Abstract:

Insulin resistance (IR) is a key pathophysiological driving factor for polycystic ovary syndrome (PCOS). Approximately 56.3% of Chinese PCOS patients have IR. Although the hyperinsulinemic-euglycemic clamp test is the gold standard for diagnosing IR, alternative indicators such as the homeostasis model assessment of insulin resistance (HOMA-IR) are more commonly used based on clinical feasibility. Lifestyle intervention is the cornerstone of treatment. High-intensity interval training can significantly improve insulin sensitivity and reproductive outcomes by enhancing skeletal muscle glucose metabolism. Time-restricted eating and ketogenic diet can enhance insulin sensitivity and improve endocrine and metabolic indicators independently of weight loss effects. Psychophysical interventions targeting psychological comorbidities also contribute to improving metabolism and enhancing the quality of life. In terms of drug therapy, apart from the traditional insulin-sensitizing drug metformin, thiazolidinediones (such as pioglitazone) have also shown potential in improving the metabolic level of PCOS. The rational use of metabolic supplements can also help PCOS patients restore menstrual regularity and improve metabolic indicators.

Key words: Polycystic ovary syndrome, Insulin resistance, Lifestyle intervention, Insulin-sensitizing drugs, Metabolic supplements