Malondialdehyde\'s Contribution to Polycystic Ovary Syndrome: Evidence from a Meta-analysis and Systematic Review

Aims and background: Malondialdehyde (MDA) represents a significant indicator for lipid peroxidation and oxidative stress (OS), which have been progressively associated with metabolic and reproductive anomalies in polycystic ovary syndrome (PCOS).Elucidating its function may enhance comprehension of the disease and inform therapeutic interventions.This meta-analysis evaluated MDA levels in PCOS-affected females.Methods: A search for available literature was performed using the PICOS framework and PRISMA 2020 standards in ScienceDirect, PubMed, and Google Scholar.Eligible studies measured MDA concentration in serum or follicular fluid and then compared the results between PCOS females and healthy controls.Study quality was assessed based on established critical appraisal standards, and combined effect sizes were estimated through a random-effects approach with 95% confidence intervals (CIs).Results: Fifteen studies met the inclusion criteria.Polycystic ovary syndrome females exhibited considerably higher concentrations of MDA than healthy subjects [standardized mean difference (SMD) = 1.62; 95% CI: 1.00-2.24;p < 0.00001; I² = 97%].Subgroup analysis revealed that serum MDA levels were significantly augmented (SMD = 1.92; 95% CI: 1.19-2.65;p < 0.00001; I² = 97%), while follicular fluid MDA exhibited no difference (SMD = 0.33; 95% CI: -0.05-0.72;p = 0.09; I² = 52%).The difference between subgroups was significant (Chi² = 14.19; p = 0.0002; I² = 92.9%),indicating that sample type influences OS measurement.Conclusion: Polycystic ovary syndrome in reproductive females exhibited elevated levels of MDA as lipid peroxidation byproducts, which suggests an increase in OS.Serum levels seem to provide a more dependable measure than follicular fluid for evaluating systemic oxidative status.High heterogeneity underscores the necessity for more studies and standardized methodologies to clarify the function of OS in PCOS.Clinical significance: Higher lipid peroxidation levels point to OS as a major factor in the endocrine and physiological disturbances seen in PCOS.Assessing these markers may help in evaluating disease severity and treatment response.Recognizing this link may also help guide the invention of antioxidant-based therapies for managing PCOS, reducing oxidative damage and leading to better overall outcomes in PCOS.