Bone as an active connective and endocrine tissue is influenced by hormones, physical activity, inflammatory factors, minerals, dietary components, and body weight. Bone fractures are a major cause of decreased quality of life and mortality in humans. Polycystic ovary syndrome (PCOS), is one of the most common endocrine disorders in women of reproductive age worldwide. PCOS is associated with disturbances in androgen and estrogen levels, insulin resistance (IR), obesity, as well as low-grade chronic inflammation, and gut microbiota (GM) dysbiosis, all of which may negatively or positively affect bone metabolism. However, it has not yet been well clarified whether PCOS is bone-protective or bone-destructive. This study aimed to review the association between bone health and PCOS, and summarize its related factors. PubMed, Scopus, and Web of Science databases were searched to retrieve relevant English publications investigating the relationship between bone health and PCOS. Several disorders associated with PCOS can negatively or positively affect bone metabolism. Despite some positive effects of insulin, androgens, estrogens, and obesity on bone, IR, estrogen deficiency, low-grade chronic inflammation, and GM dysbiosis may adversely affect the bone metabolism in PCOS women. Studies comparing bone mineral density or bone metabolism and the risk of bone fractures in women with PCOS have controversial results. Further studies are required to understand the mechanisms underlying bone metabolism in PCOS subjects. Moreover, prospective studies are needed to estimate the risk of bone fractures and osteoporosis in PCOS subjects.

骨骼作为一种活跃的结缔组织和内分泌组织，会受到激素、体力活动、炎症因子、矿物质、饮食成分和体重的影响。骨折是人类生活质量下降和死亡率下降的主要原因。多囊卵巢综合征（PCOS）是全球育龄妇女最常见的内分泌疾病之一。PCOS 与雄激素和雌激素水平紊乱、胰岛素抵抗 (IR)、肥胖以及低度慢性炎症和肠道菌群(GM) 失调有关，所有这些都可能对骨代谢. 然而，目前还没有很好地阐明 PCOS 是保护骨还是破坏骨。本研究旨在回顾骨骼健康与 PCOS 之间的关系，并总结其相关因素。搜索 PubMed、Scopus 和 Web of Science 数据库以检索研究骨骼健康与 PCOS 之间关系的相关英文出版物。与 PCOS 相关的几种疾病会对骨代谢产生负面或正面影响。尽管胰岛素、雄激素、雌激素和肥胖对骨骼、IR、雌激素缺乏有一些积极影响、低度慢性炎症和 GM 生态失调可能对 PCOS 女性的骨代谢产生不利影响。比较骨矿物质密度或骨代谢与 PCOS 女性骨折风险的研究结果存在争议。需要进一步的研究来了解 PCOS 受试者骨代谢的潜在机制。此外，需要前瞻性研究来评估 PCOS 受试者发生骨折和骨质疏松症的风险。