 10.35845/kmuj.2021.21298
    [Google Scholar]
  147. Li S. Zhai J. Chu W. Alleviation of Limosilactobacillus reuteri in polycystic ovary syndrome protects against circadian dysrhythmia-induced dyslipidemia via capric acid and GALR1 signaling. NPJ Biofilms Microbiomes 2023 9 1 47 10.1038/s41522‑023‑00415‑2
    [Google Scholar]
  148. Sangaraju S.L. Yepez D. Grandes X.A. Talanki Manjunatha R. Habib S. Cardio-metabolic disease and polycystic ovarian syndrome (PCOS): A narrative review. Cureus 2022 14 5 e25076 10.7759/cureus.25076 35719759
    [Google Scholar]
  149. Ishrat S. Hussain M. Prevalence of insulin resistance, dyslipidemia and metabolic syndrome in infertile women with polycystic ovary syndrome. J. Bangladesh Coll. Phys. Surg. 2021 39 4 225 232 10.3329/jbcps.v39i4.55943
    [Google Scholar]
  150. Bai R. Guo J. Ye X.Y. Xie Y. Xie T. Oxidative stress: The core pathogenesis and mechanism of Alzheimer’s disease. Ageing Res. Rev. 2022 77 101619 10.1016/j.arr.2022.101619 35395415
    [Google Scholar]
  151. Rudnicka E. Duszewska A.M. Kucharski M. Tyczyński P. Smolarczyk R. Oxidative stress and reproductive function: Oxidative stress in polycystic ovary syndrome. Reproduction 2022 164 6 F145 F154 10.1530/REP‑22‑0152 36279177
    [Google Scholar]
  152. Mancini A. Bruno C. Vergani E. d’Abate C. Giacchi E. Silvestrini A. Oxidative stress and low-grade inflammation in polycystic ovary syndrome: controversies and new insights. Int. J. Mol. Sci. 2021 22 4 1667 10.3390/ijms22041667 33562271
    [Google Scholar]
  153. Panti A.A. Shehu C.E. Saidu Y. Oxidative stress and outcome of antioxidant supplementation in patients with polycystic ovarian syndrome (PCOS). Int. J. Reprod. Contracept. Obstet. Gynecol. 2018 7 5 1667 10.18203/2320‑1770.ijrcog20181892
    [Google Scholar]
  154. Sandhu J.K. Waqar A. Jain A. Oxidative stress in polycystic ovarian syndrome and the effect of antioxidant N-acetylcysteine on ovulation and pregnancy rate. Cureus 2021 13 9 e17887 10.7759/cureus.17887 34660086
    [Google Scholar]
  155. Zuo T. Zhu M. Xu W. Roles of oxidative stress in polycystic ovary syndrome and cancers. Oxid. Med. Cell. Longev. 2016 2016 1 8589318 10.1155/2016/8589318 26770659
    [Google Scholar]
  156. Uçkan K. Demir H. Turan K. Sarıkaya E. Demir C. Role of oxidative stress in obese and nonobese PCOS patients. Int. J. Clin. Pract. 2022 2022 1 1 9 10.1155/2022/4579831 35685525
    [Google Scholar]
  157. Hyderali B.N. Mala K. Oxidative stress and cardiovascular complications in polycystic ovarian syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol. 2015 191 15 22 10.1016/j.ejogrb.2015.05.005 26066290
    [Google Scholar]
  158. Dubey P. Reddy S. Boyd S. Effect of nutritional supplementation on oxidative stress and hormonal and lipid profiles in PCOS-affected females. Nutrients 2021 13 9 2938 10.3390/nu13092938 34578816
    [Google Scholar]
  159. Cui X. Gong J. Han H. Relationship between free and total malondialdehyde, a well-established marker of oxidative stress, in various types of human biospecimens. J. Thorac. Dis. 2018 10 5 3088 3197 10.21037/jtd.2018.05.92 29997978
    [Google Scholar]
  160. Tsikas D. Rothmann S. Schneider J.Y. Development, validation and biomedical applications of stable-isotope dilution GC-MS and GC-MS/MS techniques for circulating malondialdehyde (MDA) after pentafluorobenzyl bromide derivatization: MDA as a biomarker of oxidative stress and its relation to 15(S)-8- iso -prostaglandin F 2α and nitric oxide (NO). J. Chromatogr. B Analyt. Technol. Biomed. Life Sci. 2016 1019 95 111 10.1016/j.jchromb.2015.10.009 26522895
