PCOS Forum

Research in Polycystic Ovary Syndrome Today and Tomorrow

Renato Pasquali; Elisabet Stener-Victorin; Bulent O. Yildiz; Antoni J. Duleba; Kathleen Hoeger; Helen Mason; Roy Homburg; Theresa Hickey; Steve Franks; Juha S. Tapanainen; Adam Balen; David H. Abbott; Evanthia Diamanti-Kandarakis; Richard S. Legro

Disclosures

Clin Endocrinol. 2011;74(4):424-433. 

In This Article

The Role of Diet in the Pathogenesis of PCOS: Focus on Dietary Advanced Glycated End-products (AGEs)

Lifestyle contributors to disease include not only calorie excess but also the dietary intake of specific nutrients. Advanced glycated end-products (AGEs) is a class of nutrients incriminated in the pathogenesis of diet-related diseases. AGEs are reactive derivatives of nonenzymatic glucose–protein reactions either produced endogenously or ingested from dietary sources. Cooking or processing at high temperatures such as broiling, grilling, frying and roasting is the major source of AGEs. By modulating the activity of protein kinases, AGEs promote oxidative stress and insulin resistance in peripheral tissues. PCOS women have increased serum AGEs levels, and these have been positively correlated with serum androgen levels.[64] In women with PCOS, dietary modification or use of a gastric lipase inhibitor may reduce serum AGEs and oxidative stress markers as well as serum testosterone levels.[65] PI3K mediates insulin signalling at the postreceptor level and also mediates the clearance of AGEs via the macrophage scavenger receptor pathway. The inhibition of phosphatidylinositol 3 kinase (PI3K) may play a dual role in the coexistence of AGE excess and insulin resistance in PCOS. By activating protein kinase C, AGEs may impair insulin action, thereby perpetuating insulin resistance, an intrinsic feature of PCOS.[66] Furthermore, a potential direct action of AGEs on ovarian function is suggested by their increased immunohistochemical localization in PCO.[67] Overall, AGEs, both endogenously and exogenously derived, may play a part in the pathogenesis of PCOS. However, there are no data in comparing different ethnic populations with different diets regarding the impact of AGEs. The environmental source of AGEs can be reduced by dietary modifications.

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