The role of genes and environment in the etiology of PCOS.
Both genes and the environment contribute to PCOS. Obesity, exacerbated by poor dietary choices and physical inactivity, worsens PCOS in susceptible individuals. The role of other environmental modifiers such as infectious agents or toxins are speculative. Phenotype confusion has characterized genetic studies of PCOS. Although several loci have been proposed as PCOS genes including CYP11A, the insulin gene, the follistatin gene, and a region near the insulin receptor, the evidence supporting linkage is not overwhelming. The strongest case can be made for the region near the insulin receptor gene (but not involving this gene), as it has been identified in two separate studies, and perhaps most importantly has not yet been refuted by larger studies. However, the responsible gene at chromosome 19p13.3 remains to be identified. To date, no gene has been identified that causes or contributes substantially to the development of a PCOS phenotype.
Diamanti-Kandarakis
Evanthia
E
Endocrine Section, First Department of Medicine, University of Athens Medical School, Athens, Greece.
Kandarakis
Helen
H
Legro
Richard S
RS
D002786:Cholesterol Side-Chain Cleavage Enzyme / Q000235:genetics / Q000502:physiology; D002903:Chromosomes, Human, 19-20 / Q000235:genetics*; D004777:Environment; D005190:Family; D005260:Female; D038681:Follistatin / Q000235:genetics / Q000502:physiology; D020022:Genetic Predisposition to Disease; D006801:Humans; D007328:Insulin / Q000235:genetics / Q000502:physiology; D009765:Obesity / Q000235:genetics* / Q000473:pathology; D011085:Polycystic Ovary Syndrome / Q000235:genetics* / Q000473:pathology; D011972:Receptor, Insulin / Q000235:genetics / Q000502:physiology
D038681:Follistatin; D007328:Insulin; D002786:Cholesterol Side-Chain Cleavage Enzyme; D011972:Receptor, Insulin