Nutrient-Induced Inflammation in Polycystic Ovary Syndrome: Role in the Development of Metabolic Aberration and Ovarian Dysfunction
Abstract
A pathophysiology paradigm shift has emerged with the discovery that polycystic ovary syndrome (PCOS) is a proinflammatory state. Despite the dogma that the compensatory hyperinsulinemia of insulin resistance is the promoter of hyperandrogenism, physiological insulin infusion has no effect on androgen levels in PCOS. The dogma also does not explain the cause of hyperandrogenism and ovarian dysfunction in the 30 to 50% of women with PCOS who are of normal weight and lack insulin resistance. Inflammation is the underpinning of insulin resistance in obesity and type 2 diabetes, and may also be the cause of insulin resistance when present in PCOS. The origin of inflammation in PCOS has been ascribed to excess abdominal adiposity or frank obesity. However, nutrients such as glucose and saturated fat can incite inflammation from circulating mononuclear cells (MNC) of women with PCOS independent of excess adiposity and insulin resistance, and can also promote atherogenesis. Hyperandrogenism activates MNC in the fasting state to increase MNC sensitivity to nutrients, and is a potential mechanism for initiating inflammation in PCOS. However, chronic ovarian androgen suppression does not reduce inflammation in normal-weight women with PCOS. Direct exposure of ovarian theca cells to proinflammatory stimuli in vitro increases androgen production. These findings may be corroborated in vivo with anti-inflammatory therapy to normal-weight insulin-sensitive women with PCOS without abdominal adiposity to observe for amelioration of ovarian dysfunction.
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Specific nutrients, such as glucose, are able to stimulate the production of androgen by ovarian and directly promote inflammation in PCOS women.
“specific nutrients, such as glucose, are able to stimulate the production of androgen by ovarian and directly promote inflammation in PCOS women [65,68].”
From Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS) (2019) · cites this paper as [68]
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Rosenfield, R. L., & Ehrmann, D. A. (2016) · Endocrine Reviews · doi:10.1210/er.2015-1104 · Cited by 1,603 · see citing works
Chronic Low Grade Inflammation in Pathogenesis of PCOS
Rudnicka, E., Suchta, K., Grymowicz, M., Calik-Ksepka, A., Smolarczyk, K., Duszewska, A. M., Smolarczyk, R., & Meczekalski, B. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22073789 · Cited by 680 · see citing works
Characteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics
Glueck, C. J., & Goldenberg, N. (2019) · Metabolism · doi:10.1016/j.metabol.2018.11.002 · Cited by 442 · see citing works
Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A., & Savastano, S. (2019) · Nutrients · doi:10.3390/nu11102278 · Cited by 306 · see citing works
“able to stimulate the production of androgen by ovarian and directly promote inflammation in PCOS women [65,68].”
BackgroundDumesic, D. A., Akopians, A. L., Madrigal, V. K., Ramirez, E., Margolis, D. J., Sarma, M. K., Thomas, A. M., Grogan, T. R., Haykal, R., Schooler, T. A., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2586 · Cited by 222 · see citing works
Jeanes, Y. M., & Reeves, S. (2017) · Nutrition Research Reviews · doi:10.1017/s0954422416000287 · Cited by 194 · see citing works
Barrea, L., Marzullo, P., Muscogiuri, G., Di Somma, C., Scacchi, M., Orio, F., Aimaretti, G., Colao, A., & Savastano, S. (2018) · Nutrition Research Reviews · doi:10.1017/s0954422418000136 · Cited by 171 · see citing works
Jamilian, M., Mansury, S., Bahmani, F., Heidar, Z., Amirani, E., & Asemi, Z. (2018) · Journal of Ovarian Research · doi:10.1186/s13048-018-0457-1 · Cited by 156 · see citing works
