Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment

Zhao, Han; Zhang, Jiaqi; Cheng, Xiangyi; Nie, Xiaozhao; He, Bing

doi:10.1186/s13048-022-01091-0

Cited by 86 publications

(66 citation statements)

References 226 publications

(242 reference statements)

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“…Polymorphisms of insulin receptor substrate 1 (IRS-1) have been found to increase fasting glucose levels and the risk of PCOS. In PCOS, insulin resistance is associated with genetic and epigenetic changes to signalling, as well as obesity [ 52 ].…”

Section: Clinical Overlap Between Asthma and Pcosmentioning

confidence: 99%

The “Asthma-Polycystic Ovary Overlap Syndrome” and the Therapeutic Role of Myo-Inositol

Guarnieri

Iervolino²,

Cavallone³

et al. 2023

IJMS

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Asthma is a heterogeneous inflammatory disease characterized by abnormalities in immune response. Due to the inherent complexity of the disease and the presence of comorbidities, asthma control is often difficult to obtain. In asthmatic patients, an increased prevalence of irregular menstrual cycles, infertility, obesity, and insulin resistance has been reported. Given that these conditions are also common in patients with polycystic ovary syndrome (PCOS), we propose the definition of “asthma-PCOS overlap syndrome” to indicate a medical condition which shares characteristics of both diseases. The aim of this review is to analyze the links between asthma and PCOS and evaluate the therapeutic role of myo-inositol, a natural compound currently utilized in patients with PCOS, in the management of asthma patients.

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Section: Clinical Overlap Between Asthma and Pcosmentioning

confidence: 99%

The “Asthma-Polycystic Ovary Overlap Syndrome” and the Therapeutic Role of Myo-Inositol

Guarnieri

Iervolino²,

Cavallone³

et al. 2023

IJMS

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“…After prolonged estrus signs resolved she became sound and is scheduled for ovariectomy. Hyperinsulinemia effects on ovarian function or vice versa, have been well described in women with the polycystic ovarian syndrome ( Zhao et al , 2023 ). Potential similar interactions have been reported in mares ( Sessions et al , 2004 ).…”

Section: Case Detailsmentioning

confidence: 99%

Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors

Kellon¹,

Gustafson²

2023

Open Vet J

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Background: Sodium-Glucose CoTransporter-2 [SGLT2] inhibitors, the -flozin group of drugs, which block glucose reuptake in the renal proximal tubule, are being increasingly used off-label to treat horses with refractory hyperinsulinemia. After two years of use by animals in our group, a horse on canagliflozin was incidentally noted to be hyperlipemic. Case Description: We have been following a cohort of equines (n=20) treated with SGLT2 inhibitors due to refractory hyperinsulinemia. The animals are owned by members of the Equine Cushing’s and Insulin Resistance Group (ECIR) and treated by their attending veterinarians. The index case was a 23 year old gelding with a 2 year history of recurring laminitis that began canagliflozin therapy to control hyperinsulinemia which was no longer responsive to metformin. Between 6-10 weeks post therapy, significant weight loss was noticed. Two days later he was hospitalized with colic symptoms and hyperlipemia but was bright, alert and eating well throughout. Canagliflozin was discontinued and triglycerides returned to normal reference values within 10 days. Subsequent study of 19 other horses on SGLT2 inhibitors revealed varying degrees of hypertriglyceridemia, all asymptomatic. Conclusion: While this class of drugs holds great promise for cases of refractory hyperinsulinemia and laminitis that do not respond to diet or metformin therapy, hypertriglyceridemia is a potential side effect. In our experience, animals remained asymptomatic and eating well. Further study of hypertriglyceridemia in horses on SGLT2 inhibitors and the possible mitigating effect of diet is indicated. To our knowledge, this is the first published report of hypertriglyceridemia with SGLT2 inhibitor treatment in equines.

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“…In pregnancy, the placenta is an insulin independent organ, and the development of maternal IR is expected to divert more nutrients through the placenta. The ovary does not develop IR and remains sensitive to the high levels of insulin that occur in IR and hyperinsulinemia (241,242). This may be a mechanism to downregulate fertility at times of physiological or psychological stress.…”

Section: Insulin Resistance and Hyperandrogenismmentioning

confidence: 99%

Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms that Disturb the Hallmarks of Health in Polycystic Ovary Syndrome

Parker¹

2023

Preprint

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Polycystic ovary syndrome (PCOS) is increasingly being characterized as an evolutionary mismatch disorder that presents with a complex mixture of metabolic and endocrine symptoms. The Evolutionary Model proposes that PCOS arises from a collection of inherited polymorphisms that have been consistently demonstrated in a variety of ethnic groups and races. In-utero developmental programming of susceptible genomic variants are thought to predispose the offspring to develop PCOS. Postnatal exposure to lifestyle and environmental risk factors results in epigenetic activation of developmentally programmed genes and disturbance of the hallmarks of health. The resulting pathophysiological changes represent the consequences of poor-quality diet, sedentary behaviour, endocrine disrupting chemicals, stress, circadian disruption, and other lifestyle factors. Emerging evidence suggests that lifestyle-induced gastrointestinal dysbiosis plays a central role in the pathogenesis of PCOS. Lifestyle and environmental exposures initiate changes that result in disturbance of the gastrointestinal microbiome (dysbiosis), immune dysregulation (chronic inflammation), altered metabolism (insulin resistance), endocrine and reproductive imbalance (hyperandrogenism), and central nervous system dysfunction (neuroendocrine, autonomic nervous system). PCOS can be a progressive metabolic condition that leads to obesity, gestational diabetes, type 2 diabetes, metabolic-associated fatty liver disease, metabolic syndrome, cardiovascular disease, and cancer. This review explores the mechanisms that underpin the evolutionary mismatch between ancient survival pathways and contemporary lifestyle factors involved in the pathogenesis and pathophysiology of PCOS.

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Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment

Cited by 86 publications

References 226 publications

The “Asthma-Polycystic Ovary Overlap Syndrome” and the Therapeutic Role of Myo-Inositol

The “Asthma-Polycystic Ovary Overlap Syndrome” and the Therapeutic Role of Myo-Inositol

Hypertriglyceridemia in equines with refractory hyperinsulinemia treated with SGLT2 inhibitors

Pathophysiological Effects of Contemporary Lifestyle on Evolutionary-Conserved Survival Mechanisms that Disturb the Hallmarks of Health in Polycystic Ovary Syndrome

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