Chromatin remodeling as a molecular bridge between insulin resistance and hyperandrogenism in polycystic ovary syndrome: Current evidence and future perspectives
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Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine and metabolic disorder, in which the interaction between insulin resistance (IR) and hyperandrogenism (HA) is a major driver of reproductive and metabolic complications. Accumulating evidence ...
MorePolycystic ovary syndrome (PCOS) is a heterogeneous endocrine and metabolic disorder, in which the interaction between insulin resistance (IR) and hyperandrogenism (HA) is a major driver of reproductive and metabolic complications. Accumulating evidence suggests that chromatin remodeling may represent a regulatory layer linking metabolic stress, inflammation, steroidogenic gene expression, and androgen receptor activity. Research indicates that chromatin remodeling may be a key regulatory factor linking metabolic stress, inflammation, steroidogenic gene expression, and androgen receptor activity. This review systematically summarizes current evidence on chromatin remodeling in PCOS-related IR and HA, focusing on histone modifications, DNA methylation, ATP-dependent remodeling complexes, transcription factors, and non-coding RNA-mediated regulation. We distinguish between direct evidence from PCOS tissues and cells and indirect evidence from metabolic, endocrine, and hormone-responsive disease models, proposing a hierarchy of evidence. Available data suggest that chromatin remodeling may influence insulin signaling genes, adipogenesis, ovarian steroidogenic enzymes, and co-transcriptional networks involving Forkhead box protein O1 (FOXO1), Peroxisome Proliferator-Activated Receptor γ (PPARγ), nuclear factor-kappa B (NF-κB), androgen receptor (AR) signaling, and SWI/SNF-related complexes. However, PCOS-specific functional validation remains limited, particularly in theca cells, granulosa cells, adipose tissue, and cell-type-resolved chromatin. Integrating multi-omics, single-cell epigenomics, and CRISPR-based epigenome editing may help identify causal chromatin regulators and clinically relevant PCOS subtypes. We further discuss how computational biomedical approaches, including bioinformatics, Artificial Intelligence (AI), machine learning, and multi-omics integration, can enhance mechanistic inference, biomarker discovery, and PCOS subtype stratification. A chromatin-centric framework may deepen our understanding of the IR-HA cycle and support future biomarker discovery and precision interventions in PCOS.
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Maoxing Ran, ... Huimin Dang
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DOI: https://doi.org/10.70401/cbm.2026.0024 - September 11, 2026
