Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome

Abstract Women with polycystic ovary syndrome (PCOS) often experience infertility, potentially mediated by metabolic factors altered by elevated body mass index (BMI). While triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood sugar (FBS) are known med...

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Main Authors: Kasra Jafari, Nooshan Tajik, Ashraf Moini, SeyedAhmad SeyedAlinaghi, Amene Abiri
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-01287-6
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author Kasra Jafari
Nooshan Tajik
Ashraf Moini
SeyedAhmad SeyedAlinaghi
Amene Abiri
author_facet Kasra Jafari
Nooshan Tajik
Ashraf Moini
SeyedAhmad SeyedAlinaghi
Amene Abiri
author_sort Kasra Jafari
collection DOAJ
description Abstract Women with polycystic ovary syndrome (PCOS) often experience infertility, potentially mediated by metabolic factors altered by elevated body mass index (BMI). While triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood sugar (FBS) are known mediators in the BMI-infertility relationship, the extent of their mediation effects remains unquantified in prior studies. This study quantifies the mediation effect of these metabolic factors. We conducted a cross-sectional study on 669 women diagnosed with PCOS at a tertiary hospital in Tehran, Iran, from 2021 to 2023. Data on BMI, TG, LDL, HDL, and FBS were collected, with infertility defined as the inability to conceive after 12 months of unprotected intercourse. Mediation analysis was performed using the Karlson Holm Breen (KHB) method, adjusting for age. Higher BMI was associated with increased levels of TG, LDL, and FBS and decreased HDL, all of which (except for LDL) were linked to infertility. Mediation analysis revealed that after adjusting for age, TG, HDL, and FBS significantly mediated the BMI-infertility association, accounting for 52.98%, 79.19%, and 49.7% of the effect, respectively. Our study identified TG, HDL, and FBS as significant mediators of the BMI-infertility link, with over half of the association mediated through these factors. Targeting metabolic improvements may help reduce infertility risk in this population.
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spelling doaj-art-523c2e11b1c848e4a8d98fdf21c55c042025-08-20T03:53:12ZengNature PortfolioScientific Reports2045-23222025-05-011511710.1038/s41598-025-01287-6Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndromeKasra Jafari0Nooshan Tajik1Ashraf Moini2SeyedAhmad SeyedAlinaghi3Amene Abiri4Research Development Center, Arash Women’s Hospital, Tehran University of Medical SciencesDepartment of Obstetrics and Gynecology, Arash Women’s Hospital, Tehran University of Medical SciencesDepartment of Obstetrics and Gynecology, Endocrinology and Female Infertility Unit, Arash Women’s Hospital, Tehran University of Medical SciencesResearch Development Center, Arash Women’s Hospital, Tehran University of Medical SciencesDepartment of Obstetrics and Gynecology, School of Medicine, Arash Women’s Hospital, Tehran University of Medical SciencesAbstract Women with polycystic ovary syndrome (PCOS) often experience infertility, potentially mediated by metabolic factors altered by elevated body mass index (BMI). While triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood sugar (FBS) are known mediators in the BMI-infertility relationship, the extent of their mediation effects remains unquantified in prior studies. This study quantifies the mediation effect of these metabolic factors. We conducted a cross-sectional study on 669 women diagnosed with PCOS at a tertiary hospital in Tehran, Iran, from 2021 to 2023. Data on BMI, TG, LDL, HDL, and FBS were collected, with infertility defined as the inability to conceive after 12 months of unprotected intercourse. Mediation analysis was performed using the Karlson Holm Breen (KHB) method, adjusting for age. Higher BMI was associated with increased levels of TG, LDL, and FBS and decreased HDL, all of which (except for LDL) were linked to infertility. Mediation analysis revealed that after adjusting for age, TG, HDL, and FBS significantly mediated the BMI-infertility association, accounting for 52.98%, 79.19%, and 49.7% of the effect, respectively. Our study identified TG, HDL, and FBS as significant mediators of the BMI-infertility link, with over half of the association mediated through these factors. Targeting metabolic improvements may help reduce infertility risk in this population.https://doi.org/10.1038/s41598-025-01287-6OverweightBody mass indexInfertility, femalePolycystic ovary syndromeMediation analysis
spellingShingle Kasra Jafari
Nooshan Tajik
Ashraf Moini
SeyedAhmad SeyedAlinaghi
Amene Abiri
Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome
Scientific Reports
Overweight
Body mass index
Infertility, female
Polycystic ovary syndrome
Mediation analysis
title Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome
title_full Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome
title_fullStr Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome
title_full_unstemmed Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome
title_short Metabolic mediators of the overweight’s effect on infertility in women with polycystic ovary syndrome
title_sort metabolic mediators of the overweight s effect on infertility in women with polycystic ovary syndrome
topic Overweight
Body mass index
Infertility, female
Polycystic ovary syndrome
Mediation analysis
url https://doi.org/10.1038/s41598-025-01287-6
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