{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:38:48Z","timestamp":1789605528721,"version":"build-2803163510"},"reference-count":64,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Polycystic ovarian syndrome (PCOS) is an endocrine condition that impacts nutritional status, metabolic, and hormonal function in females of reproductive age. This condition is associated with increased androgen production (hyperandrogenism) and decreased insulin sensitivity, which often leads to insulin resistance and hyperinsulinemia. This increase in androgen production and insulin resistance is strongly associated with a high incidence of obesity, type-2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and certain types of gonad-related cancers among females who suffer from this condition. As research continues to grow, it has been demonstrated that PCOS is a complex condition, and some of its characteristics vary among the females that have this disorder. However, it has been suggested that oxidative stress and low-grade chronic inflammation could play an important role in the development of PCOS. Current evidence suggest that phytochemicals could potentially help with weight-loss by reducing oxidative stress and low-grade inflammation, as well as aid in metabolic and hormonal regulation due to their antioxidant properties. Some of the bioactive compounds found in plants that have shown positive effects in the attenuation of PCOS include flavonoids, polyphenols, phytoestrogen, and polyunsaturated fatty acids (PUFAs). Thus, a review of the current literature published on PCOS and phytochemicals was conducted in PubMed, Google Scholar, and the Academy of Nutrition and Dietetics databases for articles published between 2013 and 2023 with a study duration of 1 to 3 months and adequate sample sizes. The main purpose of this review of literature was to investigate the metabolic effects of phytochemical compounds and phytochemical-rich diets on females with PCOS by comparing the results of several randomized clinical trials.<\/jats:p>","DOI":"10.3390\/ijerph20156534","type":"journal-article","created":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T10:01:53Z","timestamp":1691316113000},"page":"6534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Effects of Plant-Derived Phytochemical Compounds and Phytochemical-Rich Diets on Females with Polycystic Ovarian Syndrome: A Scoping Review of Clinical Trials"],"prefix":"10.3390","volume":"20","author":[{"given":"Guadalupe Nayeli","family":"Chavez","sequence":"first","affiliation":[{"name":"Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kataryna","family":"Jaworsky","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA"},{"name":"Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV 89106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpita","family":"Basu","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,6]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention (2022). PCOS (Polycystic Ovary Syndrome) and Diabetes, Centers for Disease Control and Prevention."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wolf, W.M., Wattick, R.A., Kinkade, O.N., and Olfert, M.D. (2018). Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race\/Ethnicity. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15112589"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.4103\/jhrs.JHRS_95_18","article-title":"The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review","volume":"13","author":"Deswal","year":"2020","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1210\/er.2015-1104","article-title":"The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited","volume":"37","author":"Rosenfield","year":"2016","journal-title":"Endocr. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum. Reprod., 19, 41\u201347.","DOI":"10.1093\/humrep\/deh098"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"9240569","DOI":"10.1155\/2022\/9240569","article-title":"Association of Insulin Resistance and Elevated Androgen Levels with Polycystic Ovarian Syndrome (PCOS): A Review of Literature","volume":"2022","author":"Xu","year":"2022","journal-title":"J. Healthc. Eng."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4103\/idoj.IDOJ_249_17","article-title":"Update on Management of Polycystic Ovarian Syndrome for Dermatologists","volume":"10","author":"Gainder","year":"2019","journal-title":"Indian Dermatol. Online J."},{"key":"ref_8","unstructured":"Marieb, E.N. (2016). Human Anatomy & Physiology, Student Edition, Pearson. [10th ed.]."},{"key":"ref_9","unstructured":"(2021). Impact of Polycystic Ovarian Syndrome, Metabolic Syndrome, and Obesity on Women\u2019s Health, Springer International Publishing AG."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s40618-020-01351-0","article-title":"Insulin Resistance and PCOS: Chicken or Egg?","volume":"44","author":"Moghetti","year":"2021","journal-title":"J. Endocrinol. Invest."