The DOI matches its Crossref record; 107 of the 108 references it cites were found in a registry or an index.
The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism
Open accessAbstract
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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“Insulin suppresses hepatic SHBG secretion and acts on the ovary to promote thecal cell androgen synthesis 58 with the net effect of increasing circulating free testosterone concentrations.”
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Citations
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Metadata
- Authors
- Wallach, E. E., Barbieri, R. L., Smith, S., & Ryan, K. J.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1988-08
- Volume
- 50
- Issue
- 2
- Pages
- 197-212
- ISSN
- 0015-0282 (ISSN-L)
- 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
- 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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