Fig. 4: Macronutrient balance does not modulate adipocyte hypertrophy or elevated adiponectin levels in a PCOS mouse model.

a Histological sections of representative parametrial fat pads from a control and PCOS mouse, showing development of adipocyte hypertrophy only in PCOS mice. Magnification ×40, scale bar 50 µm. b Adipocyte area, showing that regardless of diet PCOS mice exhibit adipocyte hypertrophy (P = 0.04). Significance determined by two-tailed Student’s t test, asterisk (*) indicates P-value <0.05. c Response difference between control and PCOS mice for adipocyte area, showing that adipocyte size in PCOS mice was significantly increased at low carbohydrate and fat intakes. b–c n = 35 control and 38 PCOS mice. d Serum levels of adiponectin, showing that irrespective of diet PCOS mice exhibit lower serum adiponectin levels (P < 0.001). Significance determined by two-tailed Student’s t test, asterisk (*) indicates P-value <0.05. e–j 3D GAM response surfaces displaying the relationship between macronutrient intake (kJ/day) and serum adiponectin levels in control (e–g) and PCOS mice (h–j), showing a global decrease of adiponectin in PCOS mice irrespective of macronutrient intakes. Red areas indicate the greatest value for each response, which then decreases to the lowest value as the color shifts to blue. k–m Response surfaces showing the effects of C and F intakes on adiponectin levels in control mice (k), PCOS mice (l), and the response difference (m), demonstrating that overall adiponectin levels are significantly different between control and PCOS mice, consequently serum adiponectin levels in PCOS mice are heavily influenced by the PCOS pathophysiology and not diet. d–m n = 78 control and 87 PCOS mice. b, d Data presented as violin plots, doted lines indicate the median and dashed lines the 25 and 75% percentiles.