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100937","DOI":"10.1016\/j.molmet.2020.01.001","article-title":"Metabolic Dysfunction in Polycystic Ovary Syndrome: Pathogenic Role of Androgen Excess and Potential Therapeutic Strategies","volume":"35","year":"2020","journal-title":"Mol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.bbadis.2016.11.010","article-title":"Mitochondrial Dysfunction and Oxidative Stress in Metabolic Disorders\u2014A Step Towards Mitochondria Based Therapeutic Strategies","volume":"1863","author":"Bhatti","year":"2017","journal-title":"BBA-Mol. Basis Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Victor, V.M., Rovira-Llopis, S., Ba\u00f1uls, C., Diaz-Morales, N., De Mara\u00f1on, A.M., Rios-Navarro, C., Alvarez, A., Gomez, M., Rocha, M., and Hern\u00e1ndez-Mijares, A. (2016). Insulin Resistance in PCOS Patients Enhances Oxidative Stress and Leukocyte Adhesion: Role of Myeloperoxidase. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151960"},{"key":"ref_14","first-page":"4579831","article-title":"Role of Oxidative Stress in Obese and Nonobese PCOS Patients","volume":"2022","author":"Demir","year":"2022","journal-title":"Int. J. Clin. Pract."},{"key":"ref_15","first-page":"551","article-title":"Nutrients as Novel Therapeutic Approaches for Metabolic Disturbances in Polycystic Ovary Syndrome","volume":"15","author":"Mansour","year":"2016","journal-title":"EXCLI J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Rudnicka, E., Suchta, K., Grymowicz, M., Calik-ksepka, A., Smolarczyk, K., Duszewska, A.M., Smolarczyk, R., and Meczekalski, B. (2021). Chronic Low-Grade Inflammation in Pathogenesis of PCOS. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22073789"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ejogrb.2011.07.012","article-title":"Low-Grade Chronic Inflammation in the Peripheral Blood and Ovaries of Women with Polycystic Ovarian Syndrome","volume":"159","author":"Xiong","year":"2011","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Dabravolski, S.A., Nikiforov, N.G., Eid, A.H., Nedosugova, L.V., Starodubova, A.V., Popkova, T.V., Bezsonov, E.E., and Orekhov, A.N. (2021). Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22083923"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"21138","DOI":"10.3390\/molecules201219753","article-title":"Antioxidant Phytochemicals for the Prevention and Treatment of Chronic Diseases","volume":"20","author":"Zhang","year":"2015","journal-title":"Molecules"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Iervolino, M., Lepore, E., Forte, G., Lagan\u00e0, A.S., Buzzaccarini, G., and Unfer, V. (2021). Natural Molecules in the Management of Polycystic Ovary Syndrome (PCOS): An Analytical Review. Nutrients, 13.","DOI":"10.3390\/nu13051677"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/jehp.jehp_67_15","article-title":"Effect of Green Tea on Metabolic and Hormonal Aspect of Polycystic Ovarian Syndrome in Overweight and Obese Women Suffering from Polycystic Ovarian Syndrome: A Clinical Trial","volume":"6","author":"Tehrani","year":"2017","journal-title":"J. Educ. Health Promot."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1002\/ptr.5795","article-title":"The Impact of Green Tea Supplementation on Anthropometric Indices and Inflammatory Cytokines in Women with Polycystic Ovary Syndrome: Green Tea Effect on Anthropometric Indices and Cytokines","volume":"31","author":"Mombaini","year":"2017","journal-title":"Phytother. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"97","DOI":"10.4103\/jrptps.JRPTPS_14_19","article-title":"Comparison of Green Tea and Metformin Effects on Anthropometric Indicators in Women with Polycystic Ovarian Syndrome: A Clinical Trial Study","volume":"9","author":"Farhadian","year":"2020","journal-title":"J. Rep. Pharm. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.clnesp.2020.01.005","article-title":"Effects of Curcumin on Body Weight, Glycemic Control and Serum Lipids in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial","volume":"36","author":"Jamilian","year":"2020","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"153395","DOI":"10.1016\/j.phymed.2020.153395","article-title":"Effects of Curcumin Supplementation on Blood Glucose, Insulin Resistance and Androgens in Patients with Polycystic Ovary Syndrome: A Randomized Double-Blind Placebo-Controlled Clinical Trial","volume":"80","author":"Heshmati","year":"2021","journal-title":"Phytomedicine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"102201","DOI":"10.1016\/j.ctim.2019.102201","article-title":"The Effects of Curcumin Supplementation on Glycemic Status, Lipid Profile and Hs-CRP Levels in Overweight\/Obese Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial","volume":"47","author":"Sohaei","year":"2019","journal-title":"Complement. Ther. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2282","DOI":"10.1002\/ptr.6166","article-title":"The Effects of Quercetin Supplementation on Metabolic and Hormonal Parameters as Well as Plasma Concentration and Gene Expression of Resistin in Overweight or Obese Women with Polycystic Ovary Syndrome: Quercetin Supplementation and Resistin Level in PCOS","volume":"32","author":"Khorshidi","year":"2018","journal-title":"Phytother. Res."