    [Google Scholar]
  161. Zhang S. Yang T. Xu X. Oxidative stress and nitric oxide signaling related biomarkers in patients with pulmonary hypertension: A case control study. BMC Pulm. Med. 2015 15 1 50 10.1186/s12890‑015‑0045‑8 25934483
    [Google Scholar]
  162. Förstermann U. Xia N. Li H. Roles of vascular oxidative stress and nitric oxide in the pathogenesis of atherosclerosis. Circ. Res. 2017 120 4 713 735 10.1161/CIRCRESAHA.116.309326 28209797
    [Google Scholar]
  163. Ighodaro O.M. Akinloye O.A. First line defence antioxidants-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX): Their fundamental role in the entire antioxidant defence grid. Alex. J. Med. 2018 54 4 287 293 10.1016/j.ajme.2017.09.001
    [Google Scholar]
  164. Younus H. Therapeutic potentials of superoxide dismutase. Int. J. Health Sci. (Qassim) 2018 12 3 88 93 29896077
    [Google Scholar]
  165. Pei J. Pan X. Wei G. Hua Y. Research progress of glutathione peroxidase family (GPX) in redoxidation. Front. Pharmacol. 2023 14 1147414 10.3389/fphar.2023.1147414 36937839
    [Google Scholar]
  166. Sarıkaya E. Doğan S. Glutathione peroxidase in health and diseases. Intechopen 2020 10.5772/intechopen.91009
    [Google Scholar]
  167. Gebicka L. Krych-Madej J. The role of catalases in the prevention/promotion of oxidative stress. J. Inorg. Biochem. 2019 197 110699 10.1016/j.jinorgbio.2019.110699 31055214
    [Google Scholar]
  168. Chen B. He Q. Chen C. Combination of curcumin and catalase protects against chondrocyte injury and knee osteoarthritis progression by suppressing oxidative stress. Biomed. Pharmacother. 2023 168 115751 10.1016/j.biopha.2023.115751 37879214
    [Google Scholar]
  169. Vale-Fernandes E. Moreira M.V. Rodrigues B. Anti-Müllerian hormone a surrogate of follicular fluid oxidative stress in polycystic ovary syndrome? Front. Cell Dev. Biol. 2024 12 1408879 10.3389/fcell.2024.1408879 39011395
    [Google Scholar]
  170. Li W. Liu C. Yang Q. Zhou Y. Liu M. Shan H. Oxidative stress and antioxidant imbalance in ovulation disorder in patients with polycystic ovary syndrome. Front. Nutr. 2022 9 1018674 10.3389/fnut.2022.1018674 36386912
    [Google Scholar]
  171. Jakubiak G.K. Osadnik K. Lejawa M. “Obesity and insulin resistance” is the component of the metabolic syndrome most strongly associated with oxidative stress. Antioxidants 2021 11 1 79 10.3390/antiox11010079 35052583
    [Google Scholar]
  172. Bhattacharya K. Dey R. Sen D. Polycystic ovary syndrome and its management: In view of oxidative stress. Biomol. Concepts 2024 15 1 20220038 10.1515/bmc‑2022‑0038 38242137
    [Google Scholar]
  173. Sengupta P. Dutta S. Fallah Hassan M. Polycystic ovary syndrome (PCOS) and oxidative stress. J Integ Sci Technol 2024 12 3 752 10.62110/sciencein.jist.2024.v12.752
    [Google Scholar]
  174. Awonuga A.O. Camp O.G. Abu-Soud H.M. A review of nitric oxide and oxidative stress in typical ovulatory women and in the pathogenesis of ovulatory dysfunction in PCOS. Reprod. Biol. Endocrinol. 2023 21 1 111 10.1186/s12958‑023‑01159‑6 37996893
    [Google Scholar]
  175. Avelino CM Araújo RF Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: A meta-analysis study. Revista Brasileira de Ginecologiae Obstetrícia 2024 46 rbgo37 10.61622/rbgo/2024rbgo37
    [Google Scholar]
  176. Velez L.M. Seldin M. Motta A.B. Inflammation and reproductive function in women with polycystic ovary syndrome. Biol. Reprod. 2021 104 6 1205 1217 10.1093/biolre/ioab050 33739372
    [Google Scholar]
  177. Özay A.C. Özay Ö.E. The importance of inflammation markers in polycystic ovary syndrome. Rev. Assoc. Med. Bras. 2021 67 3 411 417 10.1590/1806‑9282.20200860 34468607
