The role of adrenal hyperandrogenism, insulin resistance, and obesity in the pathogenesis of polycystic ovarian syndrome

Background: Ovarian androgen production can be promoted by insulin resistance which leads to reproductive abnormalities in Polycystic Ovarian Syndrome (PCOS). A wide variety of female tissues can synthesize and secrete Prostate Specific Antigen (PSA). Androgens may take part a significant role in PSA secretion in PCOS. As insulin resistance stimulates androgen production, the baseline value of PSA may decline by insulin sensitising agents in PCOS. Present study is an attempt to measure the function of PSA as a marker of androgen excess in PCOS and to assess the role of insulin sensitising agent metformin in altering PSA level in PCOS.Methods: The study was undertaken to assess the insulin resistance, testosterone and PSA level in 45 women diagnosed as PCOS and 45 healthy controls. Alteration of insulin resistance, serum testosterone and PSA levels by metformin was also analysed.Results: A significant increase in testosterone, PSA level and insulin resistance was observed in PCOS cases when compared with control (p<0.001). When metformin was given for 4 months, improvement in insulin resistance and testosterone level was found in cases, but PSA values observed no change. Correlation was not found linking insulin resistance with PSA level prior to and after therapy.Conclusions: Serum PSA level could be detected in high significant concentration in PCOS women. Various researches explain that insulin resistance and BMI may perhaps control serum PSA level, but our result demonstrate no effect of insulin sensitising agent on serum PSA value.

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A lesson from polycystic ovarian syndrome: untangling the role of renal sympathetic nervous system on hypertension and insulin resistance

Journal of Hypertension ◽

10.1097/hjh.0b013e3283462d0d ◽

2011 ◽

Vol 29 (5) ◽

pp. 836-837 ◽

Cited By ~ 3

Author(s):

Giuseppe Lembo ◽

Guido Grassi

Keyword(s):

Insulin Resistance ◽

Nervous System ◽

Sympathetic Nervous System ◽

Polycystic Ovarian Syndrome ◽

Sympathetic Nervous ◽

Ovarian Syndrome ◽

Renal Sympathetic

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New concepts in pathogenesis and management of polycystic ovarian syndrome: Insulin resistance and role of insulin sensitizers

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v3i1.1431 ◽

1970 ◽

Vol 3 (1) ◽

pp. 3-9

Author(s):

Rashmi Prasad Yadav

Keyword(s):

Insulin Resistance ◽

Polycystic Ovarian Syndrome ◽

Positive Association ◽

Regulatory Peptides ◽

Symptomatic Treatment ◽

Adrenal Hyperandrogenism ◽

New Concepts ◽

Insulin Sensitizers ◽

Clinical Triad ◽

Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is classically characterized by the clinical triad of androgen excess, anovulation infertility and obesity. Anovulation occurs due to functional ovarian and/or adrenal hyperandrogenism. The etiology and patho physiology of PCOS is unknown .Proposed theories include excess of gonadotropins; the effect of which is amplified by disturbances in intrinsic regulatory peptides, such as inhibin or extrinsic regulatory peptides, such as insulin or insulin like growth factor ( IGF). For over 25 years insulin resistance has been known to be associated with PCOS. Improvement in insulin resistance with the use of insulin sensitizers, such as metformin and thiazoldinediones (TZDs) have been seen to be associated with better ovulation and reduced testosterone levels in patients with PCOS. Aims: The aim of the present review is to discuss the new concepts in the pathogenesis of PCOS and to know usefulness of insulin sensitizers in such patients. Methods: Over 50 articles extending the span of more than 25 years have been reviewed and an attempt has been made to know the etiopathogenesis of PCOS and also to assess the validity for the uses of insulin sensitizers in patients of PCOS. Results: With the advancement of knowledge regarding etiopathogenesis, the management of PCOS has changed in recent years. In view of positive association between hyperinsulinemia and PCOS, improvement in insulin resistance through weight loss and use of insulin sensitizing drugs has been recommended. Conclusions: Besides symptomatic treatment, recent studies recommend use of insulin sensitizers in management in PCOS for better outcome in them. Key words: Polycystic ovarian syndrome (PCOS), Insulin resistance (IR) Insulin sensitizers (IS).doi:10.3126/njog.v3i1.1431 NJOG 2008 May-June; 3(1): 3 - 9

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