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Polycystic ovary syndrome: What is it? Pathogenetic enigma and therapeutic dilemma

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References

  1. Stein I., Leventhal M. Amenorrhea associated with bilateral polycystic ovaries. Am. J. Obstet. Gynecol. 29: 181, 1935.

    Google Scholar 

  2. Vaitukaitis J.I. Polycystic ovary syndrome-what is it? N. Engl. J. Med. 309: 1245, 1983.

    Article  PubMed  CAS  Google Scholar 

  3. McArthur J.W., Ingersoll F.M., Worcester J. The urinary excretion of interstitial cell and follicle-stimulating hormone activity by women with diseases of the reproductive system. J. Clin. Endocrinol. Metab. 18: 1202, 1958.

    Article  PubMed  CAS  Google Scholar 

  4. Kahn C.R., Flier J.S., Bar R.S., Archer J.A., Gorden P., Martin M.M., Roth J. The syndromes of insulin resistance and acanthosis nigricans. N. Engl. J. Med. 294: 739, 1976.

    Article  PubMed  CAS  Google Scholar 

  5. Burghen G.A., Givens J.R., Kitabchi A.E. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J. Clin. Endocrinol. Metab. 50: 113, 1980.

    Article  PubMed  CAS  Google Scholar 

  6. Adams J., Franks S., Poison D.W., Mason H.D. Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotrophin releasing hormone. Lancet ii: 1375, 1985.

    Article  Google Scholar 

  7. Franks S. Polycystic ovary syndrome. N. Engl. J. Med. 333: 853, 1995.

    Article  PubMed  CAS  Google Scholar 

  8. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr. Rev. 18: 774, 1997.

    PubMed  CAS  Google Scholar 

  9. Franks S. The ubiquitous polycystic ovary. J. Endocrinol. 129: 317, 1991.

    Article  PubMed  CAS  Google Scholar 

  10. Toscano V., Adamo M.V., Caiola S., Foli S., Petrangeli E., Casilli D., Sciarra F. Is hirsutism an evolving syndrome? J. Endocrinol. 97: 379, 1983.

    Article  PubMed  CAS  Google Scholar 

  11. Abbott D.H., Dumesic D.A., Eisner J.R., Colman R.J., Kemnitz J.W. Insights into the development of polycystic ovary syndrome (PCOS) from studies of prenatally androgenized female rhesus monkeys. TEM 9: 62, 1998.

    PubMed  CAS  Google Scholar 

  12. Kahsar-Miller M., Azziz R. The development of the polycystic ovary syndrome: family history as a risk factor. TEM 9: 55, 1998.

    PubMed  CAS  Google Scholar 

  13. Watherworth D.M., Bennet S.T., Gharani N., McCharthy M.I., Hague S., Batty S., Conway G.S., White D., Todd J.A., Franks S., Williamson R. Linkage and association of insulin gene VNTR regulatory polymorphism with polycystic ovary syndrome. Lancet 349: 986, 1997.

    Article  Google Scholar 

  14. Franks S., Gharani N., Watherworth D.M., Batty S., White D., Williamson R., McCharthy M. The genetic basis of polycystic ovary syndrome. Hum. Reprod. 12: 2641, 1997.

    Article  PubMed  CAS  Google Scholar 

  15. Franks S., Gharani N., Watherworth D.M., Batty S., White D., Williamson R., McCharthy M. The current developments in the molecular genetics of the polycystic ovary syndrome. TEM 9: 51, 1998.

    PubMed  CAS  Google Scholar 

  16. Zhang L., Rodriguez H., Ohno S., Miller W.L. Serine phosphorylation of human P450c17 increases 17,20 lyase activity: implications for adrenarche and the polycystic ovary syndrome. Proc. Natl. Acad. Sci. USA. 92: 10619, 1995.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  17. Auchus R.J., Geller D. H., Lee T. C., Miller W.L. The regulation of human P450c17 activity: relationship to premature adrenarche, insulin resistance and the polycystic ovary syndrome. TEM. 9: 47, 1998.

    PubMed  CAS  Google Scholar 

  18. Ibáñez L., Potau N., Francois I., de Zegher F. Precocious pubarche, hyperinsulinism and ovarian hyperandrogenism in girls: relation to reduced fetal growth. J. Clin. Endocrinol. Metab. 1998 (in press).

