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Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance

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Barber, Dimitriadis et al Clin Med 2015 for deposit.pdfPublished version239.86 kBAdobe PDFView/Open
Title: Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance
Authors: Barber, TM
Dimitriadis, GK
Andreou, A
Franks, S
Item Type: Journal Article
Abstract: Polycystic ovary syndrome (PCOS) is a common condition that typically develops in reproductive-age women. The cardinal clinical and biochemical characteristics of PCOS include reproductive dysfunction and hyperandrogenic features. PCOS is also strongly associated with obesity based on data from epidemiological and genetic studies. Accordingly, PCOS often becomes manifest in those women who carry a genetic predisposition to its development, and who also gain weight. The role of weight gain and obesity in the development of PCOS is mediated at least in part, through worsening of insulin resistance. Compensatory hyperinsulinaemia that develops in this context disrupts ovarian function, with enhanced androgen production and arrest of ovarian follicular development. Insulin resistance also contributes to the strong association of PCOS with adverse metabolic risk, including dysglycaemia, dyslipidaemia and fatty liver. Conversely, modest weight loss of just 5% body weight with improvement in insulin sensitivity, frequently results in clinically meaningful improvements in hyperandrogenic, reproductive and metabolic features. Future developments of novel therapies for obese women with PCOS should focus on promotion of weight loss and improvement in insulin sensitivity. In this context, therapies that complement lifestyle changes such as dietary modification and exercise, particularly during the maintenance phase of weight loss are important. Putative novel targets for therapy in PCOS include human brown adipose tissue.
Date of Acceptance: 1-Dec-2015
URI: http://hdl.handle.net/10044/1/53737
DOI: 10.7861/clinmedicine.16-3-262
ISSN: 1470-2118
Publisher: Royal College of Physicians
Start Page: 262
End Page: 266
Journal / Book Title: Clinical Medicine
Volume: 16
Issue: 3
Sponsor/Funder: Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
MRC
Wellbeing of Women
Funder's Grant Number: G0802782
RDD03 79560
G0802782
RG1853
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
PCOS
insulin resistance
metabolic dysfunction
obesity
BROWN ADIPOSE-TISSUE
METABOLIC DYSFUNCTION
ANOVULATORY WOMEN
SENSITIVITY
IDENTIFICATION
PREVALENCE
MANAGEMENT
PHENOTYPES
SECRETION
Female
Humans
Insulin Resistance
Obesity
Polycystic Ovary Syndrome
1103 Clinical Sciences
General Clinical Medicine
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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