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Published on: March 5, 2022
Association between dietary inflammatory index and polycystic ovary syndrome: a meta-analysis of case-control studies
Junmei Huang1, Chunyan Dong1, Danyi Qiu1
1Department of Nutrition, Sanya Central Hospital (The Third People's Hospital of Hainan Province), Sanya, China.
Objective:
This study aimed to systematically analyze the association of the dietary inflammatory index (DII) with polycystic ovary syndrome (PCOS) status, thus offering evidence-based support for dietary interventions in the management of PCOS.
Methods:
Four databases were systematically searched to collect case-control studies on DII and PCOS published up to December 21, 2025. The Newcastle-Ottawa Scale (NOS) was utilized to assess the risk of bias in the included studies. Using Stata 15.0, we conducted a meta-analysis to compare DII scores in PCOS patients versus those in healthy controls. Subgroup analyses were conducted to identify sources of heterogeneity. An exploratory meta-regression was conducted, but due to the small number of studies, the results could not be interpreted.
Results:
Six case-control studies involving 1,554 participants were ultimately included. Meta-analysis revealed slightly but statistically significantly higher DII scores in the PCOS group than in healthy controls (standardized mean difference [SMD]: 0.23; 95% confidence interval [CI]: 0.06-0.40; P = 0.008). Sensitivity analyses suggested robustness of the results. Egger's test showed no statistical evidence of publication bias (P = 0.611); however, with only six studies the statistical power was very low, so publication bias cannot be excluded, and this analysis should be regarded as exploratory.
Conclusion:
Pro-inflammatory dietary patterns are modestly associated with PCOS. Although causality inference is impossible due to the design of included studies, existing evidence supports DII as a potential tool for estimating PCOS status associated with diet. The small effect size observed in this study indicates a significant association between DII and PCOS. However, statistical association does not necessarily imply practical clinical relevance, and further studies are warranted to replicate and validate this relationship.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/1239576, identifier CRD420251239576.
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