Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp
Open accessAbstract
STUDY QUESTION: What is the prevalence of insulin resistance (IR) and the contributions of intrinsic and extrinsic IR in women diagnosed with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria? SUMMARY ANSWER: We report novel clamp data in Rotterdam diagnosed PCOS women, using World Health Organization criteria for IR showing that women with PCOS have a high prevalence of IR, strengthening the evidence for an aetiological role of IR in both National Institutes of Health (NIH) and Rotterdam diagnosed PCOS in lean and overweight women. WHAT IS KNOWN ALREADY: PCOS is a complex endocrine condition with a significant increased risk of gestational diabetes and type 2 diabetes. STUDY DESIGN, SIZE, DURATION: Using a cross-sectional study design, 20 overweight and 20 lean PCOS (Rotterdam criteria), 14 overweight and 19 lean body mass index (BMI)-matched control non-PCOS women underwent clinical measures of IR after a 3-month withdrawal of insulin sensitizers and the oral contraceptive pill. MATERIALS, SETTING, METHODS: In an academic clinic setting, glucose infusion rate (GIR) on euglycaemic-hyperinsulinaemic clamp was investigated as a marker of insulin sensitivity. MAIN RESULTS AND THE ROLE OF CHANCE: PCOS women were more IR than BMI-matched controls (main effect for BMI and PCOS; P < 0.001). IR was present in 75% of lean PCOS, 62% of overweight controls and 95% of overweight PCOS. Lean controls (mean ± SD; GIR 339 ± 76 mg min⁻¹ m⁻²) were less IR than lean PCOS (270 ± 66 mg min⁻¹ m⁻²), overweight controls (264 ± 66 mg min⁻¹ m⁻²) and overweight PCOS (175 ± 96 mg min⁻¹ m⁻²). The negative relationship between BMI and IR reflected by GIR was more marked in PCOS (y = 445.1 - 7.7x, R² = 0.42 (P < 0.0001) than controls (y = 435.5 - 4.6x, R² = 0.04 (P < 0.01)). LIMITATIONS, REASONS FOR CAUTION: The study did not use glucose tracer techniques to completely characterize the IR, as well as the lack of matching for body composition and age. WIDER IMPLICATIONS OF THE FINDINGS: IR is exacerbated by increased BMI, supporting intrinsic IR in PCOS. BMI impact on IR is greater in PCOS, than in controls, irrespective of visceral fat, prioritizing lifestyle intervention and the need for effective therapeutic interventions to address intrinsic IR and prevent diabetes in this high-risk population. STUDY FUNDING/COMPETING INTEREST(S): This investigator-initiated trial was supported by grants from the National Health & Medical Research Council (NHMRC) Grant number 606553 (H.J.T., N.K.S. and S.K.H.) as well as Monash University and The Jean Hailes Foundation. H.J.T. is an NHMRC Research Fellow. N.K.S. is supported through the Australian Government's Collaborative Research Networks (CRN) programme. A.E.J. is a Jean Hailes and NHMRC scholarship holder. The authors declare that there is no conflict of interest associated with this manuscript.
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Insulin resistance is hypothesized to be a significant proximate cause of PCOS and intrinsic to the underlying pathophysiology.
“Despite these limitations, it is hypothesized that IR is a significant proximate cause of PCOS and is intrinsic to the underlying pathophysiology [44,156].”
From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [156]
The Introduction describes insulin resistance as a central characteristic of PCOS that drives hyperandrogenism and clinical features. The Discussion reports evidence for intrinsic insulin resistance, including in lean women with PCOS. Neither section establishes that insulin resistance is a proximate cause of PCOS itself; the paper says PCOS aetiology remains unclear. (LLM, conf=0.82)
Experimental — accuracy not yet measuredInsulin resistance affects about 85% of PCOS cases, including 75% of lean and 95% of overweight cases.
“insulin resistance affects ≏ 85% (75% of lean and 95% of overweight) of cases (Stepto et al. , 2013).”
From Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis (2015) · cites this paper as Stepto et al., 2013
Insulin resistance and hyperandrogenism are central to the pathophysiology of PCOS.
“Insulin resistance and hyperandrogenism play a key role in the pathophysiology of PCOS”
From Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis (2015) · cites this paper as Stepto et al., 2013
Insulin resistance is present in 75% of lean and 95% of overweight women with polycystic ovary syndrome.
“According to a cross-sectional study, IR is present in 75% of lean and 95% of overweight women with PCOS [8].”
From Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials (2023) · cites this paper as [8]
Overall, 75% of lean women and 95% of obese women with PCOS have IR.
“Overall, 75% of lean women and 95% of obese women with PCOS have IR (16).”
From Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome (2020) · cites this paper as [16]
Insulin resistance is a key pathophysiological feature of PCOS and is present in even lean women with PCOS.
“Insulin resistance is a key pathophysiological feature of PCOS and is present in even lean women with PCOS in a form that is proposed to be mechanistically distinct from obesityassociated insulin resistance [7].”
From Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success (2021) · cites this paper as [7]
Insulin resistance affects 75% of lean women and 95% of overweight women with PCOS.
“Additionally, insulin resistance, which is positively correlated with visceral fat thickness (Karabulut et al., 2012), affects 75% of lean women and 95% of overweight women with PCOS (Stepto et al., 2013).”
From Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention (2021) · cites this paper as Stepto et al., 2013
PCOS patients commonly have metabolic complications, such as type 2 diabetes, insulin resistance (IR), and adipose tissue dysfunction.
“PCOS patients commonly have metabolic complications, such as type 2 diabetes, insulin resistance (IR), and adipose tissue dysfunction (7–9).”
From Circulating Adipokine Levels in Nonobese Women with Polycystic Ovary Syndrome and in Nonobese Control Women: A Systematic Review and Meta-Analysis (2021) · cites this paper as [8]
Increased insulin resistance plays a key role in the pathophysiology of PCOS.
“It is widely accepted that increased insulin resistance plays a key role in the pathophysiology of PCOS.”
Insulin resistance in PCOS is independent of weight but is exacerbated by excess weight gain.
“This is independent of weight, but is exacerbated by excess weight gain.7,8”
Both lean and overweight women with PCOS have greater insulin resistance/hyperinsulinemia than women without PCOS.
“Both lean and overweight women with PCOS have been found to have greater insulin resistance/hyperinsulinemia compared to women without PCOS, 7”
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Cites
(2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.10.004 · Cited by 9,050 · see citing works
Grundy, S. M., Brewer, H. B., Cleeman, J. I., Smith, S. C., & Lenfant, C. (2004) · Circulation · doi:10.1161/01.cir.0000111245.75752.c6 · Cited by 5,982 · see citing works
Men at risk: occupation and male infertility.
Claman, P. (2004) · Fertility and Sterility · doi:10.1016/s0015-0282(03)01188-9 · Cited by 2,219 · see citing works
Profound Peripheral Insulin Resistance, Independent of Obesity, in Polycystic Ovary Syndrome
Dunaif, A., Segal, K. R., Futterweit, W., & Dobrjansky, A. (1989) · Diabetes · doi:10.2337/diab.38.9.1165 · Cited by 1,967 · see citing works
March, W. A., Moore, V. M., Willson, K. J., Phillips, D. I. W., Norman, R. J., & Davies, M. J. (2010) · Human Reproduction · doi:10.1093/humrep/dep399 · Cited by 1,799 · see citing works
Moran, L. J., Misso, M. L., Wild, R. A., & Norman, R. J. (2010) · Human Reproduction Update · doi:10.1093/humupd/dmq001 · Cited by 1,108 · see citing works
Legro, R. S., Finegood, D. T., & Dunaif, A. E. (1998) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.83.8.5054 · Cited by 748 · see citing works
Carmina, E., Koyama, T., Chang, L., Stanczyk, F. Z., & Løbo, R. A. (1992) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(92)91779-a · Cited by 441 · see citing works
Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus
Ovalle, F., & Azziz, R. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03111-4 · Cited by 428 · see citing works
Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline
Teede, H. J., Misso, M. L., Deeks, A. A., Moran, L. J., Stuckey, B. G. A., Wong, J. L. A., Norman, R. J., Costello, M. F., & Groups, O. B. O. T. G. D. (2011) · Medical Journal of Australia · doi:10.5694/mja11.10915 · Cited by 379 · see citing works
Self-citationMetabolic features of the reproductive phenotypes of polycystic ovary syndrome
Moran, L., & Teede, H. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmp008 · Cited by 362 · see citing works
Self-citationMolecular mechanisms of insulin resistance in polycystic ovary syndrome
Diamanti-Kandarakis, E., & Papavassiliou, A. G. (2006) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2006.05.006 · Cited by 301 · see citing works
Corbould, A., Kim, Y.-B., Youngren, J. F., Pender, C., Kahn, B. B., Lee, A., & Dunaif, A. (2005) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00361.2004 · Cited by 283 · see citing works
Overweight Women with Polycystic Ovary Syndrome Have Evidence of Subclinical Cardiovascular Disease
Meyer, C., McGrath, B. P., & Teede, H. J. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-0011 · Cited by 273 · see citing works
Self-citationWelt, C. K., Gudmundsson, J., Arason, G., Adams, J., Pálsdottir, H. S., Gudlaugsdottir, G. J., Ingadóttir, G., & Crowley, W. F. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1327 · Cited by 260 · see citing works
Barber, T. M., Wass, J. A. H., McCarthy, M. I., & Franks, S. (2007) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2007.02764.x · Cited by 254 · see citing works
