Ovulatory disorders are the most common clinical feature exhibited among obese women. Initiation of ovulation physiologically requires a surge of gonadotropin-releasing hormone (GnRH) released from GnRH neurons located in the hypothalamus. These GnRH neurons receive metabolic signals from circulation and vicinal neurons to regulate GnRH release. Leptin acts indirectly on GnRH via adjacent leptin receptor (LEPR)-expressing neurons such as proopiomelanocortin (POMC), neuropeptide Y (NPY)/agouti-related peptide (AgRP), and neuronal nitric oxide (NO) synthase (nNOS) neurons to affect GnRH neuronal activities. Additionally, hypothalamic inflammation also affects ovulation independent of obesity. Therefore, this review focuses on hypothalamic mechanisms that underlie the disturbance of hypothalamic–pituitary–ovarian (HPO) axis during obesity with an attempt to promote future studies and/or novel therapeutic strategies for ovulatory disorders in obesity.

排卵障碍是肥胖女性最常见的临床特征。生理上排卵的开始需要从位于下丘脑的 GnRH 神经元释放的促性腺激素释放激素 (GnRH) 激增。这些 GnRH 神经元接收来自循环和邻近神经元的代谢信号以调节 GnRH 的释放。瘦素通过邻近的表达瘦素受体 (LEPR) 的神经元间接作用于 GnRH，如阿片黑皮质素原 (POMC)、神经肽 Y (NPY)/刺鼠相关肽 (AgRP) 和神经元一氧化氮 (NO) 合酶 (nNOS) 神经元，以影响GnRH 神经元活动。此外，下丘脑炎症也会影响排卵，而与肥胖无关。所以，