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The increase in PYY and gastric inhibitory polypeptide affects the secretion of sex hormones from the pituitary gland and hypothalamus through the gut-brain axis, leading to the hypothesis that brain-gut mediators may be involved in the occurrence and development of PCOS by influencing the HPG axis and HPA axis ( 4 Gut microbiota-based therapies 4.1 Diet-targeted intervention A systematic review and meta-analysis of 39 471 women showed that women with PCOS have a lower overall diet quality, poorer dietary intakes (higher cholesterol, lower magnesium and zinc), and lower total physical activity (61)

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Immunometabolism is the study of immune cell metabolism and aim to develop therapies which modulate metabolism and regulate endogenous metabolites with anti-inflammatory effects (235)