  19. Hales C.H.D., Barker D.J.P. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 35: 595, 1993.

    Article  Google Scholar 

  20. Barnes R., Rosenfield R.L. The polycystic ovary syndrome: pathogenesis and treatment. Ann. Intern. Med. 110: 386, 1989.

    Article  PubMed  CAS  Google Scholar 

  21. Barnes R.B., Rosenfield R.L., Burstein S., Ehrmann D.A. Pituitary-ovarian responses to nafarelin testing in the polycystic ovary syndrome. N. Engl. J. Med. 320: 559, 1989.

    Article  PubMed  CAS  Google Scholar 

  22. Ehrmann D.A., Barnes R.B., Rosenfield R.L. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion. Endocr. Rev. 16: 322, 1995.

    Article  PubMed  CAS  Google Scholar 

  23. Gilling-Smith C., Willis D.S., Beard R.W., Franks S. Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries. J. Clin. Endocrinol. Metab. 79: 1158, 1994.

    PubMed  CAS  Google Scholar 

  24. Gilling-Smith C., Story H., Rogers V., Franks S. Evidence for a primary abnormality of thecal cell steroidogenesis on the polycystic ovary syndrome. Clin. Endocrinol. 47: 93, 1997.

    Article  CAS  Google Scholar 

  25. Daniels T.L., Berga S.L. Resistance of gonadotropin releasing hormone drive to sex steroid-induced suppression in hyperandrogenic anovulation. J. Clin. Endocrinol. Metab. 82: 4179, 1997.

    PubMed  CAS  Google Scholar 

  26. McKenna T.J., Cunningham S.K. Adrenal androgen production in polycystic ovary syndrome. Eur. J. Endocrinol. 133: 383, 1995.

    Article  PubMed  CAS  Google Scholar 

  27. Cara J.F., Rosenfield R.L. Insulin-like growth factor I and insulin potentiate luteinizing hormone-induced androgen synthesis by rat ovarian thecal-interstitial cells. Endocrinology 123: 733, 1988.

    Article  PubMed  CAS  Google Scholar 

  28. Barbieri R.L., Makris A., Randall R.W., Daniels G., Kistner R.W., Ryan K.J. Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. J. Clin. Endocrinol. Metab. 62: 904, 1986.

    Article  PubMed  CAS  Google Scholar 

  29. Duleba A.J., Spacynski R.Z., Olive D.L. Insulin and insulin-like growth factor I stimulate the proliferation of human ovarian theca-interstitial cells. Fertil. Steril. 69: 335, 1998.

    Article  PubMed  CAS  Google Scholar 

  30. L’Allemand D., Penhoat A., Lebrethon M.C., Ardèvol R., Baehr V., Oelkers W., Saez J.M. Insulin-like growth factors enhance steroidogenic enzyme and corticotropin receptor messenger ribonucleic acid levels and corticotropin steroidogenic responsiveness in cultured human adrenocortical cells. J. Clin. Endocrinol. Metab. 81: 3892, 1996.

    PubMed  Google Scholar 

  31. Moghetti P., Castello R., Negri C., Tosi F., Spiazzi G., Brun E., Balducci R., Toscano V., Muggeo M. Insulin infusion amplifies 17α-hydroxycorticosteroid intermediates response to adrenocorticotropin in hyperandrogenic women: apparent relative impairment of 17,20 lyase activity. J. Clin. Endocrinol. Metab. 81: 881, 1996.

    PubMed  CAS  Google Scholar 

  32. Mesiano S., Katz L.S., Lee J.Y., Jaffe R.B. Insulin-like growth factors augment steroid production and expression of steroidogenic enzymes in human fetal adrenal cortical cells: implications for adrenal androgen production. J. Clin. Endocrinol. Metab. 82: 1390, 1997.

    PubMed  CAS  Google Scholar 

  33. Toscano V., Balducci R., Mangiantini A., Falasca P., Sciarra F. Hyperandrogenism in adolescent female. Steroids 63: 308, 1998.