    [Google Scholar]
  178. Gonzalez F. Nutrient-induced inflammation in polycystic ovary syndrome: Role in the development of metabolic aberration and ovarian dysfunction. Semin. Reprod. Med. 2015 33 4 276 10.1055/s‑0035‑1554918
    [Google Scholar]
  179. Mohammadi S. Kayedpoor P. Karimzadeh-Bardei L. Nabiuni M. The effect of curcumin on TNF-α, IL-6 and CRP expression in a model of polycystic ovary syndrome as an inflammation state. J. Reprod. Infertil. 2017 18 4 352 360 29201665
    [Google Scholar]
  180. Orisaka M. Mizutani T. Miyazaki Y. Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging. Front. Endocrinol. (Lausanne) 2023 14 1324429 10.3389/fendo.2023.1324429 38192421
    [Google Scholar]
  181. Liu Y. Liu H. Li Z. The release of peripheral immune inflammatory cytokines promote an inflammatory cascade in PCOS patients via altering the follicular microenvironment. Front. Immunol. 2021 12 685724 10.3389/fimmu.2021.685724 34079559
    [Google Scholar]
  182. Barrea L. Marzullo P. Muscogiuri G. Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr. Res. Rev. 2018 31 2 291 301 10.1017/S0954422418000136 30033891
    [Google Scholar]
  183. Marciniak A. Nawrocka Rutkowska J. Brodowska A. Wiśniewska B. Starczewski A. Cardiovascular system diseases in patients with polycystic ovary syndrome - the role of inflammation process in this pathology and possibility of early diagnosis and prevention. Ann. Agric. Environ. Med. 2016 23 4 537 541 10.5604/12321966.1226842 28030919
    [Google Scholar]
  184. Szczuko M. Zapałowska-Chwyć M. Maciejewska D. Drozd A. Starczewski A. Stachowska E. Significant improvement selected mediators of inflammation in phenotypes of women with PCOS after reduction and low GI diet. Mediators Inflamm. 2017 2017 1 1 7 10.1155/2017/5489523 28655971
    [Google Scholar]
  185. Khashchenko E. Vysokikh M. Uvarova E. Activation of systemic inflammation and oxidative stress in adolescent girls with polycystic ovary syndrome in combination with metabolic disorders and excessive body weight. J. Clin. Med. 2020 9 5 1399 10.3390/jcm9051399 32397375
    [Google Scholar]
  186. Zhang Y. Ran Y. Kong L. Decreased SFRP5 correlated with excessive metabolic inflammation in polycystic ovary syndrome could be reversed by metformin: Implication of its role in dysregulated metabolism. J. Ovarian Res. 2021 14 1 97 10.1186/s13048‑021‑00847‑4 34284806
    [Google Scholar]
  187. Jabarpour M. Amidi F. Aleyasin A. Nashtaei M.S. Marghmaleki M.S. Randomized clinical trial of astaxanthin supplement on serum inflammatory markers and ER stress‐apoptosis gene expression in PBMCs of women with PCOS. J. Cell. Mol. Med. 2024 28 14 e18464 10.1111/jcmm.18464 39036884
    [Google Scholar]
  188. Vasyukova E. Zaikova E. Kalinina O. Inflammatory and anti-inflammatory parameters in PCOS patients depending on body mass index: A case-control study. Biomedicines 2023 11 10 2791 10.3390/biomedicines11102791 37893164
    [Google Scholar]
  189. Dey R. Bhattacharya K. Basak A.K. Inflammatory perspectives of polycystic ovary syndrome: Role of specific mediators and markers. Middle East Fertil. Soc. J. 2023 28 1 33 10.1186/s43043‑023‑00158‑2
    [Google Scholar]
  190. He C. Lin Z. Robb S. Ezeamama A. Serum vitamin D levels and polycystic ovary syndrome: A systematic review and meta-analysis. Nutrients 2015 7 6 4555 4577 10.3390/nu7064555 26061015
    [Google Scholar]
  191. Wu M-H. Lin M-W. The role of vitamin D in polycystic ovary syndrome. Indian J. Med. Res. 2015 142 3 238 240 10.4103/0971‑5916.166527 26458338
