Elevated PKM2 levels, coupled with reduced circulating TPI1 and FBP1 levels (Supplementary Fig. 1d-f), demonstrated a causal association with PCOS risk, with PKM2 emerging as the primary driver among glycolysis-related factors in multivariable MR analyses (Supplementary Fig. 1g). Here, TPI1 is linked to polycystic ovary syndrome.