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The case group, aged 18\u201345 years and PCOS diagnosed according to the Rotterdam criteria, and controls were healthy women matched by age and BMI. All participants underwent periodontal examinations, biochemical and hormonal blood analyses, anthropometric assessments, and oral hygiene habits questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PCOS group exhibited an altered metabolic profile, including elevated insulin levels, insulin resistance, dyslipidemia, and increased inflammatory markers, indicating a systemic pro-inflammatory state. PD were significantly more prevalent in PCOS than controls (40.5% vs. 11.2%), with higher rates of gingivitis and slightly increased periodontitis. PCOS showed greater bleeding on probing, plaque accumulation, and clinical attachment loss in PCOS. Correlation analyses revealed associations between PD and metabolic\/inflammatory markers, including insulin, HDL cholesterol, hsCRP, C3c, and RBP4. Multivariate regression identified insulin and HDL cholesterol as independent predictors of periodontal inflammation, while C3c predicted plaque accumulation. CHAID analysis indicated fasting insulin as the strongest discriminator, with higher levels linked to increased PD prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PCOS is independently associated with periodontal diseases, and this relationship appears mediated by metabolic and inflammatory alterations, with insulin resistance emerging as a central mechanistic link between systemic and oral health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12903-026-09196-4","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:02:18Z","timestamp":1783638138000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Polycystic ovary syndrome and periodontal disease: an until-now undiscovered connection influenced by metabolic parameters"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0185-6180","authenticated-orcid":false,"given":"Cecilia Fabiana","family":"M\u00e1rquez-Arrico","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Pelech\u00e1-Salvador","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"L\u00f3pez-Dom\u00e8nech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meylin","family":"Fern\u00e1ndez-Reyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Javier","family":"Silvestre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Silvestre-Rangil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Montiel-Company","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milagros","family":"Rocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"3","key":"9196_CR1","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/JCPE.13189","volume":"47","author":"M Sanz","year":"2020","unstructured":"Sanz M, Marco del Castillo A, Jepsen S, Gonzalez-Juanatey JR, D\u2019Aiuto F, Bouchard P, et al. 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All procedures were approved by the \u201cResearch Ethics Committee for Medicines\u201d (CEIm) of the Doctor Peset University Hospital in Valencia (approval document n\u00ba Ceim 31\/19, registered under NCT06184412). Written informed consent and a signed confidentiality agreement were obtained from all participants in the study who voluntarily participated.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1909"}}