Systemic Low-Grade Chronic Inflammation and Cardiometabolic Risk Factors in Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome is one of the most common endocrine and metabolic disorders affecting women of reproductive age, with reported prevalence estimates ranging from five to twenty percent depending on the diagnostic criteria applied. Although the condition has historically been classified as a reproductive disorder defined by irregular ovulation, excess androgen production, and polycystic ovarian morphology, a growing body of evidence now positions polycystic ovary syndrome as a multisystem metabolic disease. This review examines the role of systemic low-grade chronic inflammation in the development of polycystic ovary syndrome and its close relationship with cardiometabolic risk factors such as insulin resistance, visceral obesity, abnormal lipid profiles, and early atherosclerotic changes. The review draws on systematic reviews, meta-analyses, and original research published between 2011 and 2026 and discusses molecular mechanisms, including immune cell infiltration of adipose tissue, dysregulated adipokine secretion, activation of the NLRP3 inflammasome, alterations of the intestinal microbial community, and micronutrient deficiencies. The evidence indicates that excess insulin secretion, excess androgen production, and chronic low-grade inflammation form a mutually reinforcing cycle that drives both the reproductive and metabolic features of the syndrome, ultimately increasing long-term cardiovascular disease risk. Clinical implications for screening and long-term management are discussed alongside limitations of the current evidence base.