    [Google Scholar]
  192. Joham A.E. Teede H.J. Cassar S. Vitamin D in polycystic ovary syndrome: Relationship to obesity and insulin resistance. Mol. Nutr. Food Res. 2016 60 1 110 118 10.1002/mnfr.201500259 26255991
    [Google Scholar]
  193. Miao C.Y. Fang X.J. Chen Y. Zhang Q. Effect of vitamin-D supplementation on polycystic ovary syndrome: A meta analysis. Exp. Ther. Med. 2020 19 4 2641 2649 10.3892/etm.2020.8525 32256745
    [Google Scholar]
  194. Amin Zaki El-Bahya A. Radwanb R.A. Gadc M.Z. Abdel S.M. A closer insight into the role of vitamin D in polycystic ovary syndrome (Pcos). Global J Pharm Science 2018 6 4 79 87 10.19080/GJPPS.2018.06.555692
    [Google Scholar]
  195. Irani M. Seifer D. Grazi R. Irani S. Rosenwaks Z. Tal R. Vitamin D decreases serum VEGF correlating with clinical improvement in vitamin D-deficient women with PCOS: A randomized placebo-controlled trial. Nutrients 2017 9 4 334 10.3390/nu9040334 28350328
    [Google Scholar]
  196. Davis E.M. Peck J.D. Hansen K.R. Neas B.R. Craig L.B. Associations between vitamin D levels and polycystic ovary syndrome phenotypes. Minerva Endocrinol. 2019 44 2 176 184 10.23736/S0391‑1977.18.02824‑9 29652114
    [Google Scholar]
  197. Gupta T. Rawat M. Gupta N. Arora S. Study of effect of vitamin D supplementation on the clinical, hormonal and metabolic profile of the PCOS women. J. Obstet. Gynaecol. India 2017 67 5 349 355 10.1007/s13224‑017‑1008‑1 28867886
    [Google Scholar]
  198. Trummer C. Schwetz V. Kollmann M. Effects of vitamin D supplementation on metabolic and endocrine parameters in PCOS: a randomized-controlled trial. Eur. J. Nutr. 2019 58 5 2019 2028 10.1007/s00394‑018‑1760‑8 29946756
    [Google Scholar]
  199. Eftekhar M. Mirhashemi E.S. Molaei B. Pourmasumi S. Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes? Arch. Endocrinol. Metab. 2019 64 1 11 16 10.20945/2359‑3997000000177 31576965
    [Google Scholar]
  200. Várbíró S. Takács I. Tűű L. Effects of Vitamin D on fertility, pregnancy and polycystic ovary syndrome—a review. Nutrients 2022 14 8 1649 10.3390/nu14081649 35458211
    [Google Scholar]
  201. Trummer C. Pilz S. Schwetz V. Obermayer-Pietsch B, Lerchbaum E, Vitamin D. Vitamin D, PCOS and androgens in men: A systematic review. Endocr. Connect. 2018 7 3 R95 R113 10.1530/EC‑18‑0009 29449314
    [Google Scholar]
  202. Guo S. Tal R. Jiang H. Yuan T. Liu Y. Vitamin D supplementation ameliorates metabolic dysfunction in patients with PCOS: a systematicreview of RCTs and insight into the underlying mechanism. Int. J. Endocrinol. 2020 2020 1 1 18 10.1155/2020/7850816 33424968
    [Google Scholar]
  203. Lerchbaum E. Theiler-Schwetz V. Kollmann M. Effects of vitamin D supplementation on surrogate markers of fertility in PCOS women: A randomized controlled trial. Nutrients 2021 13 2 547 10.3390/nu13020547 33562394
    [Google Scholar]
  204. Yılmaz S.A. Altınkaya S.Ö. Kebabçılar A. The relationship between Polycystic ovary syndrome and vitamin D levels. J Turkish Societ Obstetric Gynecol 2015 12 1 18 24 10.4274/tjod.76148 28913035
    [Google Scholar]
  205. Seyyed Abootorabi M. Ayremlou P. Behroozi-Lak T. Nourisaeidlou S. The effect of vitamin D supplementation on insulin resistance, visceral fat and adiponectin in vitamin D deficient women with polycystic ovary syndrome: a randomized placebo-controlled trial. Gynecol. Endocrinol. 2018 34 6 489 494 10.1080/09513590.2017.1418311 29271278
    [Google Scholar]
  206. Ahmed A. Saleem M.A. Saeed F. A comprehensive review on the impact of calcium and vitamin D insufficiency and allied metabolic disorders in females. Food Sci. Nutr. 2023 11 9 5004 5027 10.1002/fsn3.3519 37701195
