Obesity, insulin, sex steroids and ovulation.
Obesity is a major feature in women with polycystic ovary syndrome (PCOS), and evidence suggests that obesity contributes to the pathogenesis of PCOS by aggravating the intrinsic insulin resistance of these women. Hyperinsulinemia appears to increase circulating androgens in PCOS by stimulating ovarian androgen production and suppressing serum SHBG, and also appears to play a pathogenic role in the anovulation of the disorder. The use of insulin sensitizing drugs has been shown to decrease serum insulin in both obese and nonobese women with PCOS, and to simultaneously reduce circulating ovarian androgens and to improve ovulation.
Nestler
J E
JE
Division of Endocrinology and Metabolism, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0111, USA. nestler@hsc.vcu.edu
D000728:Androgens / Q000096:biosynthesis; D005260:Female; D012739:Gonadal Steroid Hormones; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology; D007328:Insulin; D007333:Insulin Resistance; D009765:Obesity; D010053:Ovary / Q000378:metabolism; D010060:Ovulation
D000728:Androgens; D012739:Gonadal Steroid Hormones; D007328:Insulin