Assessment of Oxidative Stress Markers in Women with PCOS Versus Controls- A Cross-Sectional Study
DOI:
https://doi.org/10.61919/4q90qg72Abstract
Background: Polycystic ovary syndrome is a common endocrine-metabolic disorder characterised by insulin resistance, hyperandrogenism, and increased cardiometabolic risk. Oxidative stress has been proposed as a mechanistic link between metabolic dysfunction and endocrine disturbance in PCOS, yet data from South Asian populations remain limited. Objective: To compare circulating oxidative stress markers and antioxidant capacity between women with PCOS and healthy controls and to examine their associations with metabolic and hormonal parameters. Methods: In this cross-sectional study, 100 women aged 18–35 years were enrolled, including 50 women with PCOS diagnosed using Rotterdam criteria and 50 healthy controls. Anthropometric measurements, metabolic indices, and reproductive hormones were assessed. Serum malondialdehyde, total antioxidant capacity, and superoxide dismutase activity were measured using standard spectrophotometric assays. Group comparisons and correlation analyses were performed using appropriate parametric methods. Results: Women with PCOS exhibited significantly higher malondialdehyde levels and significantly lower total antioxidant capacity and superoxide dismutase activity compared with controls. Oxidative stress markers were strongly associated with insulin resistance and total testosterone concentrations, while antioxidant markers correlated inversely with adverse metabolic parameters. Conclusion: Women with PCOS demonstrate increased oxidative stress and impaired antioxidant defence closely linked to metabolic and hormonal abnormalities. Oxidative imbalance may represent a biologically relevant component of PCOS pathophysiology and a potential target for metabolic risk modification.
References
1. Bahreiny SS, Ahangarpour A, Saki N, Dabbagh MR, Ebrahimi R, Mahdizade AH, et al. Association of Free Radical Product and Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Reprod Sci. 2024;31(6):1486-95.
2. Amirkhizi F, Taghizadeh M, Khalese-Ranjbar B, Hamedi-Shahraki S, Asghari S. Association of Serum Selenium and Selenoprotein P With Oxidative Stress Biomarkers in Patients With Polycystic Ovary Syndrome. Biol Trace Elem Res. 2024;202(3):947-54.
3. Li YY, Peng YQ, Yang YX, Shi TJ, Liu RX, Luan YY, et al. Baicalein Improves the Symptoms of Polycystic Ovary Syndrome by Mitigating Oxidative Stress and Ferroptosis in the Ovary and Gravid Placenta. Phytomedicine. 2024;128:155423.
4. Wang M, Zhang BQ, Ma S, Xu Y, Zhao DH, Zhang JS, et al. Broadening Horizons: The Role of Ferroptosis in Polycystic Ovary Syndrome. Front Endocrinol (Lausanne). 2024;15:1390013.
5. Yang L, Xu Y, Gao Y, Wan X, Chen N. Cadmium-Mediated Autophagy Increases Ferroptosis of Ovarian Granulosa Cells. Toxicology. 2025;517:154224.
6. Abudawood M, Tabassum H, Binhassan S, Aljohar HI, AbdelJawad JM. Dysprosium, Cerium, Indium, Yttrium, and Lutetium as Emerging Contributors to Oxidative Stress in Polycystic Ovary Syndrome. Sci Rep. 2025;15(1):25343.
7. Zadeh Modarres S, Asemi Z, Heidar Z. The Effects of Selenium Supplementation on Glycemic Control, Serum Lipoproteins, and Biomarkers of Oxidative Stress in Infertile Women Diagnosed With Polycystic Ovary Syndrome Undergoing In Vitro Fertilization: A Randomized, Double-Blind, Placebo-Controlled Trial. Clin Nutr ESPEN. 2022;51:92-6.
8. Oktanella Y, Ismiawati H, Zakaria H, Untari H. Exploring Blood Pressure Dynamics and Oxidative Stress Markers in an Animal Model of Polycystic Ovary Syndrome. Open Vet J. 2024;14(8):1858-65.
9. Maleki-Hajiagha A, Mojab F, Amidi F, Amini L. Exploring the Therapeutic Impact of Salvia officinalis on Lipid and Oxidative Stress Markers in Patients With Polycystic Ovary Syndrome: A Randomized Placebo-Controlled Clinical Trial. BMC Complement Med Ther. 2025;25(1):114.