},{"key":"ref_28","first-page":"627","article-title":"Oral Quercetin Supplementation Enhances Adiponectin Receptor Transcript Expression in Polycystic Ovary Syndrome Patients: A Randomized Placebo-Controlled Double-Blind Clinical Trial","volume":"19","author":"Rezvan","year":"2018","journal-title":"Cell J. (Yakhteh)"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4322","DOI":"10.1210\/jc.2016-1858","article-title":"Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial","volume":"101","author":"Banaszewska","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4106","DOI":"10.1016\/j.clnu.2021.02.004","article-title":"Effect of Resveratrol on Menstrual Cyclicity, Hyperandrogenism and Metabolic Profile in Women with PCOS","volume":"40","author":"Mansour","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e200","DOI":"10.1016\/j.clnme.2013.07.002","article-title":"Berberine improves reproductive features in obese Caucasian women with polycystic ovary syndrome independently of changes of insulin sensitivity","volume":"8","author":"Orio","year":"2013","journal-title":"E-SPEN J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/cen.12294","article-title":"The use of Berberine for Women with Polycystic Ovary Syndrome Undergoing IVF Treatment","volume":"80","author":"An","year":"2014","journal-title":"Clin. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.numecd.2018.07.002","article-title":"Effect of Synbiotic Pomegranate Juice on Glycemic, Sex Hormone Profile and Anthropometric Indices in PCOS: A Randomized, Triple Blind, Controlled Trial","volume":"29","author":"Esmaeilinezhad","year":"2019","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1002\/ptr.7731","article-title":"The Effect of Concentrated Pomegranate Juice on Biomarkers of Inflammation, Oxidative Stress, and Sex Hormones in Overweight and Obese Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial","volume":"37","author":"Abedini","year":"2023","journal-title":"Phytother. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1055\/s-0034-1376990","article-title":"DASH Diet, Insulin Resistance, and Serum Hs-CRP in Polycystic Ovary Syndrome: A Randomized Controlled Clinical Trial","volume":"47","author":"Asemi","year":"2015","journal-title":"Horm. Metab. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/jhn.12433","article-title":"Effects of Dietary Approach to Stop Hypertension Diet on Androgens, Antioxidant Status and Body Composition in Overweight and Obese Women with Polycystic Ovary Syndrome: A Randomised Controlled Trial","volume":"30","author":"Fallahzadeh","year":"2017","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/cen.13333","article-title":"The Effects of Dietary Approaches to Stop Hypertension Diet on Weight Loss, anti-M\u00fcllerian Hormone and Metabolic Profiles in Women with Polycystic Ovary Syndrome: A Randomized Clinical Trial","volume":"87","author":"Foroozanfard","year":"2017","journal-title":"Clin. Endocrinol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"876620","DOI":"10.3389\/fnut.2022.876620","article-title":"Mediterranean Diet Combined with a Low-Carbohydrate Dietary Pattern in the Treatment of Overweight Polycystic Ovary Syndrome Patients","volume":"9","author":"Mei","year":"2022","journal-title":"Front. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1289\/ehp.02110s3435","article-title":"Androgens and environmental antiandrogens affect reproductive development and play behavior in the Sprague-Dawley rat","volume":"110","author":"Hotchkiss","year":"2002","journal-title":"Environ. Heal. Perspect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/17446651.2021.1896966","article-title":"Weight Management Strategies for Patients with PCOS: Current Perspectives","volume":"16","author":"Yildiz","year":"2021","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.ijbiomac.2022.03.004","article-title":"Role of Polyphenols in Combating Type 2 Diabetes and Insulin Resistance","volume":"206","author":"Shahwan","year":"2022","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kamal, D.A.M., Salamt, N., Zaid, S.S.M., and Mokhtar, M.H. (2021). Beneficial Effects of Green Tea Catechins on Female Reproductive Disorders: A Review. Molecules, 26.","DOI":"10.3390\/molecules26092675"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1186\/s12958-021-00831-z","article-title":"A Comprehensive Insight into Effects of Green Tea Extract in Polycystic Ovary Syndrome: A Systematic Review","volume":"19","author":"Maleki","year":"2021","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_44","first-page":"379","article-title":"Complementary Administration of Curcumin in PCOS: A Systematic Review","volume":"75","author":"Venkatesan","year":"2022","journal-title":"Minerva Obstet. Gynecol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"11999","DOI":"10.1039\/D2FO02625B","article-title":"Effects of Curcumin, a Bioactive Component of Turmeric, on Type 2 Diabetes Mellitus and its Complications: An Updated Review","volume":"13","author":"Bozkurt","year":"2022","journal-title":"Food Funct."},{"key":"ref_46","first-page":"2113293","article-title":"Curcumin Inhibits Hyperandrogen-Induced IRE1\u03b1-XBP1 Pathway Activation by Activating the PI3K\/AKT Signaling in Ovarian Granulosa Cells of PCOS Model Rats","volume":"2022","author":"Zhang","year":"2022","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"289","DOI":"10.5455\/medarh.2020.74.289-293","article-title":"Follicle Stimulating Hormone (LH: FSH) Ratio in Polycystic Ovary Syndrome (PCOS)\u2014Obese Vs. Non-Obese Women","volume":"74","author":"Saadia","year":"2020","journal-title":"Med Arch."