Abstract
Women with polycystic ovary syndrome have an increased rate of obesity, with a propensity
toward abdominal deposition of body fat. Independent of obesity, at least half of
affected women have insulin resistance. To understand the mechanisms of insulin resistance
in polycystic ovary syndrome, it is necessary to understand normal insulin signaling.
Women with polycystic ovary syndrome have normal binding of insulin to its receptor
but have decreased activation of events downstream of the receptor. This insulin resistance
occurs mostly in the peripheral tissues (muscle and fat cells), and results in increased
pancreatic insulin secretion to maintain normal glucose levels. Obese women with polycystic
ovary syndrome have a relative defect in insulin secretion. At least 20% of obese
patients with polycystic ovary syndrome have glucose intolerance or diabetes, versus
about 5% of the healthy age-matched population. Obesity and insulin resistance probably
increase the risk of cardiovascular disease in women with polycystic ovary syndrome.
The metabolic features of polycystic ovary syndrome are important health risk factors
and need to be considered seriously, even if the patient seeks treatment for other
concerns. (Am J Obstet Gynecol 1998;179:S94-100.)
Keywords
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Article info
Footnotes
☆Reprint requests: Ann E. Taylor, MD, Reproductive Endocrine Unit and National Center for Infertility Research, Massachusetts General Hospital, 55 Fruit St, BHX-5, Boston, MA 02114.
☆☆0002-9378/98 $5.00 + 06/0/94976
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Copyright
© 1998 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
