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Insulin Resistance and the Polycystic Ovary Syndrome: Mechanism and Implications for Pathogenesis¹

Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033

I. Introduction

A. Background and historical perspective

B. Definition of PCOS

II. Insulin Action in PCOS

A. Glucose tolerance

B. Insulin action in vivo in PCOS

C. Insulin secretion in PCOS

D. Insulin clearance in PCOS

E. Cellular and molecular mechanisms of insulin resistance

F. Constraints of insulin action studies in PCOS

G. PCOS as a unique NIDDM subphenotype

III. Hypotheses Explaining the Association of Insulin Resistance and PCOS

A. Causal association

B. Possible genetic association of PCOS and insulin resistance

IV. Clinical Implications of Insulin Resistance in PCOS

A. Clinical diagnosis of insulin resistance

B. Other metabolic disorders in PCOS

C. Therapeutic considerations

V. Summary

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				E. Codner and H. F. Escobar-Morreale Hyperandrogenism and Polycystic Ovary Syndrome in Women with Type 1 Diabetes Mellitus J. Clin. Endocrinol. Metab., April 1, 2007; 92(4): 1209 - 1216. [Abstract] [Full Text] [PDF]

				K.-M. Seow, C.-C. Juan, Y.-P. Hsu, J.-L. Hwang, L.-W. Huang, and L.-T. Ho Amelioration of insulin resistance in women with PCOS via reduced insulin receptor substrate-1 Ser312 phosphorylation following laparoscopic ovarian electrocautery Hum. Reprod., April 1, 2007; 22(4): 1003 - 1010. [Abstract] [Full Text] [PDF]

				K.-M. Seow, C.-C. Juan, L.-T. Ho, Y.-P. Hsu, Y.-H. Lin, L.-W. Huang, and J.-L. Hwang Adipocyte resistin mRNA levels are down-regulated by laparoscopic ovarian electrocautery in both obese and lean women with polycystic ovary syndrome Hum. Reprod., April 1, 2007; 22(4): 1100 - 1106. [Abstract] [Full Text] [PDF]

				S. E Kasim-Karakas, W. M Cunningham, and A. Tsodikov Relation of nutrients and hormones in polycystic ovary syndrome Am. J. Clinical Nutrition, March 1, 2007; 85(3): 688 - 694. [Abstract] [Full Text] [PDF]

				A Corbould Chronic testosterone treatment induces selective insulin resistance in subcutaneous adipocytes of women J. Endocrinol., March 1, 2007; 192(3): 585 - 594. [Abstract] [Full Text] [PDF]

				R. S. Legro A 27-Year-Old Woman With a Diagnosis of Polycystic Ovary Syndrome JAMA, February 7, 2007; 297(5): 509 - 519. [Abstract] [Full Text] [PDF]

				B. K. Tan, J. Chen, J. E. Digby, S. D. Keay, C. R. Kennedy, and H. S. Randeva Increased Visfatin Messenger Ribonucleic Acid and Protein Levels in Adipose Tissue and Adipocytes in Women with Polycystic Ovary Syndrome: Parallel Increase in Plasma Visfatin J. Clin. Endocrinol. Metab., December 1, 2006; 91(12): 5022 - 5028. [Abstract] [Full Text] [PDF]

				C. Li, E. S. Ford, L. C. McGuire, A. H. Mokdad, R. R. Little, and G. M. Reaven Trends in hyperinsulinemia among nondiabetic adults in the u.s. Diabetes Care, November 1, 2006; 29(11): 2396 - 2402. [Abstract] [Full Text] [PDF]

				F. Alvarez-Blasco, J. I. Botella-Carretero, J. L. San Millan, and H. F. Escobar-Morreale Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women. Arch Intern Med, October 23, 2006; 166(19): 2081 - 2086. [Abstract] [Full Text] [PDF]

				A. G. Hoppin, E. S. Katz, L. M. Kaplan, and G. Y. Lauwers Case 31-2006 -- A 15-Year-Old Girl with Severe Obesity. N. Engl. J. Med., October 12, 2006; 355(15): 1593 - 1602. [Full Text] [PDF]

				D. R. Stewart, B. A. Dombroski, M. Urbanek, W. Ankener, K. G. Ewens, J. R. Wood, R. S. Legro, J. F. Strauss III, A. Dunaif, and R. S. Spielman Fine Mapping of Genetic Susceptibility to Polycystic Ovary Syndrome on Chromosome 19p13.2 and Tests for Regulatory Activity J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 4112 - 4117. [Abstract] [Full Text] [PDF]

				H.F. Escobar-Morreale, G. Villuendas, J.I. Botella-Carretero, F. Alvarez-Blasco, R. Sanchon, M. Luque-Ramirez, and J.L. San Millan Adiponectin and resistin in PCOS: a clinical, biochemical and molecular genetic study Hum. Reprod., September 1, 2006; 21(9): 2257 - 2265. [Abstract] [Full Text] [PDF]