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    Dietary Antioxidant Capacity, Inflammation, and Insulin Resistance in Women with Polycystic Ovary Syndrome: An Integrated Metabolic and Nutritional Assessment
    (Dove Medical Press Ltd, 2026) Alatas, Hacer; Arslan, Nurgul; Keskin, Lezan; Agrali, Cansu
    Background: Polycystic ovary syndrome (PCOS) is characterized by metabolic dysfunction, low-grade inflammation, and oxidative stress. However, the role of dietary antioxidant capacity in shaping inflammatory and metabolic outcomes remains insufficiently explored. Objective: To evaluate dietary antioxidant capacity and its associations with inflammation and insulin resistance among women with PCOS compared with healthy controls. Methods: A cross-sectional study was conducted with 129 women with PCOS and 135 age-matched controls. Dietary antioxidant capacity was assessed through a composite antioxidant score. Anthropometric indices, inflammatory markers (WBC, neutrophils, NLR), and metabolic parameters (fasting glucose, insulin, HOMA-IR) were compared. Structural equation modeling (SEM) and hierarchical regression were used to test direct and indirect pathways linking diet, inflammation, and insulin resistance. Results: Women with PCOS had significantly lower total dietary antioxidant scores than controls (11.8 vs. 14.3). Inflammatory status was higher, with NLR values elevated in the PCOS group (2.09 vs. 1.63). Insulin resistance showed the largest difference: HOMA-IR levels were nearly twice as high in women with PCOS (3.52 vs. 1.98). Structural equation modeling indicated that higher antioxidant intake reduced insulin resistance both directly ((3 = -0.21) and indirectly by lowering inflammation ((3 = -0.13). Regression analyses confirmed that PCOS status, higher inflammation, and lower antioxidant intake independently predicted increased HOMA-IR. Conclusion: Reduced antioxidant intake is strongly linked with heightened inflammation and impaired insulin sensitivity in women with PCOS. Enhancing antioxidant-rich dietary patterns may offer a promising nutritional strategy to mitigate metabolic and inflammatory disturbances in PCOS.