Abstract
The pathophysiology of Polycystic Ovary Syndrome (PCOS) is quite complex and different mechanisms could contribute to hyperandrogenism and anovulation, which are the main features of the syndrome. Obesity and insulin-resistance are claimed as the principal factors contributing to the clinical presentation; in normal weight PCOS either, increased visceral adipose tissue has been described. However, their role is still debated, as debated are the biochemical markers linked to obesity per se. Oxidative stress (OS) and low-grade inflammation (LGI) have recently been a matter of researcher attention; they can influence each other in a reciprocal vicious cycle. In this review, we summarize the main mechanism of radical generation and the link with LGI. Furthermore, we discuss papers in favor or against the role of obesity as the first pathogenetic factor, and show how OS itself, on the contrary, can induce obesity and insulin resistance; in particular, the role of GH-IGF-1 axis is highlighted. Finally, the possible consequences on vitamin D synthesis and activation on the immune system are briefly discussed. This review intends to underline the key role of oxidative stress and low-grade inflammation in the physiopathology of PCOS, they can cause or worsen obesity, insulin-resistance, vitamin D deficiency, and immune dyscrasia, suggesting an inverse interaction to what is usually considered.
Highlights
Since neutrophil/lymphocytes ratio (NLR) and PLR were significantly increased in all Polycystic Ovary Syndrome (PCOS) subjects compared to the BMI-matched controls, again the authors hypothesized that PCOS is a chronic inflammatory process independent of obesity
PCOS is a gynecological endocrine disorder reported in patients with heterogeneous clinical manifestations with different phenotypes
Environmental and genetic factors have a role in the development of PCOS condition
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Its diagnosis is based on Rotterdam criteria [2] since hyperandrogenism, chronic oligo- or anovulation, and echographic pattern of polycystic ovaries are the main features, differently combined in the various phenotypes of the syndrome [3]. Classes: (1)phenotype characterized by of the syndrome, according to different diagnostic in A, National clinical (HY), ovulatory classification, dysfunction previously (OD), and polyInstituteorofbiochemical. Classification, most studies consider evident subjects while the prevalence couldthis be different other than its clinical and statistical usefulness, covers pathophysiological meaning, in the general population [7]. Whatever the case, this classification, other than its clinical since it is generally accepted phenotypes.
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