| Abstract: | 
                    
                        
                         Endocrine multisystem defect polycystic ovary syndrome (PCOS) causes hyperandrogenism and infertility. Half of PCOS women  have (non-alcoholic fatty liver disease) NAFLD, which increases metabolic disease risk. We tested decorin ’ s effect on NAFLD and related processes in PCOS. NAFLD + PCOS, PCOS + decorin, and control rats were  studied.  Decorin  was  evaluated  on  NAFLD/PCOS  rats.  Test  group  rats  received  HF  for  eight  weeks  to generate NAFLD. The rats got 1 mg/kg letrozole orally daily for 21 days to diagnosis PCOS. Afterward, rats got injectable decorin for 14 days. Body weight, liver weight, liver coefficient Abdominal Circumference (AC) and body mass index (BMI) were determined. Blood triglycerides (TG), total cholesterol, LDL-c, AST, and glucose were measured. The insulin, testosterone, estrogen, LH, and FSH were measured by ELISA. GPx, SOD, MDA, TNF-alpha,  and  Caspase-3  liver  immunohistochemistry  were  evaluated.  NAFLD  liver  tissues  in  PCOS  models  showed biochemical  and  histological  alterations.  NAFLD + PCOS  raised  BMI,  AC,  liver  weight,  and  coefficient.  Blood glucose, insulin resistance, TG, ALT, and AST increased. Lipid abnormalities (TG, cholesterol, LDL-c, and HDL-c), oxidative stress markers (MDA, SOD, and GPx), and liver dysfunction were found. Low serum E2 and high T supported PCO. Decorin reduced model rat BMI, liver weight, coefficient, insulin resistance, TG, ALT, and AST. It reduced liver inflammation, improved liver extract lipids, and normalized MDA, SOD, and GPx. In the model group, decorin lowered serum T, E2, LH, caspase 3, and TNF-alpha. Decorating improved NAFLD/PCOS group liver histology and function. Decorin reduces hepatosteatosis by reducing liver inflammation, oxidative stress, and dyslipidemia. 
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