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The importance of metabolic dysfunction in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder characterized by reproductive and metabolic disturbances. Androgen excess is a hallmark of PCOS, driving many of the phenotypic features. In 2020, several findings highlight altered metabolic pathways as an underlying biological mechanism in PCOS. These findings add to our understanding of the complex interaction between metabolic homeostasis and reproduction.

Key advances

  • Polycystic ovary syndrome (PCOS) has genetically distinct reproductive and metabolic subtypes4.

  • A polygenic risk score-based phenome-wide association study has identified shared biological pathways between PCOS and obesity5.

  • Both the brain and adipose tissue are key tissues in the development of androgen-induced reproductive dysfunction in a mouse model of PCOS7.

  • Intranasal insulin administration improves the reduced adaptive thermogenesis in a sheep model of PCOS8.

  • Unfavourable changes in the diversity and composition of the gut microbiome are already present in adolescents with PCOS, independent of obesity9.

  • Changes in the dietary macronutrient balance improve reproductive dysfunction in a mouse model of PCOS, without beneficial effects on metabolic dysfunction10.

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Correspondence to Jenny A. Visser.

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The author declares no competing interests.

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Visser, J.A. The importance of metabolic dysfunction in polycystic ovary syndrome. Nat Rev Endocrinol 17, 77–78 (2021).

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