Cited by 348Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsAdrenal Hormones and Disorders

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The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism

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Wallach, Edward E., Barbieri, Robert L., Smith, Samuel, Ryan, Kenneth J.·1988·Fertility and Sterility

DOI 10.1016/s0015-0282(16)60060-2

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Abstract

The evidence that supports the hypothesis that insulin and LH both regulate ovarian androgen production was presented. The most dramatic clinical example of the association between hyperinsulinemia and hyperandrogenism is the HAIR-AN syndrome. Our hypothesis is that, in the HAIR-AN syndrome, the severe insulin resistance causes a compensatory hyperinsulinemia, which stimulates ovarian androgen production if adequate LH is present. The acanthosis nigricans is an epiphenomenon of the syndrome. Acanthosis nigricans is a dermatologic manifestation of severe insulin resistance. In vitro evidence suggests that insulin and IGF-I stimulate androgen production in incubations of human stroma and theca. The stromatropic effects of insulin may sensitize the stroma to the stimulatory effects of LH. In some hyperandrogenic-insulin-resistant women, a glucose load appears to produce an acute rise in circulating androgens. The magnitude of the rise in circulating androgens is proportional to the magnitude of the insulin response to the glucose load. These data suggest that hyperinsulinemia may play a central role in the development of ovarian hyperandrogenism.

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Background
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Authors: Wallach, E. E., Barbieri, R. L., Smith, S., & Ryan, K. J.
Affiliations: Brigham and Women's Hospital (US)
ORCID: Barbieri, Robert L.
Ryan, Kenneth J.
Venue: Fertility and Sterility
Publisher: Elsevier BV
Published: 1988-08
Volume: 50
Issue: 2
Pages: 197-212
ISSN: 0015-0282 (ISSN-L)
DOI: 10.1016/s0015-0282(16)60060-2
OpenAlex: W194639418
Cited by: 348
References: 108
Citations by year: 2026: 4 · 2025: 6 · 2024: 3 · 2023: 9 · 2022: 9 · 2021: 8 · 2020: 4 · 2019: 5 · 2018: 5 · 2017: 7 · 2016: 6 · 2015: 5 · 2014: 7 · 2013: 4 · 2012: 2
FWCI: 10.95
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 12352 d)
Locations: Fertility and Sterility (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: hyperinsulinemia, ovarian hyperandrogenism, polycystic ovary syndrome, androgen overproduction, PCOS pathogenesis, insulin resistance, hypothalamic-pituitary-ovarian axis, adrenal androgen production
MeSH terms: Acanthosis Nigricans, Androgens, Female, Humans, Hyperinsulinism, Insulin Resistance, Ovary, Polycystic Ovary Syndrome, Syndrome

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The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism

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