    [Google Scholar]
  207. Butts S.F. Seifer D.B. Koelper N. Vitamin D deficiency is associated with poor ovarian stimulation outcome in PCOS but not unexplained infertility. J. Clin. Endocrinol. Metab. 2019 104 2 369 378 10.1210/jc.2018‑00750 30085176
    [Google Scholar]
  208. Huffman A.M. Rezq S. Basnet J. Romero D.G. Biomarkers in polycystic ovary syndrome. Curr. Opin. Physiol. 2023 36 100717 10.1016/j.cophys.2023.100717 37842179
    [Google Scholar]
  209. Bannigida D.M. Nayak B.S. Vijayaraghavan R. Insulin resistance and oxidative marker in women with PCOS. Arch. Physiol. Biochem. 2020 126 2 183 186 10.1080/13813455.2018.1499120 30450993
    [Google Scholar]
  210. Rahmatnezhad L. Moghaddam-Banaem L. Behrouzi Lak T. Shiva A. Rasuli J. Free androgen index (FAI)’s relations with oxidative stress and insulin resistance in polycystic ovary syndrome. Sci. Rep. 2023 13 1 5118 10.1038/s41598‑023‑31406‑0 36991023
    [Google Scholar]
  211. Liu C.C. Huang S.P. Cheng K.H. Lower SHBG level is associated with higher leptin and lower adiponectin levels as well as metabolic syndrome, independent of testosterone. Sci. Rep. 2017 7 1 2727 10.1038/s41598‑017‑03078‑0 28577342
    [Google Scholar]
  212. Sever M.J. Janež A. Dolžan V. Interplay between oxidative stress and chronic inflammation in PCOS: The role of genetic variability in PCOS risk and treatment responses. Polycystic Ovarian Syndrome. Intechopen 2019 10.5772/intechopen.88698
    [Google Scholar]
  213. Biswas S.K. Does the interdependence between oxidative stress and inflammation explain the antioxidant paradox? Oxid. Med. Cell. Longev. 2016 2016 1 5698931 10.1155/2016/5698931 26881031
    [Google Scholar]
  214. Güngör K. Güngör N.D. The relationship between Anti-mullerian hormone and prolactin levels in polycystic ovarian syndrome. Anatol J Fam Med 2023 6 3 128 134 10.5505/anatoljfm.2023.00821
    [Google Scholar]
  215. Macotela Y. Triebel J. Clapp C. Time for a new perspective on prolactin in metabolism. Trends Endocrinol. Metab. 2020 31 4 276 286 10.1016/j.tem.2020.01.004 32044206
    [Google Scholar]
  216. Khan M.J. Ullah A. Basit S. Genetic basis of polycystic ovary syndrome (PCOS): Current perspectives. Appl. Clin. Genet. 2019 12 249 260 10.2147/TACG.S200341 31920361
    [Google Scholar]
  217. Chitme H.R. Al Azawi E. Al Manwari H.A. Al Saadi A.A. Al Dulaimi M.A. Role of cystic fluid growth factors and inflammatory mediators in pathogenesis of polycystic ovary syndrome. J Gynecol Reproductive Medicine 2019 3 2 1 7 10.33140/JGRM
    [Google Scholar]
  218. Coutinho E.A. Kauffman A.S. The role of the brain in the pathogenesis and physiology of polycystic ovary syndrome (PCOS). Med. Sci. 2019 7 8 84 10.3390/medsci7080084 31382541
    [Google Scholar]
  219. Siddiqui S. Mateen S. Ahmad R. Moin S. A brief insight into the etiology, genetics, and immunology of polycystic ovarian syndrome (PCOS). J. Assist. Reprod. Genet. 2022 39 11 2439 2473 10.1007/s10815‑022‑02625‑7 36190593
    [Google Scholar]
  220. Wanderley M.S. Pereira L.C.R. Santos C.B. Cunha V.S. Neves M.V.J. Association between insulin resistance and cardiovascular risk factors in polycystic ovary syndrome patients. Rev. Bras. Ginecol. Obstet. 2018 40 4 188 195 10.1055/s‑0038‑1642634 29747212
    [Google Scholar]
  221. Polak K. Czyzyk A. Simoncini T. Meczekalski B. New markers of insulin resistance in polycystic ovary syndrome. J. Endocrinol. Invest. 2017 40 1 1 8 10.1007/s40618‑016‑0523‑8 27473078
    [Google Scholar]
