Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity

Zeng, Xin; Xie, Yuanjie; Liu, Yating; Long, Shuang-lian; Zhang, Mo

doi:10.1016/j.cca.2019.11.003

Cited by 300 publications

(274 citation statements)

References 76 publications

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“…It is sometimes not easy to distinguish IR from hyperandrogenism in PCOS women. Both are often accompanied by the other, contributing to the uncertainty of the molecular mechanism of IR in PCOS [79]. Two major molecular signaling pathways are mediated by insulin, including the phosphatidylinositol (PI)3-kinase (PI-3K)/Akt pathway, which is involved in metabolism effects, and the mitogen-activated protein kinase (MAPK) pathway, which is involved in cell growth, proliferation, and differentiation [79].…”

Section: The Molecular Mechanisms Of Ir In Polycystic Ovary Syndrome mentioning

confidence: 99%

“…Hyperinsulinemia apparently increases ovarian androgen production in PCOS via the inhibition of hepatic SHBG production [69]. Furthermore, insulin counters normal homologous desensitization, upregulating the granulosa or theca cell LH receptors and ovarian cytochrome P450c17a activity, and acting synergistically with LH to enhance theca cell androgen production [69,72,79]. In PCOS patients, ovarian androgen is the main source of hyperandrogenism, accounting for 70% of the total androgen level in PCOS [79].…”

Section: The Molecular Mechanisms Of Ir In Polycystic Ovary Syndrome mentioning

confidence: 99%

“…Furthermore, insulin counters normal homologous desensitization, upregulating the granulosa or theca cell LH receptors and ovarian cytochrome P450c17a activity, and acting synergistically with LH to enhance theca cell androgen production [69,72,79]. In PCOS patients, ovarian androgen is the main source of hyperandrogenism, accounting for 70% of the total androgen level in PCOS [79]. The remaining 30% of androgen is produced by the adrenal glands [79].…”

Section: The Molecular Mechanisms Of Ir In Polycystic Ovary Syndrome mentioning

confidence: 99%

See 2 more Smart Citations

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

Seow¹,

Chang

Chen

et al. 2020

IJMS

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Polycystic ovary syndrome (PCOS) is a common endocrinopathy, characterized by chronic anovulation, hyperandrogenism, and multiple small subcapsular cystic follicles in the ovary during ultrasonography, and affects 5–10% of women of reproductive age. PCOS is frequently associated with insulin resistance (IR) accompanied by compensatory hyperinsulinemia and, therefore, presents an increased risk of type 2 diabetes mellitus (DM). The pathophysiology of PCOS is unclear, and many hypotheses have been proposed. Among these hypotheses, IR and hyperandrogenism may be the two key factors. The first line of treatment in PCOS includes lifestyle changes and body weight reduction. Achieving a 5–15% body weight reduction may improve IR and PCOS-associated hormonal abnormalities. For women who desire pregnancy, clomiphene citrate (CC) is the front-line treatment for ovulation induction. Twenty five percent of women may fail to ovulate spontaneously after three cycles of CC treatment, which is called CC-resistant PCOS. For CC-resistant PCOS women, there are many strategies to improve ovulation rate, including medical treatment and surgical approaches. Among the various surgical approaches, one particular surgical method, called laparoscopic ovarian drilling (LOD), has been proposed as an alternative treatment. LOD results in an overall spontaneous ovulation rate of 30–90% and final pregnancy rates of 13–88%. These benefits are more significant for women with CC-resistant PCOS. Although the intra- and post-operative complications and sequelae are always important, we believe that a better understanding of the pathophysiological changes and/or molecular mechanisms after LOD may provide a rationale for this procedure. LOD, mediated mainly by thermal effects, produces a series of morphological and biochemical changes. These changes include the formation of artificial holes in the very thick cortical wall, loosening of the dense and hard cortical wall, destruction of ovarian follicles with a subsequently decreased amount of theca and/or granulosa cells, destruction of ovarian stromal tissue with the subsequent development of transient but purulent and acute inflammatory reactions to initiate the immune response, and the continuing leakage or drainage of “toxic” follicular fluid in these immature and growth-ceased pre-antral follicles. All these factors contribute to decreasing local and systemic androgen levels, the following apoptosis process with these pre-antral follicles to atresia; the re-starting of normal follicular recruitment, development, and maturation, and finally, the normalization of the “hypothalamus–pituitary–ovary” axis and subsequent spontaneous ovulation. The detailed local and systematic changes in PCOS women after LOD are comprehensively reviewed in the current article.

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Section: The Molecular Mechanisms Of Ir In Polycystic Ovary Syndrome mentioning

confidence: 99%

Section: The Molecular Mechanisms Of Ir In Polycystic Ovary Syndrome mentioning

confidence: 99%

Section: The Molecular Mechanisms Of Ir In Polycystic Ovary Syndrome mentioning

confidence: 99%

See 1 more Smart Citation

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

Seow¹,

Chang

Chen

et al. 2020

IJMS

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show abstract

“…Furthermore, 5α reductase leads to the development of insulin resistance [37]. PCOS is found to be composed of a complex chain reaction in which hyperandrogenism can be exacerbated by weight gain and insulin resistance, leading to the progression of PCOS [2].…”

Section: Hormonesmentioning

confidence: 99%

“…It is the most prevalent heterogeneous condition, with cardinal features consisting of hyperandrogenism and reproductive and metabolic dysfunction. Among these features, hyperandrogenism is the most crucial clinical finding with different symptoms of presentation [2].…”

Section: Introductionmentioning

confidence: 99%

The Association Between Polycystic Ovary Syndrome and Its Dermatological Manifestations

Sekhon

Zergham

Tserenpil

et al. 2020

Cureus

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Reproductive Organ Therapies

2023

Endocrinology

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Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity

Cited by 300 publications

References 76 publications

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

Molecular Mechanisms of Laparoscopic Ovarian Drilling and Its Therapeutic Effects in Polycystic Ovary Syndrome

The Association Between Polycystic Ovary Syndrome and Its Dermatological Manifestations

Reproductive Organ Therapies

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