Association of Increased Body Mass Index with LipidPeroxidation in Patients with Polycys tic Ovary Syndrome(PCOS): A Review, and Meta-Analysis

ackground: Polycys tic ovary syndrome PCOS is the mos tcommon endocrine-metabolic disorder and the mos t commoncause of anovulatory infertility in women of reproductive age.Oxidative s tress (OS) plays a critical role in the pathogenesisof PCOS. Several s tudies have demons trated increased OS inPCOS patients. One of the important biomarkers of oxidatives tress is lipid peroxidation. Malondialdehyde (MDA) is a lipidperoxidation product. MDA is an indicator of persis tent OS, resultingfrom lipid peroxidation of polyunsaturated fatty acids.Its concentration increases when the formation of Reactive oxygenspecies (ROS) increases.Materials and Methods: The keywords "oxidative s tress,""polycys tic ovary syndrome," and Malondialdehyde (MDA)were searched in PubMed, EMBASE, MEDLINE, Scopus, andCochrane Library databases (CENTRAL). ۹ articles with thedesired parameters were extracted, and the accumulated datawere analyzed using Comprehensive Meta-Analysis V۳ softwarefor meta-analysis.Results: ۹ observational s tudies from ۱۹۹۵ to ۲۰۲۲ with asample size of ۱۷۹۱۳ women were reviewed and showed thatchange in MDA levels in women with PCOS. Respectively,Result showed a significantly higher MDA level (SMD= ۱.۱۶;۹۵% CI, ۰.۷۶, ۱.۵۵; P=۰.۰۰۱; I۲>۷۵%), in the PCOS groupcompared with the healthy control group. In addition, after performinga meta-regression, a relationship was found betweenbody mass index (BMI) and MDA level (P value= ۰.۰۱; ۹۵%CI; Tau-sq: ۰.۱۷, R۲: ۰.۴۵); Which shows an increase in lipidperoxidation with weight gain.Conclusion: Monitoring of specific MDA biomarkers might bebeneficial to the diagnosis and prognosis of PCOS. Also, the increase in lipid peroxidation in PCOS obese women showed usthe importance of setting a proper diet for these patients.