Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome

L. Barrea, P. Marzullo, G. Muscogiuri, C. Di Somma, M. Scacchi, F. Orio, G. Aimaretti, A. Colao, S. Savastano

Research output: Contribution to journalArticlepeer-review

Abstract

High carbohydrate intake and low-grade inflammation cooperate with insulin resistance and hyperandrogenism to constitute an interactive continuum acting on the pathophysiology of polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age characterised by oligo-anovulatory infertility and cardiometabolic disorders. The role of insulin in PCOS is pivotal both in regulating the activity of ovarian and liver enzymes, respectively involved in androgen production and in triggering low-grade inflammation usually reported to be associated with an insulin resistance, dyslipidaemia and cardiometabolic diseases. Although an acute hyperglycaemia induced by oral glucose loading may increase inflammation and oxidative stress by generating reactive oxygen species through different mechanisms, the postprandial glucose increment, commonly associated with the Western diet, represents the major contributor of chronic sustained hyperglycaemia and pro-inflammatory state. Together with hyperinsulinaemia, hyperandrogenism and low-grade inflammation, unhealthy diet should be viewed as a key component of the 'deadly quartet' of metabolic risk factors associated with PCOS pathophysiology. The identification of a tight diet-inflammation-health association makes the adoption of healthy nutritional approaches a primary preventive and therapeutic tool in women with PCOS, weakening insulin resistance and eventually promoting improvements of reproductive life and endocrine outcomes. The intriguing nutritional-endocrine connections operating in PCOS underline the role of expert nutritionists in the management of this syndrome. The aim of the present review is to provide an at-a-glance overview of the possible bi-directional mechanisms linking inflammation, androgen excess and carbohydrate intake in women with PCOS. © The Authors 2018.
Original languageEnglish
Pages (from-to)291-301
Number of pages11
JournalNutrition Research Reviews
Volume31
Issue number2
DOIs
Publication statusPublished - Jul 23 2018

Keywords

  • Carbohydrates
  • Hyperandrogenism
  • Low-grade inflammation
  • Polycystic ovary syndrome
  • androgen
  • insulin
  • reactive oxygen metabolite
  • androgen synthesis
  • Article
  • carbohydrate diet
  • cardiometabolic risk
  • diet therapy
  • dyslipidemia
  • female
  • human
  • hyperandrogenism
  • hyperglycemia
  • hyperinsulinemia
  • inflammation
  • insulin resistance
  • oral glucose tolerance test
  • ovary polycystic disease
  • oxidative stress
  • pathophysiology
  • postprandial state
  • primary prevention
  • Western diet

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