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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
Review

Abstract

Background

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).

Objective

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.

Methods

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

Results

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.

Conclusions

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.

Keywords

PCOS Insulin resistance Obesity Hyperandrogenism 

Abbreviations

A

Androstenedione

AACE

American Association of Clinical Endocrinology

ACE

American College of Endocrinology

BMI

Body mass index

DHEAS

Dehydroepiandrosterone sulfate

DHT

Di-hydro-testosterone

DM II

Type II diabetes mellitus

DNMT3

De novo methyl-transferase 3

FFA

Free fatty acids

FPIR

First phase insulin response

IGT

Impaired glucose tolerance

LDL-R

LDL receptor

MetS

Metabolic syndrome

NAFLD

Non-alcoholic fatty liver disease

NASH

Non-alcoholic steatoepatitis

NIH

National Institutes of Health

17αOH-P

17α-Hydroxy-progesterone

OGTT

Oral glucose tolerance test

PCOS

Polycystic ovary syndrome

SC

Subcutaneous

SHBG

Sex hormone-binding globulin

SSPG

Steady-state plasma glucose

T

Testosterone

Notes

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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