  222. Namavar Jahromi B. Dabaghmanesh M.H. Parsanezhad M.E. Fatehpoor F. Association of leptin and insulin resistance in PCOS: A case-controlled study. Int. J. Reprod. Biomed. (Yazd) 2017 15 7 423 428 10.29252/ijrm.15.7.423 29177243
    [Google Scholar]
  223. Aboeldalyl S. James C. Seyam E. Ibrahim E.M. Shawki H.E.D. Amer S. The role of chronic inflammation in polycystic ovarian syndrome: A systematic review and meta-analysis. Int. J. Mol. Sci. 2021 22 5 2734 10.3390/ijms22052734 33800490
    [Google Scholar]
  224. Dabravolski S.A. Nikiforov N.G. Eid A.H. Mitochondrial dysfunction and chronic inflammation in polycystic ovary syndrome. Int. J. Mol. Sci. 2021 22 8 3923 10.3390/ijms22083923 33920227
    [Google Scholar]
  225. Regidor P.A. Mueller A. Sailer M. Gonzalez Santos F. Rizo J.M. Moreno Egea F. Chronic inflammation in PCOS: The potential benefits of specialized pro-resolving lipid mediators (SPMs) in the improvement of the resolutive response. Int. J. Mol. Sci. 2020 22 1 384 10.3390/ijms22010384 33396555
    [Google Scholar]
  226. Szukiewicz D. Trojanowski S. Kociszewska A. Szewczyk G. Modulation of the inflammatory response in polycystic ovary syndrome (PCOS)—searching for epigenetic factors. Int. J. Mol. Sci. 2022 23 23 14663 10.3390/ijms232314663 36498989
    [Google Scholar]
  227. Sulaiman M. Al-Farsi Y. Al-Khaduri M. Saleh J. Waly M. Polycystic ovarian syndrome is linked to increased oxidative stress in Omani women. Int. J. Womens Health 2018 10 763 771 10.2147/IJWH.S166461 30568513
    [Google Scholar]
  228. Nawrocka-Rutkowska J. Szydłowska I. Jakubowska K. Assessment of the parameters of oxidative stress depending on the metabolic and anthropometric status indicators in women with PCOS. Life 2022 12 2 225 10.3390/life12020225 35207512
    [Google Scholar]
  229. Enechukwu C.I. Onuegbu A.J. Olisekodiaka M.J. Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital. Obstet. Gynecol. Sci. 2019 62 5 335 343 10.5468/ogs.2019.62.5.335 31538077
    [Google Scholar]
  230. Duică F. Dănilă C.A. Boboc A.E. Impact of increased oxidative stress on cardiovascular diseases in women with polycystic ovary syndrome. Front. Endocrinol. (Lausanne) 2021 12 614679 10.3389/fendo.2021.614679 33679617
    [Google Scholar]
  231. Perovic Blagojevic I.M. Vekic J.Z. Macut D.P. Overweight and obesity in polycystic ovary syndrome: association with inflammation, oxidative stress and dyslipidaemia. Br. J. Nutr. 2022 128 4 604 612 10.1017/S0007114521003585 34511137
    [Google Scholar]
  232. Luo X. Cai W.Y. Wu X.K. Prevalence, pattern and predictors for dyslipidemia of Chinese women with polycystic ovary syndrome. Front. Cardiovasc. Med. 2021 8 790454 10.3389/fcvm.2021.790454 34977197
    [Google Scholar]
  233. Jiang X. Lu X. Cai M. Liu Y. Guo Y. Impact of dyslipidemia on the cumulative pregnancy outcomes after first ovarian stimulation. Front. Endocrinol. (Lausanne) 2022 13 915424 10.3389/fendo.2022.915424 36017313
    [Google Scholar]
  234. Amadi C.F. Okolonkwo B.N. George-Oparati M.I. Odiabara K.K. Understanding the relationship between polycystic ovarian syndrome (PCOS) and dyslipidemia. Asian J Biochem Genetic Molecul Biol 2023 15 3 1 11 10.9734/ajbgmb/2023/v15i3333
    [Google Scholar]
  235. Rideout T.C. Harding S.V. Marinangeli C.P.F. Jones P.J.H. Combination drug-diet therapies for dyslipidemia. Transl. Res. 2010 155 5 220 227 10.1016/j.trsl.2009.12.005 20403577
    [Google Scholar]
/content/journals/cpd/10.2174/0113816128382284250822045319
Loading
/content/journals/cpd/10.2174/0113816128382284250822045319
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test