Polycystic ovary syndrome, cardiovascular risk, and coffee: a complex interplay

Anna Vittoria Mattioli

doi:10.24171/j.phrp.2025.0004

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Commentary Polycystic ovary syndrome, cardiovascular risk, and coffee: a complex interplay: Anna Vittoria Mattioli; Osong Public Health and Research Perspectives 2025;16(1):89-90.
DOI: https://doi.org/10.24171/j.phrp.2025.0004
Published online: February 17, 2025

Department of Quality of Life Sciences, University of Bologna-Alma Mater Studiorum, Bologna, Italy

Corresponding author: Anna Vittoria Mattioli Department of Quality of Life Sciences, University of Bologna-Alma Mater Studiorum, Via Irnerio 48, 40126 Bologna, Italy E-mail: annavittoria.mattioli@unibo.it

• Received: January 4, 2025 • Accepted: January 22, 2025

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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The recent article by Ildarabadi et al. [1], “Effects of green coffee supplementation on paraoxonase-1 activity and malondialdehyde levels in Iranian women with polycystic ovary syndrome: a randomized clinical trial,” published in Osong Public Health Research Perspectives (2024), highlights the potential benefits of green coffee in addressing metabolic and oxidative stress-related aspects of polycystic ovary syndrome (PCOS). This compelling research inspires further exploration into the intricate relationships among PCOS, cardiovascular risk, and coffee consumption.

PCOS is a multifaceted endocrine disorder with significant metabolic and cardiovascular implications. Its prevalence among women of reproductive age underscores the importance of understanding and mitigating associated risks [2]. Recent studies have emphasized oxidative stress, dyslipidemia, and insulin resistance as central mechanisms driving cardiovascular complications in PCOS [3,4]. Intriguingly, coffee—a widely consumed beverage with antioxidant properties—has emerged as a potential modulator of these risks [5].

Coffee contains bioactive compounds such as chlorogenic acid, which is known for its antioxidative and anti-inflammatory effects [5]. Evidence suggests that moderate coffee consumption may increase paraoxonase-1 (PON-1) activity, reduce oxidative stress markers like malondialdehyde, and improve the lipid profile [6]. The randomized trial conducted by Ildarabadi et al. [1] demonstrated that green coffee supplementation significantly increased PON-1 levels and lowered cholesterol and triglyceride levels in women with PCOS. These findings align with broader research indicating that coffee has the potential to modulate metabolic pathways implicated in PCOS, including those influencing glucose and lipid metabolism [7].

However, the relationship between coffee and cardiovascular health in PCOS is complex. High caffeine intake can intensify sympathetic nervous system activity, potentially increasing the risk of arrhythmia in predisposed individuals [8]. Moreover, disparities in the effects of coffee may arise due to varying caffeine tolerance, genetic predispositions, and the hormonal milieu specific to PCOS [7,8].

Despite these complexities, integrating coffee or its bioactive components into dietary recommendations offers promise as a complementary strategy for cardiovascular risk reduction in PCOS [9]. Future research should aim to establish dose-response relationships, explore the long-term impacts of coffee consumption, and examine interactions with common pharmacological treatments for PCOS. Such insights will be instrumental in developing personalized interventions for this high-risk population [10].

Thank you for the opportunity to share these observations. I hope they contribute to ongoing discourse and encourage further exploration of this pertinent intersection.

HIGHLIGHTS

• Bioactive compounds in coffee, such as chlorogenic acid, have antioxidative and anti-inflammatory effects, which may help reduce oxidative stress and metabolic dysfunction commonly seen in polycystic ovary syndrome (PCOS).

• Moderate coffee consumption has been associated with increased paraoxonase-1 (PON-1) activity and improved lipid profiles, which could help mitigate the heightened cardiovascular risk in women with PCOS.

• While coffee may offer benefits, excessive caffeine intake can stimulate the sympathetic nervous system, potentially worsening arrhythmia risk in predisposed individuals with PCOS, necessitating personalized dietary recommendations.

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The author has no conflicts of interest to declare.

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References

1. Ildarabadi A, Vahid-Dastjerdi M, Ghorbanpour M, et al. Effects of green coffee supplementation on paraoxonase-1 activity and malondialdehyde levels in Iranian women with polycystic ovary syndrome: a randomized clinical trial. Osong Public Health Res Perspect 2024;15:521−32. Article PubMed PMC PDF
2. Anagnostis P, Tarlatzis BC, Kauffman RP. Polycystic ovarian syndrome (PCOS): long-term metabolic consequences. Metabolism 2018;86:33−43. Article PubMed
3. Osibogun O, Ogunmoroti O, Michos ED. Polycystic ovary syndrome and cardiometabolic risk: opportunities for cardiovascular disease prevention. Trends Cardiovasc Med 2020;30:399−404. Article PubMed
4. Mattioli AV, Moscucci F, Sciomer S, et al. Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on ‘Prevention, hypertension and peripheral disease’. J Cardiovasc Med (Hagerstown) 2023;24(Suppl 2). e147−55. Article PubMed
5. Temple JL, Bernard C, Lipshultz SE, et al. The safety of ingested caffeine: a comprehensive review. Front Psychiatry 2017;8:80. Article PubMed PMC
6. Mattioli AV, Migaldi M, Farinetti A. Coffee in hypertensive women with asymptomatic peripheral arterial disease: a potential nutraceutical effect. J Cardiovasc Med (Hagerstown) 2018;19:183−5. Article PubMed
7. Singh S, Pal N, Shubham S, et al. Polycystic ovary syndrome: etiology, current management, and future therapeutics. J Clin Med 2023;12:1454. Article PubMed PMC
8. Coppi F, Bucciarelli V, Sinigaglia G, et al. Sex related differences in the complex relationship between coffee, caffeine and atrial fibrillation. Nutrients 2023;15:3299. Article PubMed PMC
9. Meliani-Rodriguez A, Cutillas-Tolin A, Mendiola J, et al. Association between coffee consumption and polycystic ovary syndrome: an exploratory case-control study. Nutrients 2024;16:2238. Article PubMed PMC
10. Mattioli AV, Gallina S. Early cardiovascular prevention: the crucial role of nurse-led intervention. BMC Nurs 2023;22:347. Article PubMed PMC PDF

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Polycystic ovary syndrome, cardiovascular risk, and coffee: a complex interplay