Introduction
Polycystic ovary syndrome (PCOS) is a common and complex
endocrine-metabolic disorder affecting 5-20% women of reproductive age
worldwide.1 Patients with PCOS are at an increased
risk of diverse reproductive and metabolic dysfunctions, such as
obesity, insulin resistance, dyslipidemia, and metabolic
syndrome.2 Using RNA sequencing techniques, our
previous studies first revealed that monosaccharide biosynthesis is a
novel marker for identifying patients with PCOS.3
Fructose is an important monosaccharide and fructose consumption is
associated with the risk of developing dyslipidemia, fatty liver and
insulin resistance,4 all of which are associated with
PCOS. Recently, we first found that
fructose metabolism of PCOS
patients has significant differences from normal controls, and the
abnormal fructose metabolism may be related to obese and insulin
resistance in PCOS patients.5 Noteworthy, fructose is
the only carbohydrate that generates uric acid during its
metabolism6 and a synergistic effect of fructose on
uric acid levels has been suggested.7 Fructose appears
to mediate the metabolic disorders in part by raising uric
acid8 and accumulating evidence indicates that
fructose-induced hyperuricemia has a key role in the development of
insulin resistance.7 Meanwhile, the importance of uric
acid in reproductive diseases has been increasingly recognized, for
example, serum uric acid levels are associated with increased odds of
anovulation among young women.9 Despite these advances
in knowledge, the relationship between serum fructose and uric acid in
PCOS remains poorly understood and their relationship with PCOS-related
metabolic disorders needs to be further explored. Thus, in this study,
we measure and evaluate serum fructose and uric acid levels in a same
cohort from PCOS patients and control subjects, and apply a flexible and
powerful approach, restricted cubic splines, to analyze the association
between fructose and uric acid in women with PCOS.