Metabolic and Molecular Mechanisms of Diet and Physical Exercise in the Management of Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is an endocrine systemic disorder mainly characterized by a hormonal and metabolic disbalance that leads to oligo/anovulation, hyperandrogenism and the formation of ovarian cysts. Despite the progress that has been reached in its diagnosis and management, little is known about the molecular mechanisms and signaling pathways underlying the pathogenic mechanisms. In this sense, recent research has suggested that the influence of multiple factors, including age, environment, lifestyle and the disease state environment can change the clinical presentation of PCOS via epigenetic modifications. Variants in the genes encoding for proteins involved in steroidogenesis and glucose homeostasis play a crucial role in the development of the disease. Other genes involved in inflammation and cell proliferation seem to undergo an epigenetic control. Moreover, lifestyle factors influence the PCOS course and prognosis, including diet and physical activity, which are fundamental in reducing oxidative stress, inflammation and in improving metabolic and hormonal parameters. In the present review, literature evidence on molecular and epigenetic mechanisms related to PCOS etiology will be discussed, with a particular attention on the positive influence of diet and physical activity as nonpharmacological ways of intervention in the management of the disease.

Automated summary

Polycystic ovary syndrome (PCOS) is an endocrine systemic disorder characterized by hormonal and metabolic imbalances, leading to ovulation disorders, increased androgen levels, and the formation of ovarian cysts. The molecular mechanisms and signaling pathways underlying the pathogenesis of PCOS are still not well understood. Recent research has suggested that epigenetic modifications, influenced by factors like age, environment, lifestyle, and disease state, can alter the clinical presentation of PCOS. Genetic variants in genes involved in steroid synthesis and glucose homeostasis play a crucial role in PCOS development. Epigenetic control may also affect inflammation- and cell proliferation-related genes. Lifestyle factors, such as diet and physical activity, are important in reducing oxidative stress, inflammation, and improving metabolic and hormonal parameters in PCOS management.