Association between Dietary Inflammatory Index and cardiometabolic risk in women with polycystic ovary syndrome

Abstract Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiometabolic disorders, often exacerbated by chronic inflammation. This study aims to investigate the effects of the Dietary Inflammatory Index (DII), a measure of the inflammatory potential of diet, on cardiometabolic risk factors in women with PCOS. We hypothesised positive associations between DII and adverse cardiometabolic profile in PCOS. In this case–control study, thirty-eight women with PCOS (mean age 21·6 years, BMI 26·3 kg/m 2 ) and 39 age- and BMI-matched healthy controls (mean age 21·2 years, BMI 25·9 kg/m 2 ) were included. Clinical, hormonal and biochemical assessments were conducted. Dietary intake was assessed using a validated FFQ to calculate DII. Women with PCOS exhibited significantly higher fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR) and a more adverse lipid profile compared with healthy controls, indicating increased cardiometabolic risk. These differences remained significant after adjusting for the DII, suggesting they are primarily attributable to PCOS, as shown by ANCOVA analysis. In contrast, higher Triglyceride-Glucose Index, Cardiometabolic Index and Visceral Adiposity Index values observed in the PCOS group were largely explained by DII. Furthermore, DII was positively associated with anthropometric and biochemical markers, including waist-to-hip ratio, fasting glucose, TAG and cardiovascular risk indices, indicating that higher dietary inflammation is linked to poorer cardiometabolic health in women with PCOS. A pro-inflammatory dietary pattern, reflected by a higher DII score, is associated with unfavourable cardiometabolic risk factors in women with PCOS. These findings underscore the importance of dietary inflammation in the pathophysiology of PCOS and support anti-inflammatory dietary strategies to mitigate associated risks.