Metabolic consequences of obesity and insulin resistance in polycystic ovary syndrome: diagnostic and methodological challenges
Open accessAbstract
Women with polycystic ovary syndrome (PCOS) have a considerable risk of metabolic dysfunction. This review aims to present contemporary knowledge on obesity, insulin resistance and PCOS with emphasis on the diagnostic and methodological challenges encountered in research and clinical practice. Variable diagnostic criteria for PCOS and associated phenotypes are frequently published. Targeted searches were conducted to identify all available data concerning the association of obesity and insulin resistance with PCOS up to September 2016. Articles were considered if they were peer reviewed, in English and included women with PCOS. Obesity is more prevalent in women with PCOS, but studies rarely reported accurate assessments of adiposity, nor split the study population by PCOS phenotypes. Many women with PCOS have insulin resistance, though there is considerable variation reported in part due to not distinguishing subgroups known to have an impact on insulin resistance as well as limited methodology to measure insulin resistance. Inflammatory markers are positively correlated with androgen levels, but detailed interactions need to be identified. Weight management is the primary therapy; specific advice to reduce the glycaemic load of the diet and reduce the intake of pro-inflammatory SFA and advanced glycation endproducts have provided promising results. It is important that women with PCOS are educated about their increased risk of metabolic complications in order to make timely and appropriate lifestyle modifications. Furthermore, well-designed robust studies are needed to evaluate the mechanisms behind the improvements observed with dietary interventions.
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Most women with PCOS tend to eat food with higher glycemic loads and intake a small amount of fiber, leading to lower insulin sensitivity and increased inflammatory markers.
“Jeanes and Reeves (2017) also mentioned that most women with PCOS tend to eat food with higher GLs, whereas they intake a small amount of fiber, which leads to lower insulin sensitivity and increased levels of inflammatory markers [129].”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as Jeanes and Reeves (2017)
Most women with PCOS tend to eat food with higher glycemic loads and intake a small amount of fiber, leading to lower insulin sensitivity and increased inflammatory markers.
“Jeanes and Reeves (2017) also mentioned that most women with PCOS tend to eat food with higher GLs, whereas they intake a small amount of fiber, which leads to lower insulin sensitivity and increased levels of inflammatory markers [129].”
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“…high-glycemic-index foods promote advanced glycation end product (AGE)-receptor for AGE (RAGE) axis activation, worsening insulin resistance, while saturated fats activate Toll-like receptor 4 (TLR4) signaling, increasing the production of pro-inflammatory cytokines like IL-1β and IL-18 23,24 .”
- Authors
- Jeanes, Y. M., & Reeves, S.
- Affiliations
- University of Roehampton (GB)
- Corresponding author
- Reeves, Sue
- Venue
- Nutrition Research Reviews
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-02-22
- Volume
- 30
- Issue
- 1
- Pages
- 97-105
- ISSN
- 0954-4224 (ISSN-L)
- 1475-2700
- OpenAlex
- W2590654260
- Cited by
- 194
- References
- 17
- Citations by year
- 2026: 12 · 2025: 27 · 2024: 31 · 2023: 36 · 2022: 34 · 2021: 22 · 2020: 15 · 2019: 10 · 2018: 7
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nutrition Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- polycystic ovary syndrome, obesity, insulin resistance, metabolic dysfunction, PCOS diagnostic criteria, PCOS phenotypes, adiposity assessment, inflammatory markers, androgens, weight management, dietary intervention, glycemic load, saturated fatty acids, advanced glycation end products, lifestyle modification
- MeSH terms
- Diabetes Mellitus, Type 2, Diet, Female, Humans, Insulin Resistance, Metabolic Diseases, Obesity, Patient Education as Topic, Phenotype, Polycystic Ovary Syndrome, Risk Factors, Hyperandrogenism, Glucose Intolerance, Metabolic Syndrome, Adiposity, Non-alcoholic Fatty Liver Disease
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