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13048-020-0616-z","article-title":"Quercetin and Polycystic Ovary Syndrome, Current Evidence and Future Directions: A Systematic Review","volume":"13","author":"Vaezi","year":"2020","journal-title":"J. Ovarian Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1006678","DOI":"10.3389\/fphar.2022.1006678","article-title":"Quercetin and Polycystic Ovary Syndrome","volume":"13","author":"Ma","year":"2022","journal-title":"Front. Pharmacol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2100457","DOI":"10.1002\/mnfr.202100457","article-title":"Resveratrol Improves Follicular Development of PCOS Rats by Regulating the Glycolytic Pathway","volume":"65","author":"Liang","year":"2021","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1007\/s43032-021-00653-9","article-title":"Resveratrol and Markers of Polycystic Ovary Syndrome: A Systematic Review of Animal and Clinical Studies","volume":"29","author":"Rafraf","year":"2022","journal-title":"Reprod. Sci."},{"key":"ref_52","first-page":"e21781","article-title":"Study on the Effect of Berberine, Myoinositol, and Metformin in Women with Polycystic Ovary Syndrome: A Prospective Randomised Study","volume":"14","author":"Mishra","year":"2022","journal-title":"Cur\u0113us"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"153654","DOI":"10.1016\/j.phymed.2021.153654","article-title":"Berberine Improves Ovulation and Endometrial Receptivity in Polycystic Ovary Syndrome","volume":"91","author":"Wang","year":"2021","journal-title":"Phytomedicine"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.2174\/1381612825666190708183941","article-title":"Composition and Potential Health Benefits of Pomegranate: A Review","volume":"25","author":"Trchounian","year":"2019","journal-title":"Curr. Pharm. Des."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.morpho.2021.04.004","article-title":"Role of Pomegranate Extract in Restoring Endometrial Androgen Receptor Expression, Proliferation, and Pinopodes in a Rat Model of Polycystic Ovary Syndrome","volume":"106","author":"Ibrahim","year":"2022","journal-title":"Morphologie"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1039\/C2FO30034F","article-title":"Pomegranate: A Fruit that Ameliorates Metabolic Syndrome","volume":"4","author":"Medjakovic","year":"2013","journal-title":"Food Funct."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1056\/NEJM199704173361601","article-title":"A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure. DASH Collaborative Research Group","volume":"336","author":"Appel","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3346","DOI":"10.1210\/clinem\/dgaa425","article-title":"Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome","volume":"105","author":"Shang","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"775543","DOI":"10.3389\/fnut.2022.775543","article-title":"The Effect of the Dietary Approaches to Stop Hypertension (DASH) Diet on Sleep, Mental Health, and Hormonal Changes: A Randomized Clinical Trial in Women with Type 2 Diabetes","volume":"9","author":"Daneshzad","year":"2022","journal-title":"Front. Nutr."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"802945","DOI":"10.3389\/fpubh.2022.802945","article-title":"Association between Dietary Inflammatory Index and Sex Hormone Binding Globulin and Sex Hormone in U.S. Adult Females","volume":"10","author":"Liu","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2147\/IJWH.S344542","article-title":"Effect of Sex Hormone-Binding Globulin on Polycystic Ovary Syndrome: Mechanisms, Manifestations, Genetics, and Treatment","volume":"14","author":"Xing","year":"2022","journal-title":"Int. J. Women\u2019s Health"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.pcad.2015.04.003","article-title":"Benefits Mediterr. Diet: Insights PREDIMED Study","volume":"58","author":"Estruch","year":"2015","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Kazemi, M., Jarrett, B.Y., Vanden Brink, H., Lin, A.W., Hoeger, K.M., Spandorfer, S.D., and Lujan, M.E. (2020). Obesity, Insulin Resistance, and Hyperandrogenism Mediate the Link between Poor Diet Quality and Ovarian Dysmorphology in Reproductive-Aged Women. Nutrients, 12.","DOI":"10.3390\/nu12071953"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A., and Savastano, S. (2019). Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients, 11.","DOI":"10.3390\/nu11102278"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/15\/6534\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:26:47Z","timestamp":1760128007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/15\/6534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,6]]},"references-count":64,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["ijerph20156534"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20156534","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,6]]}}}