Shamasbi, S. G., Ghanbari‐Homayi, S., & Mirghafourvand, M. (2019) · European Journal of Nutrition · doi:10.1007/s00394-019-02033-1 · Cited by 99 · see citing works
Fabozzi, G., Verdone, G., Allori, M., Cimadomo, D., Tatone, C., Stuppia, L., Franzago, M., Ubaldi, N., Vaiarelli, A., Ubaldi, F. M., et al. (2022) · Nutrients · doi:10.3390/nu14091918 · Cited by 80 · see citing works
Khashchenko, E., Vysokikh, M., Uvarova, E., Krechetova, L., Vtorushina, V., Ivanets, T., Volodina, M., Tarasova, N., Sukhanova, I., & Sukhikh, G. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9051399 · Cited by 64 · see citing works
Effects of myo-inositol plus alpha-lactalbumin in myo-inositol-resistant PCOS women
Oliva, M. M., Buonomo, G., Calcagno, M., & Unfer, V. (2018) · Journal of Ovarian Research · doi:10.1186/s13048-018-0411-2 · Cited by 63 · see citing works
Fuertes-Martín, R., Moncayo, S., Insenser, M. R., Martínez-García, M. Á., Luque‐Ramírez, M., Grau, N. A., Correig, X., & Escobar-Morreale, H. F. (2019) · Journal of Proteome Research · doi:10.1021/acs.jproteome.9b00528 · Cited by 63 · see citing works
Ganie, M. A., Sahar, T., Rashid, A., Wani, I. A., Nisar, S., Sathyapalan, T., Vishnubhatla, S., Ramakrishnan, L., Parvez, T., & Geer, M. I. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00699 · Cited by 58 · see citing works
Wang, Q., Sun, Y., Xu, Q., Liu, W., Wang, P., Yao, J., Zhao, A., Chen, Y., & Wang, W. (2022) · Nutrition Research · doi:10.1016/j.nutres.2021.12.006 · Cited by 49 · see citing works
Ban, Y., Ran, H., Chen, Y., & Ma, L. (2021) · Journal of Ovarian Research · doi:10.1186/s13048-021-00885-y · Cited by 44 · see citing works
Han, Y., Wu, H., Sun, S., Zhao, R., Deng, Y., Zeng, S., & Chen, J. (2023) · Nutrients · doi:10.3390/nu15092230 · Cited by 41 · see citing works
Calcaterra, V., Magenes, V. C., Massini, G., De Sanctis, L., Fabiano, V., & Zuccotti, G. (2024) · Nutrients · doi:10.3390/nu16070938 · Cited by 35 · see citing works
Wang, B., Hao, M., Yang, Q., Li, J., & Guo, Y. (2016) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-016-0704-6 · Cited by 33 · see citing works
Martínez-García, M. Á., Ojeda, M. O., Rodríguez‐Martín, E., Insenser, M. R., Moncayo, S., Álvarez‐Blasco, F., Luque‐Ramírez, M., & Escobar-Morreale, H. F. (2020) · Biomolecules · doi:10.3390/biom10010111 · Cited by 28 · see citing works
Martínez-García, M. Á., Moncayo, S., Insenser, M. R., Montes‐Nieto, R., Fernández‐Durán, E., Álvarez‐Blasco, F., Luque‐Ramírez, M., & Escobar-Morreale, H. F. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2019.03.027 · Cited by 28 · see citing works
Shi, W., Zhao, Q., Zhao, X. F., Xing, C., & He, B. (2021) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s329108 · Cited by 27 · see citing works
Glycemic Index and Glycemic Load Estimates in the Dietary Approach of Polycystic Ovary Syndrome
Manta, A., Paschou, S. Α., Isari, G., Mavroeidi, I., Kalantaridou, S., & Peppa, Μ. (2023) · Nutrients · doi:10.3390/nu15153483 · Cited by 33 · see citing works
Riley, J. K., & Jungheim, E. S. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.07.1069 · Cited by 27 · see citing works
Updates on Molecular Targets and Epigenetic-Based Therapies for PCOS
Смирнов, В. В., Beeraka, N. M., Butko, D. Y., Nikolenko, V. N., Bondarev, S., Achkasov, E. E., Sinelnikov, M. Y., & Vikram, P. R. H. (2022) · Reproductive Sciences · doi:10.1007/s43032-022-01013-x · Cited by 25 · see citing works
Zhang, S., He, H., Wang, Y., Wang, X., & Liu, X. (2023) · Scientific Reports · doi:10.1038/s41598-023-34746-z · Cited by 24 · see citing works
Hyperandrogenism and anthropometric parameters in women with polycystic ovary syndrome