    Article  PubMed  CAS  Google Scholar 

  34. Toscano V., Caiola S., Maroder M., Asamo M.V., Argiolas L., Familiari A., Familiari G. Effects of dihydrotestosterone treatment on adrenal gland function and morphology in adult female guinea pigs. J. Steroid Biochem. 36: 89, 1990.

    Article  PubMed  CAS  Google Scholar 

  35. Bianchi P., Concolino G., Adamo M.V., Rombolà N., Palma E., Monti S., Toscano V. Effects of some peptides on adrenal cells of fasciculata-glomerulosa (F-G) in primary culture. IX International Congress on Hormonal Steroids (Dallas, USA, 1994) (Abstract C134)

  36. Vendola K.A., Zhou J., Adesanya O.O., Weil S.J., Bondy C.A. Testosterone promotes primate follicular growth and survival. 80th Meeting of the Endocrine Society-New Orleans 1998 (Abstract).

  37. Bjorntorp P. Hyperandrogenicity in women-a prediabetic condotion? J. Intern. Med. 234: 579, 1993.

    Article  PubMed  CAS  Google Scholar 

  38. Christman G.M., Randolph J.F., Kelch R.P., Marshall J.C. Reduction of gonadotropin-releasing hormone pulse frequency is associated with subsequent selective follicle-stimulating hormone secretion in women with polycystic ovarian syndrome. J. Clin. Endocrinol. Metab. 72: 1278, 1991.

    Article  PubMed  CAS  Google Scholar 

  39. De Zeigler D., Steingold K., Cedars M., Lu J.K.H., Meldrum D.R., Judd H.L., Chang R.J. Recovery of hormone secretion after chronic GnRH-against administration in women with polycystic ovarian disease. J. Clin. Endocrinol. Metab. 68: 1111, 1989.

    Article  Google Scholar 

  40. DeLeo V., Lanzetta D., D’antona D., La Marca A., Margante G. Hormonal effects of flutamide in young women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 83: 99, 1998.

    Article  CAS  Google Scholar 

  41. Moghetti P., Tosi F., Castello R., Magnani C.M., Negri C., Brun E., Furlani L., Caputo M., Muggeo M. The insulin resistance in women with hyperandrogenism is partially reversed by antiandrogen treatment: evidence that androgens impair insulin action in women. J. Clin. Endocrinol. Metab. 81: 952, 1996.

    PubMed  CAS  Google Scholar 

  42. Nestler J.E., Jakubowicz D.J., Evans W.S., Pasquali R. Effects of metformin on spontaneous and clomiphene induced ovulation in the polycystic ovary syndrome. N. Engl. J. Med. 338: 1876, 1998.

    Article  PubMed  CAS  Google Scholar 

  43. Velazquez E., Mendoza S., Hamer T., Sosa F., Glueck C. Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and sytolic blood pressure, while facilitating normal menses and pregnancy. Metabolism 43: 647, 1994.

    Article  PubMed  CAS  Google Scholar 

  44. Velazquez E., Acosta A., Mendoza S. Menstrual cyclicity after metformin therapy in polycystic ovary syndrome. Obstet. Gynecol. 90: 392, 1997.

    Article  PubMed  CAS  Google Scholar 

  45. Ehrmann D., Cavaghan M., Imperial J., Sturis J., Rosenfield R., Polonsky K. Effects of metformin on insulin secretion, insulin action, and ovarian steroidogenesis in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 82: 524, 1997.

    PubMed  CAS  Google Scholar 

  46. Dunaif A., Scott D., Finegood D., Quintana B., Whitcomb R. The insulin-sensitizing agent troglitazone improves metabolic and reproductive abnormalities in the polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 81: 3299, 1996.

    PubMed  CAS  Google Scholar 

  47. Ehrmann D.A., Schneider D.J., Sobel B.E., Cavaghan M., Imperial J., Rosenfield R.L., Polonsky R.L. Troglitazone improves defects in insulin action, insulin secretion, ovarian steroidogenesis, and fibrinolysis in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 82: 2108, 1997.

    PubMed  CAS  Google Scholar 

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Toscano, V. Polycystic ovary syndrome: What is it? Pathogenetic enigma and therapeutic dilemma. J Endocrinol Invest 21, 546–550 (1998). https://doi.org/10.1007/BF03350779

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