Insulin resistance and PCOS: chicken or egg?

PCOS is a common and heterogeneous endocrine disorder in women of reproductive age, frequently associated with metabolic abnormalities. It was estimated that about 75% of these subjects have an impairment of insulin action, as measured by gold standard methods. While the relationship between insulin...

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Bibliographic Details
Published inJournal of endocrinological investigation Vol. 44; no. 2; pp. 233 - 244
Main Authors Moghetti, P., Tosi, F.
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.02.2021
Springer Nature B.V
Subjects
Androgens
Body fat
Endocrinology
Fetuses
Hyperinsulinemia
Insulin
Insulin resistance
Internal Medicine
Medicine
Medicine & Public Health
Metabolic Diseases
Metabolism
Review
Insulin resistance
Hyperandrogenism
PCOS
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Summary:PCOS is a common and heterogeneous endocrine disorder in women of reproductive age, frequently associated with metabolic abnormalities. It was estimated that about 75% of these subjects have an impairment of insulin action, as measured by gold standard methods. While the relationship between insulin resistance and PCOS is consistently shown by a number of studies, the mechanisms underlying its primary origin still remains an unsolved issue. Insulin resistance and the associated hyperinsulinemia can induce both the endocrine and reproductive traits of PCOS. However, androgen excess, in turn, can impair insulin action, directly and/or through several changes occurring in different tissues. Body fat excess, which is another common feature in these women, can contribute to worsening the whole picture. Nevertheless, insulin resistance may also be found in many normal-weight individuals. Endocrine and metabolic abnormalities can develop in different moments, and probably there is fetal programming of these alterations. However, a number of vicious circles, with bidirectional relationships between androgen excess and insulin resistance, and with the contribution of several other factors, make it extremely difficult to understand where this process really originates. This review summarizes available evidence on this topic, in order to better understand the complex relationships linking hyperandrogenism and impaired insulin action in women with PCOS.
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ISSN:1720-8386
0391-4097
1720-8386
DOI:10.1007/s40618-020-01351-0