Mansour, A., Noori, M., Hakemi, M. S., Haghgooyan, Z., Mohajeri‐Tehrani, M. R., Mirahmad, M., & Sajjadi‐Jazi, S. M. (2024) · BMC Endocrine Disorders · doi:10.1186/s12902-024-01733-y · Cited by 21 · see citing works
Arffman, R. K., Saraswat, M., Joenväärä, S., Khatun, M., Agarwal, R., Tohmola, T., Poromaa, I. S., Renkonen, R., & Piltonen, T. (2019) · Scientific Reports · doi:10.1038/s41598-019-54067-4 · Cited by 21 · see citing works
Connolly, A., Leblanc, S., & Baillargeon, J. (2018) · International Journal of Endocrinology · doi:10.1155/2018/4315413 · Cited by 19 · see citing works
Azarbayjani, K., Sadatmahalleh, S. J., Mottaghi, A., & Nasiri, M. (2024) · Scientific Reports · doi:10.1038/s41598-024-53958-5 · Cited by 18 · see citing works
Lipid Profile in Women with Polycystic Ovary Syndrome
Ibrahim, T., Ali, A. E.-S., & Radwan, M. (2020) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2020.70969 · Cited by 17 · see citing works
Qi, J., Su, Y., Zhang, H., & Ren, Y. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1309492 · Cited by 17 · see citing works
Ulrich, J., Goerges, J., Keck, C., Müller‐Wieland, D., Diederich, S., & Janssen, O. E. (2018) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0043-110480 · Cited by 17 · see citing works
Liang, X., He, H., Zeng, H., Wei, L., Yang, J., Wen, Y., Fan, S., & Fan, J. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1172750 · Cited by 18 · see citing works
Bioimpedance Measurements in Adolescents with Polycystic Ovary Syndrome: A Pilot Study
Geronikolou, S. A., Bacopoulou, F., & Cokkinos, D. (2017) · Advances in Experimental Medicine and Biology · doi:10.1007/978-3-319-57379-3_26 · Cited by 15 · see citing works
The Search for the Causes of Common Hyperandrogenism, 1965 to Circa 2015
Rosenfield, R. L. (2024) · Endocrine Reviews · doi:10.1210/endrev/bnae007 · Cited by 14 · see citing works
Al-Gareeb, A. I., Abd-Alamieer, W. S., Al-Kuraishy, H. M., & Al-Maiahy, T. J. (2016) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.29252/ijrm.14.2.81 · Cited by 14 · see citing works
Mizgier, M., Więckowska, B., Formanowicz, D., Lombardi, G., Brożek, A., Nowicki, M., Durkalec‐Michalski, K., Kędzia, W., & Jarząbek‐Bielecka, G. (2024) · Scientific Reports · doi:10.1038/s41598-024-54100-1 · Cited by 12 · see citing works
Choi, Y.-J., Kang, K., Je, M., Lee, Y., & Kim, Y. (2025) · Nutrients · doi:10.3390/nu17040674 · Cited by 12 · see citing works
Higher Chronic Endometritis Incidences within Infertile Polycystic Ovary Syndrome Clinical Cases
Wang, S., Zhao, H., Li, F., Xu, Y., Bao, H., & Zhao, D. (2022) · Journal of Healthcare Engineering · doi:10.1155/2022/9748041 · Cited by 10 · see citing works
RetractedIsatin ameliorates ovarian inflammation and apoptosis caused by hormonal imbalances in PCOS mice
Li, X., Ye, T., Zhu, W., Gu, J., Zheng, Z., Wang, C., Zhang, X., Geng, H., Zhou, W., Tan, X., et al. (2025) · Biochemical Pharmacology · doi:10.1016/j.bcp.2025.117083 · Cited by 8 · see citing works
Zhang, W., & Wu, F. (2025) · The FASEB Journal · doi:10.1096/fj.202402648rr · Cited by 7 · see citing works
Role of IL-6 in Physiology and Pathology of the Ovary
Tan, B., & Wang, J. (2024) · Clinical and Experimental Obstetrics & Gynecology · doi:10.31083/j.ceog5109208 · Cited by 6 · see citing works
Role of Branched-Chain Amino Acids in Metabolic Changes of Polycystic Ovary Syndrome
Jia, F.-C., & Li, X. (2024) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000001272 · Cited by 5 · see citing works
Talebi, S., Shab-Bidar, S., Askari, G., Mohammadi, H., Moini, A., & Djafarian, K. (2025) · Journal of Research in Medical Sciences · doi:10.4103/jrms.jrms_280_24 · Cited by 5 · see citing works
Polycystic Ovary Syndrome (PCOS)
