Unravelling the triangular relationship between polycystic ovary syndrome, cardiometabolic disease and de novo lipogenesis: It's all in the genes

Polycystic ovary syndrome (PCOS), a disorder characterized by an irregular menstrual cycle, hyperandrogenism and polycystic ovaries, is the most common hormonal imbalance among premenopausal women. It is well known that PCOS patients are at increased risk of developing cardiometabolic disease, i.e. type 2 diabetes and cardiovascular disease. By using observational and genetic studies, this thesis identified that PCOS does not lead to an increased risk of cardiometabolic disease per se. Rather, de novo lipogenesis – the conversion of glucose and fructose into fat in the liver – causally affects the risk of cardiometabolic disease and PCOS. The findings in this thesis extend our knowledge of the PCOS pathophysiology and identify potential targets for risk stratification and treatment of women with PCOS.