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Insulin Resistance and Polycystic Ovarian Syndrome pp 397–415Cite as

Insulin Resistance

Definition and Epidemiology in Normal Women and Polycystic Ovary Syndrome Women

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Insulin resistance and hyperinsulinemia are key features of women with polycystic ovary syndrome (PCOS), particularly in the presence of obesity. This has important effects in the pathophysiology of this disorder and contributes largely to its changing aspects throughout the lifespan. Insulin excess does in fact have a direct responsibility in favoring androgen excess and oligo-anovulation in PCOS. On the other hand, insulin resistance represents the main pathophysiological event leading to the development of the metabolic syndrome, which affects almost 50% of women with PCOS.

Insulin resistance and the metabolic syndrome probably represent different entities and, therefore, should not be used as a synonym. Although there are no epidemiological data, it appears that the incidence of insulin resistance in PCOS exceeds the prevalance expected in the general population. On the other hand, although prevalence largely depends on the method used, insulin resistance in PCOS appears to be even higher in the presence of obesity, particularly the abdominal phenotype. Insulin resistance may be found, however, even in some normal-weight women with PCOS. Notably, the larger the number of criteria used to define the metabolic syndrome, the higher the probability that affected women are insulin resistant.

Recognition of these abnormalities in PCOS women may be of relevance for both treatment and preventive strategies. It is in fact well defined that PCOS itself, and even more so in the presence of obesity and a positive family history, may increase individual susceptibility to an early development of T2DM.

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Authors and Affiliations

  1. Endocrinology Unit, Department of Internal Medicine and Gastroenterology and C.R.B.A., S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy

    Renato Pasquali MD & Alessandra Gambineri MD

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  1. Renato Pasquali MD
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  2. Alessandra Gambineri MD
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Editors and Affiliations

  1. Endocrine Section of First Department of Internal Medicine, Athens University School of Medicine, Athens, Greece

    Evanthia Diamanti-Kandarakis MD, PhD

  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA

    John E. Nestler MD

  3. Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Dimitrios Panidis MD, PhD

  4. Endocrinology Unit, Department of Internal Medicine and Gastroenterology and C.R.B.A., S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy

    Renato Pasquali MD

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Pasquali, R., Gambineri, A. (2007). Insulin Resistance. In: Diamanti-Kandarakis, E., Nestler, J.E., Panidis, D., Pasquali, R. (eds) Insulin Resistance and Polycystic Ovarian Syndrome. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59745-310-3_30

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  • DOI: https://doi.org/10.1007/978-1-59745-310-3_30

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