10. Voros C, Chatzinikolaou F, Papadimas G, Polykalas S, Mavrogianni D, Koulakmanidis AM, et al. Ferroptosis in the Ovarian Follicular Microenvironment: A Redox-Dependent Cell Death Pathway With Emerging Roles in PCOS, Oocyte Quality, and IVF Outcomes. Int J Mol Sci. 2025;26(21):—.
11. Zhao P, Wang X, Zhang Q, Xiu Y, Sun K, Yu Y. Growth Hormone’s Impact on Oxidative Stress, Ovarian Response, and In Vitro Fertilization in Polycystic Ovary Syndrome Across Different Ages. Br J Hosp Med (Lond). 2025;86(10):1-18.
12. Wang Y, Wang Y, Chen Y, Gao Q, Hou L, Feng X. HDAC5 Inhibits Ovarian Angiogenesis in Dehydroepiandrosterone-Induced Mouse Model of Polycystic Ovary Syndrome. Folia Histochem Cytobiol. 2022;60(3):260-70.
13. Shruthi S, Nirmaladevi V, Aravindhan V. Increased Circulating Levels of Novel Anti-Inflammatory Cytokines IL-27 and IL-38 Are Associated With Immunoendocrine Dysregulation and Altered Redox Stress in Polycystic Ovary Syndrome. J Reprod Immunol. 2024;166:104388.
14. Tosatti JAG, Alves MT, Cândido AL, Reis FM, Araújo VE, Gomes KB. Influence of n-3 Fatty Acid Supplementation on Inflammatory and Oxidative Stress Markers in Patients With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Br J Nutr. 2021;125(6):657-68.
15. Hayat N, Akram Z, Khalid N, Ullah NR, Mazhar T. Link Between Iron-Mediated Lipid Peroxidation and Polycystic Ovary Syndrome: Exploring the Genes Underlying Iron Regulatory Mechanisms. J Ovarian Res. 2025;18(1):48.
16. Azim SS, Haque Z, Khan S, Hasan JA, Zaheer S, Parveen S. Oxidative Stress in Polycystic Ovary Syndrome: A Case-Control Study. J Pak Med Assoc. 2024;74(1 Suppl 2):S2-S7.
17. Liu Y, Yu Z, Zhao S, Cheng L, Man Y, Gao X, et al. Oxidative Stress Markers in the Follicular Fluid of Patients With Polycystic Ovary Syndrome Correlate With a Decrease in Embryo Quality. J Assist Reprod Genet. 2021;38(2):471-7.
18. Ji R, Wang S, Chen X, Yang Z, Zhang Z, Bao S, et al. Platycodin D Ameliorates Polycystic Ovary Syndrome–Induced Ovarian Damage by Upregulating CD44 to Attenuate Ferroptosis. Free Radic Biol Med. 2024;224:707-22.
19. Cai Z, Zhang R, Liu R, Zhao L, Zhou L. Plumbagin Ameliorates Ferroptosis of Ovarian Granulosa Cells in Polycystic Ovary Syndrome by Downregulating SLC7A5 m6A Methylation Through Inhibition of YTHDF1. J Ovarian Res. 2025;18(1):115.
20. Mizgier M, Jarząbek-Bielecka G, Wendland N, Jodłowska-Siewert E, Nowicki M, Brożek A, et al. Relation Between Inflammation, Oxidative Stress, and Macronutrient Intakes in Normal and Excessive Body Weight Adolescent Girls With Clinical Features of Polycystic Ovary Syndrome. Nutrients. 2021;13(3):—.
21. Han T, Liu S, Liu H, Wang X, Yang X, Chan S, et al. The Role of Gut-Brain Tryptophan Metabolism and Fatty Acid Peroxidation in the Effect of Sleep Deprivation on Anxiety and Depression in PCOS Mice. Mol Neurobiol. 2025;62(10):12747-67.
22. Ye R, Mao YM, Fei YR, Shang Y, Zhang T, Zhang ZZ, et al. Targeting Ferroptosis for the Treatment of Female Reproductive System Disorders. J Mol Med (Berl). 2025;103(4):381-402.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Tania Sehar Joseph, Syeda Amnah Gillani, Naheed Shah, Hina Ali Ahmed, Ayesha Aziz, Syeda Kisa Zahra (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
