Narrative review explores hepatokines and hepato-ovarian axis in PCOS metabolic disorders

This narrative review synthesizes existing literature on the connection between polycystic ovary syndrome (PCOS), glycolipid metabolic disorders, and hepatokines in women of reproductive age. The review describes how PCOS is associated with glycolipid metabolic disorders and proposes that the liver produces hepatokines which may influence these disorders and PCOS via a 'distant crosstalk' mechanism. It notes an established connection between PCOS and non-alcoholic fatty liver disease (NAFLD), with the hepato-ovarian axis considered a possible underlying mechanism.

No new primary data, effect sizes, or statistical measures are reported, as this is a summary of associative and hypothetical evidence. The review does not report on specific interventions, comparators, primary outcomes, or safety and tolerability data. Key details such as sample size, study setting, and follow-up duration are not provided.

Major limitations stem from the nature of the evidence. The review describes associations and hypotheses but does not establish causation. It lacks quantitative data on the strength of associations or clinical outcomes. The practice relevance is not reported, and no treatment implications can be derived. Funding sources and potential conflicts of interest are also not reported.

For clinicians, this review highlights an area of ongoing biological investigation into the systemic metabolic aspects of PCOS. The proposed hepato-ovarian axis represents a theoretical framework for understanding comorbidity, not a validated therapeutic target. Current clinical management should continue to be guided by established evidence for PCOS and its associated metabolic conditions.