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Katica Bajuk Studen Nuclear Medicine Department, University Medical Centre Ljubljana, Ljubljana, Slovenia

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Marija Pfeifer Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

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aim of this article is to explore and review current evidence that associates PCOS with cardiometabolic abnormalities and possibly an increased risk of cardiovascular disease. Insulin resistance, metabolic syndrome, obesity and sleep disturbances

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Ruixin Hu School of pharmacy, Qing Dao University, Qingdao, China

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Yanting Yuan School of pharmacy, Qing Dao University, Qingdao, China

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Chaolong Liu School of pharmacy, Qing Dao University, Qingdao, China

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Ji Zhou School of pharmacy, Qing Dao University, Qingdao, China

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Lixia Ji School of pharmacy, Qing Dao University, Qingdao, China

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Guohui Jiang School of pharmacy, Qing Dao University, Qingdao, China

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ongoing leaky gut. In obesity or the early stage of T2DM, systemic insulin resistance can trigger a compensatory response, increase the workload of pancreas and enhance the insulin secretion by pancreas β-cells. Some evidence have proved that pancreas β

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Zhiwei Zhang Department of Obstetrics and Gynecology, Liaocheng People’s Hospital, Liaocheng, Shandong, China

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Hui Zhao Department of Obstetrics and Gynecology, Liaocheng People’s Hospital, Liaocheng, Shandong, China

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Aixia Wang Department of Obstetrics and Gynecology, Liaocheng People’s Hospital, Liaocheng, Shandong, China

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treating diabetes, insulin is primarily used to lower blood glucose ( 3 ), but the dosage of insulin widely varies among individuals, which in addition to insulin resistance compromises its clinical utility in reducing maternal and neonatal complications

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Charissa van Zwol-Janssens Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Aglaia Hage Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Kim van der Ham Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Birgitta K Velthuis Department of Radiology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands

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Ricardo P J Budde Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands

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Maria P H Koster Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Arie Franx Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Bart C J M Fauser Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht & University of Utrecht, Utrecht, the Netherlands

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Eric Boersma Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Daniel Bos Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Joop S E Laven Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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Yvonne V Louwers Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, the Netherlands

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the CREW consortium
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the CREW consortium

relation between PCOS and BD is less well-known. PCOS is associated with central obesity, dyslipidemia, hypertension, and insulin resistance ( 7 ), which all have been described to decrease BD ( 8 , 9 , 10 , 11 ). However, hyperandrogenism, one of the

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Jun-Xin Yan The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China

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Bin-Jing Pan The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China

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Ping-Ping Zhao The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China

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Li-Ting Wang The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

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Jing-Fang Liu The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

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Song-Bo Fu The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

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of obesity and MS. NAFLD is closely related to type 2 diabetes (T2DM), both of which have the pathophysiological manifestations of excessive fat accumulation and insulin resistance ( 3 , 4 , 5 ). Approximately 10% of adults have diabetes and 90

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Wenqi Yang Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Ling Liu Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Yuan Wei Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Chunlu Fang Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Fu Zhou Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Jinbao Chen Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Qinghua Han Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Meifang Huang Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Xuan Tan Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Qiuyue Liu Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Qiang Pan Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Lu Zhang Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Xiaojuan Lei Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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Liangming Li Center for Scientific Research and Institute of Exercise and Health, Guangzhou Sports University, Guangzhou, China
Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China

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insulin resistance and show more disorganized liver lipid metabolism compared to their WT littermate controls ( 3 , 4 , 5 ). On the other hand, replenishment of FGF21 can reduce obesity, improve insulin sensitivity and increase glucose clearance ( 5 , 6

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Alessandra Gambineri Endocrinology Unit, Department of Medical and Surgical Sciences, St Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna, Italy

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Carla Pelusi Endocrinology Unit, Department of Medical and Surgical Sciences, St Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna, Italy

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development of T2DM in PCOS ( 17 ). These data support the most widely accepted hypothesis that the increased risk of T2DM in PCOS is mainly related to the strong interaction between androgens, obesity and peripheral insulin resistance. Animal studies

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Monika Karczewska-Kupczewska Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland

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Agnieszka Nikołajuk Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland

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Magdalena Stefanowicz Department of Metabolic Diseases, Medical University of Białystok, Białystok, Poland

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Natalia Matulewicz Department of Metabolic Diseases, Medical University of Białystok, Białystok, Poland

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Irina Kowalska Department of Internal Medicine and Metabolic Diseases, Medical University of Białystok, Białystok, Poland

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Marek Strączkowski Department of Prophylaxis of Metabolic Diseases, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland

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observed in different populations ( 8 , 11 , 13 ). Systemic chemerin levels were also found to be associated with markers of fatty liver disease ( 12 ). The main pathophysiological factor of obesity-related metabolic complications is insulin resistance

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Emanuela Zaharieva Department of Internal Medicine, University Hospital Alexandrovska, Clinic of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria

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Zdravko Kamenov Department of Internal Medicine, University Hospital Alexandrovska, Clinic of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria

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Tsvetelina Velikova Department of Clinical Immunology, University Hospital St. Ivan Rilski, Laboratory of Clinical Immunology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria

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Adelina Tsakova Department of Clinical Laboratory, University Hospital Alexandrovska, Central Clinical Laboratory, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria

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Yosif El-Darawish Laboratory of Tumor Immunology and Cell Therapy, Hyogo College of Medicine, Hyogo, Japan

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Haruki Okamura Laboratory of Tumor Immunology and Cell Therapy, Hyogo College of Medicine, Hyogo, Japan

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associated with a chronic low-grade inflammation ( 5 ) that has been implicated as a crucial factor for insulin resistance ( 6 ) and also beta-cell dysfunction ( 7 , 8 ). Patients diagnosed with latent autoimmune diabetes of the adults (LADA) ( 9

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Xiaobing Lu Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Jiang Yue Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Qianjing Liu Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Shengyun He Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Ying Dong Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Ming Zhang Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Yicheng Qi Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Minglan Yang Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Wang Zhang Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Hua Xu Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Qing Lu Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Jing Ma Department of Endocrinology and Metabolism, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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glucose clearance. It is responsible for the majority of glucose uptake in the postprandial state and is also considered as the primary driver of systemic insulin resistance ( 6 , 7 ). Due to its crucial role in systemic glycometabolism, skeletal muscle

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