Cited by 527Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsGenetic and Kidney Cyst Diseases

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Polycystic Ovarian Syndrome: Correlation Between Hyperandrogenism, Insulin Resistance and Obesity.

Zeng, Xin, Xie, Yuan-jie, Liu, Ya-ting, Long, Shuang-lian, Mo, Zhong-cheng·2020·Clinica Chimica Acta

DOI 10.1016/j.cca.2019.11.003

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Abstract

Polycystic ovary syndrome (PCOS) is a complex and heterogeneous endocrine disease characterized by clinical or laboratorial hyperandrogenism, oligo-anovulation and metabolic abnormalities, including insulin resistance, excessive weight or obesity, type II diabetes, dyslipidemia and an increased risk of cardiovascular disease. The most significant clinical manifestation of PCOS is hyperandrogenism. Excess androgen profoundly affects granulosa cell function and follicular development via complex mechanisms that lead to obesity and insulin resistance. Most PCOS patients with hyperandrogenism have steroid secretion defects that result in abnormal folliculogenesis and failed dominant follicle selection. Hyperandrogenism induces obesity, hairy, acne, and androgenetic alopecia. These symptoms can bring great psychological stress to women. Drugs such as combined oral contraceptive pills, metformin, pioglitazone and low-dose spironolactone help improve pregnancy rates by decreasing androgen levels in vivo. Notably, PCOS is heterogeneous, and hyperandrogenism is not the only pathogenic factor. Obesity and insulin resistance aggravate the symptoms of hyperandrogenism, forming a vicious cycle that promotes PCOS development. Although numerous studies have been conducted, the definitive pathogenic mechanisms of PCOS remain uncertain. This review summarizes and discusses previous and recent findings regarding the relationship between hyperandrogenism, insulin resistance, obesity and PCOS.

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Authors: Zeng, X., Xie, Y.-J., Liu, Y.-T., Long, S.-L., & Mo, Z.-C.
Affiliations: University of South China (CN)
Corresponding author: Long, Shuang-lian
ORCID: Zeng, Xin
Venue: Clinica Chimica Acta
Publisher: Elsevier BV
Published: 2020-03
Volume: 502
Pages: 214-221
ISSN: 0009-8981 (ISSN-L)
DOI: 10.1016/j.cca.2019.11.003
OpenAlex: W2987017313
Cited by: 525
References: 91
Citations by year: 2026: 57 · 2025: 108 · 2024: 99 · 2023: 112 · 2022: 84 · 2021: 49 · 2020: 16
FWCI: 5.27
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinica Chimica Acta (publishedVersion)
PubMed (publishedVersion)
Funders: Natural Sciences Foundation of Hunan Province (2017JJ2233)
Key Lab for Clinical Anatomy & Reproductive Medicine of Hengyang City (2017KJ182)
University of South China (2018XJXZ373)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
Keywords: polycystic ovary syndrome, hyperandrogenism, insulin resistance, obesity, androgenetic alopecia, acne, oligoanovulation, folliculogenesis, dominant follicle selection, metformin, spironolactone, pioglitazone, oral contraceptives, type 2 diabetes, cardiovascular risk
MeSH terms: Pioglitazone, Androgens, Female, Humans, Hypoglycemic Agents, Insulin Resistance, Metformin, Obesity, Polycystic Ovary Syndrome, Spironolactone, Hyperandrogenism

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Polycystic Ovarian Syndrome: Correlation Between Hyperandrogenism, Insulin Resistance and Obesity.

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