Hepatokines and polycystic ovary syndrome: investigating the connection between the hepato-ovarian axis and disorders in glycolipid metabolism in PCOS: a narrative review.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine and reproductive disorder affecting 11-13% of women worldwide. It is defined by key clinical signs like elevated androgen levels and infrequent ovulation. PCOS, the most common endocrine cause of infertility in women of reproductive age, is often linked to insulin resistance, obesity, and other metabolic issues. It is closely associated with imbalances in the metabolism of glucose and lipids. Crucially, PCOS interacts with disorders of glucose and lipid metabolism. These metabolic disorders are the main signs of PCOS and can further aggravate the condition. As a vital metabolic organ, the liver produces a range of functional secretory factors known as hepatokines, which are crucial for metabolic regulation. These hepatokines circulate and exert a "Distant crosstalk" effect, influencing processes like glucose uptake, fatty acid breakdown, liver glucose production, inflammation, and various other functions in peripheral tissues. A recent connection between PCOS and nonalcoholic fatty liver disease (NAFLD) has been established, with the hepato-ovarian axis hypothesis considered a possible mechanism. As a result, the liver plays a key role in PCOS and is closely linked to the metabolic disorders involving glycolipids that are often seen with the condition. This review presents an in-depth overview of hepatokines that affect PCOS and its associated glycolipid metabolic disorders, providing key insights into the hepato-ovarian axis.