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This low-grade systemic inflammation: Impairs insulin receptor signalling, directly worsening insulin resistance Damages ovarian granulosa cells, impairing egg development and ovarian function Disrupts gut barrier integrity, contributing to what some researchers call a "leaky gut" pattern associated with systemic inflammation Amplifies HPA axis dysregulation, raising cortisol and further disrupting sex hormone balance Chronic inflammation is both a consequence of PMOS and a driver that perpetuates it

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Alongside impairments in carbohydrate metabolism, evidence of reduced carnitine levels suggest a dysfunction in mitochondrial -oxidation, leading to accumulation of long-chain fatty acids and elevated markers of lipid elongation and desaturation (Filipek et al., 2004

Virus Res 286:198003