Medicine-Food Homology Bioactives for Polyendocrine Metabolic Ovarian Syndrome: Multi-Target Mechanisms and Functional Food Translation.

Polyendocrine Metabolic Ovarian Syndrome (PMOS) is characterized by insulin resistance, hyperandrogenism, chronic inflammation, and oxidative stress, with a global prevalence of 10-13% and limited current drug treatments. Medicine-Food Homology (MFH) materials are rich in bioactive compounds such as polyphenols, flavonoids, and polysaccharides, offering potential multi-target nutritional interventions for PMOS, although safety data remain limited mainly to single compounds. A systematic search of the literature was conducted across PubMed/MEDLINE, Web of Science CNKI, and Wanfang Data, spanning from database inception to August 2026, utilizing predefined search terms and inclusion/exclusion criteria. This review summarizes research on MFH-derived bioactive compounds in PMOS, covering active component identification, network pharmacology-based target prediction, key signaling pathways (PI3K/AKT, AMPK, NF-κB, Nrf2/HO-1), and formulation strategies including green extraction, nano-encapsulation, and controlled release. It further discusses functional food development from five perspectives: meal replacement powders, functional teas, fermented beverages, dietary supplements, and compound formulations. Key bottlenecks hindering commercialization are analyzed, including insufficient high-quality clinical evidence, unclear dose-response relationships, and limited long-term stability data. Future directions are proposed, such as organoids, organ-on-a-chip, AI-driven formulation optimization, and international multicenter trials. In summary, MFH bioactive compounds show potential as multi-target interventions for PMOS; however, most mechanistic evidence comes from non-PMOS metabolic models, and direct PMOS-specific evidence is limited. Their translation from empirical use to evidence-based intervention requires PMOS-specific preclinical validation, randomized controlled trials, safety assessments, bioavailability evaluation, and standardized product validation, alongside collaborative efforts across research paradigms, technology development, and industrial translation.