Polycystic ovary syndrome (PCOS), insulin resistance and insulin-like growth factors (IGfs)/IGF-binding proteins (IGFBPs).
Polycystic ovary syndrome (PCOS) is the most frequent androgen disorder of ovarian function. Hyperinsulinemia with insulin resistance is believed to be a key link in the enigmatic generation of the symptoms of PCOS such as anovulatory infertility and hyperandrogenism. Regression of these symptoms may be achieved by reducing the hyperinsulinemia. A growing body of evidence suggests that PCOS patients with hyperinsulinemia have a higher risk to develop diabetes mellitus, hypertension and cardiovascular disease as compared to age-matched women. Although oral contraceptives, progestins, antiandrogens, and ovulation induction agents remain standard therapies, weight loss should also be vigorously encouraged to ameliorate the metabolic consequences of PCOS. In addition, insulin-sensitizing agents are now being shown to be useful alone or combined with standard therapies to alleviate hyperinsulinemia in PCOS. Finally and most importantly, early identification of patients at risk and prompt initiation of therapies, followed by long-term surveillance and management, may promote the patient's long-term health.
Wang
Hsin-Shih
HS
Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC. hswang86@ms17.hinet.net
Wang
Tzu-Hao
TH
D000726:Androgen Antagonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000502:physiology*; D007334:Insulin-Like Growth Factor I / Q000502:physiology*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D011627:Puberty
D000726:Androgen Antagonists; D018970:Insulin-Like Growth Factor Binding Protein 1; D007334:Insulin-Like Growth Factor I