Journal of Endocrinological Investigation

, Volume 41, Issue 4, pp 383–388 | Cite as

Androgen excess and metabolic disorders in women with PCOS: beyond the body mass index

  • R. A. Condorelli
  • A. E. Calogero
  • M. Di Mauro
  • L. M. Mongioi’
  • R. Cannarella
  • G. Rosta
  • S. La Vignera



Insulin resistance is a common feature among women with polycystic ovary syndrome (PCOS), especially in those patients with hyperandrogenism and chronic anovulation. PCOS women are at risk for developing metabolic syndrome, impaired glucose tolerance and type II diabetes mellitus (DM II).


The aim of this review is to explore the existing knowledge of the interplay between androgen excess, pancreatic β-cell function, non-alcoholic fatty liver disease (NAFLD), intra-abdominal and subcutaneous (SC) abdominal adipocytes in PCOS, providing a better comprehension of the molecular mechanisms of diabetologic interest.


A comprehensive MEDLINE® search was performed using relevant key terms for PCOS and DM II.


Insulin-induced hyperandrogenism could impair pancreatic β-cell function, the SC abdominal adipocytes’ lipid storage capacity, leading to intra-abdominal adipocyte hypertrophy and lipotoxicity, which in turn promotes insulin resistance, and could enhance NAFLD. Fetal hyperandrogenism exposure prompts to metabolic disorders. Treatment with flutamide showed to partially reverse insulin resistance.


Metabolic impairment seems not to be dependent only on the total fat mass content and body weight in women with PCOS and might be ascribed to the androgen excess.


PCOS Insulin resistance Obesity Hyperandrogenism 





American Association of Clinical Endocrinology


American College of Endocrinology


Body mass index


Dehydroepiandrosterone sulfate




Type II diabetes mellitus


De novo methyl-transferase 3


Free fatty acids


First phase insulin response


Impaired glucose tolerance


LDL receptor


Metabolic syndrome


Non-alcoholic fatty liver disease


Non-alcoholic steatoepatitis


National Institutes of Health




Oral glucose tolerance test


Polycystic ovary syndrome




Sex hormone-binding globulin


Steady-state plasma glucose




Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical approval

This article does not contain studies with human participants or animals performed by any of the authors.

Informed consent

No informed consent.


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Copyright information

© Italian Society of Endocrinology (SIE) 2017

Authors and Affiliations

  • R. A. Condorelli
    • 1
  • A. E. Calogero
    • 1
  • M. Di Mauro
    • 1
  • L. M. Mongioi’
    • 1
  • R. Cannarella
    • 1
  • G. Rosta
    • 1
  • S. La Vignera
    • 1
  1. 1.Department of Clinical and Experimental MedicineUniversity of Catania, Policlinico “G. Rodolico”CataniaItaly

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