Hechtman, L. (2020) · Elsevier eBooks · doi:10.1016/b978-0-323-43044-9.00209-0 · Cited by 6 · see citing works
Association of diet quality and hormonal status in exercising women with menstrual disturbances
Łagowska, K., Strock, N. C. A., Koltun, K. J., Williams, N. I., & Souza, M. J. D. (2022) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2021-0789 · Cited by 4 · see citing works
The Endocrinological Basis for Polycystic Ovary Syndrome: An Evolutionary Perspective
Dumesic, D. A., Crespi, B. J., Padmanabhan, V., & Abbott, D. H. (2025) · Endocrinology · doi:10.1210/endocr/bqaf160 · Cited by 4 · see citing works
Geronikolou, S. A., Bacopoulou, F., Chryssanthopoulos, S., Cokkinos, D. V., & Chrousos, G. P. (2022) · Children · doi:10.3390/children9030316 · Cited by 3 · see citing works
Darand, M., Arabi, V., Ghorbani, M., Salimi, Z., & Hosseinzadeh, M. (2024) · BMC Nutrition · doi:10.1186/s40795-024-00933-y · Cited by 3 · see citing works
Darand, M., Ghorbani, M., Ghadiri‐Anari, A., Arabi, V., & Hosseinzadeh, M. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03695-2 · Cited by 2 · see citing works
To explore the relationship between endometrial hyperemia and polycystic ovary syndrome
Wang, S., Li, F., Zhang, W., Bao, H., & Hao, C. (2025) · Open Life Sciences · doi:10.1515/biol-2025-1154 · Cited by 2 · see citing works
Çağlar, Y. A., & Taşkın, M. İ. (2024) · Medicina · doi:10.3390/medicina60122102 · Cited by 1 · see citing works
Upadhyay, S., Mazumder, A., & Das, S. (2025) · Current Pharmaceutical Design · doi:10.2174/0113816128382284250822045319 · Cited by 1 · see citing works
Síndrome do Ovário Policístico e Vitamina D
Dias, D. D. A. M., Silva, I. L., & Jovita, M. C. (2022) · Research Society and Development · doi:10.33448/rsd-v11i11.31907 · Cited by 1 · see citing works
INFLAMMATORY GENE EXPRESSION IN WOMEN DIAGNOSED WITH POLYCYSTIC OVARIAN SYNDROME
Taylor, M. K. (2016) · Pittsburg State University Digital Commons (Pittsburg State University)
Elevated body fat percentage as a predictor of irregular ovulation and menstruation
Azhary, N. M. E., El-Beltagy, N., Elhabashy, A., Shaer, N. E., & Hassan, S. (2022) · Bulletin of Egyptian Society for Physiological Sciences · doi:10.21608/besps.2021.80618.1103
Polycystic ovarian syndrome and reproductive failure
Duero, J., & Tal, R. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-90805-4.00009-2
Ban, Y., Ran, H., Chen, Y., & Ma, L. (2021) · Figshare · doi:10.6084/m9.figshare.16807631
Li, T., Zhao, S., Zhou, X., Kong, M., Dai, Z., & Chen, X. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1764278
- Authors
- González, F.
- Affiliations
- Indiana University Indianapolis (US)
- Corresponding author
- González, Frank
- ORCID
- González, Frank
- Venue
- Seminars in Reproductive Medicine
- Publisher
- Georg Thieme Verlag KG
- Published
- 2015-07-01
- Volume
- 33
- Issue
- 04
- Pages
- 276-286
- ISSN
- 1526-4564 (ISSN-L)
- 1526-8004
- OpenAlex
- W2409982131
- Cited by
- 60
- References
- 0
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 10 · 2023: 4 · 2022: 9 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 6 · 2017: 2 · 2016: 6
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Seminars in Reproductive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD-048535, R03HD048535)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- polycystic ovary syndrome, inflammation, hyperandrogenism, insulin resistance, normal-weight women, circulating mononuclear cells, glucose, saturated fat, atherogenesis, ovarian dysfunction, theca cells, androgen production, anti-inflammatory therapy, obesity
- MeSH terms
- Female, Humans, Inflammation, Insulin Resistance, Obesity, Ovary, Polycystic Ovary Syndrome, Hyperandrogenism
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