Consensus Development Conference on Insulin Resistance: 5–6 November 1997
American Diabetes Association (1998) · Diabetes Care · doi:10.2337/diacare.21.2.310 · Cited by 251 · see citing works
Anxiety and depression in polycystic ovary syndrome: a comprehensive investigation
Deeks, A. A., Gibson-Helm, M. E., & Teede, H. J. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.09.018 · Cited by 246 · see citing works
Self-citationSkov, V., Glintborg, D., Knudsen, S., Jensen, T. E., Kruse, T. A., Tan, Q., Brusgaard, K., Beck‐Nielsen, H., & Højlund, K. (2007) · Diabetes · doi:10.2337/db07-0275 · Cited by 205 · see citing works
Oligoanovulation with Polycystic Ovaries But Not Overt Hyperandrogenism
Dewailly, D., Catteau-Jonard, S., Reyss, A.-C., Leroy, M., & Pigny, P. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1054 · Cited by 198 · see citing works
Hutchison, S. K., Stepto, N. K., Harrison, C. L., Moran, L. J., Strauss, B. J., & Teede, H. J. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0828 · Cited by 192 · see citing works
Self-citationEnhanced Mitogenic Signaling in Skeletal Muscle of Women With Polycystic Ovary Syndrome
Corbould, A. M., Zhao, H., Mirzoeva, S., Aird, F., & Dunaif, A. E. (2006) · Diabetes · doi:10.2337/diabetes.55.03.06.db05-0453 · Cited by 166 · see citing works
Rachoń, D., & Teede, H. (2010) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2009.09.026 · Cited by 161 · see citing works
Self-citationPrevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia
Boyle, J. A., Cunningham, J., OˈDea, K., Dunbar, T., & Norman, R. J. (2012) · Medical Journal of Australia · doi:10.5694/mja11.10553 · Cited by 160 · see citing works
Lord, J., Thomas, R., Fox, B., Acharya, U., & Wilkin, T. (2006) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.00973.x · Cited by 158 · see citing works
The management of insulin resistance in polycystic ovary syndrome
Teede, H. J., Hutchison, S. K., & Zoungas, S. (2007) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2007.08.001 · Cited by 135 · see citing works
Self-citationMisso, M. L., Costello, M. F., Garrubba, M., Wong, J., Hart, R., Rombauts, L., Melder, A. M., Norman, R. J., & Teede, H. J. (2013) · Human Reproduction Update · doi:10.1093/humupd/dms036 · Cited by 81 · see citing works
Self-citationHarrison, C. L., Stepto, N. K., Hutchison, S. K., & Teede, H. J. (2012) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04160.x · Cited by 80 · see citing works
Self-citationHutchison, S. K., Teede, H. J., Rachoń, D., Harrison, C. L., Strauss, B. J., & Stepto, N. K. (2012) · Diabetologia · doi:10.1007/s00125-011-2442-8 · Cited by 57 · see citing works
Self-citationMancini, F., Cianciosi, A., Marchesini, G., Facchinetti, F., Battaglia, C., & Aloysio, D. D. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.03.023 · Cited by 43 · see citing works
Diabetes risk score in the diagnostic categories of polycystic ovary syndrome
Moran, L. J., Strauss, B. J., & Teede, H. J. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.01.133 · Cited by 41 · see citing works
Self-citationEstévez, D. A. G., Araújo‐Vilar, D., Saavedra, Á., Fiestras-Janeiro, M. G., & Cabezas-Cerrato, J. (2004) · Metabolism · doi:10.1016/j.metabol.2004.06.014 · Cited by 40 · see citing works
Skeletal muscle mitochondrial function in polycystic ovarian syndrome
Rabøl, R., Svendsen, P. F., Skovbro, M., Boushel, R., Schjerling, P., Nilas, L., Madsbad, S., & Dela, F. (2011) · European Journal of Endocrinology · doi:10.1530/eje-11-0419 · Cited by 33 · see citing works
Dysregulation of glucose metabolism even in Chinese PCOS women with normal glucose tolerance
Li, W., & Li, Q. (2012) · Endocrine Journal · doi:10.1507/endocrj.ej12-0049 · Cited by 23 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J. S. E., Legro, R. S., Lizneva, D., Natterson-Horowtiz, B., Teede, H. J., & Yildiz, B. O. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.57 · Cited by 2,005 · see citing works
Self-citationRosenfield, R. L., & Ehrmann, D. A. (2016) · Endocrine Reviews · doi:10.1210/er.2015-1104 · Cited by 1,603 · see citing works
Dumesic, D. A., Oberfield, S. E., Stener-Victorin, E., Marshall, J. C., Laven, J. S., & Legro, R. S. (2015) · Endocrine Reviews · doi:10.1210/er.2015-1018 · Cited by 1,020 · see citing works
Balen, A. H., Morley, L. C., Misso, M., Franks, S., Legro, R. S., Wijeyaratne, C. N., Stener-Victorin, E., Fauser, B. C. J. M., Norman, R. J., & Teede, H. (2016) · Human Reproduction Update · doi:10.1093/humupd/dmw025 · Cited by 705 · see citing works
Self-citationTang, T., Lord, J. M., Norman, R. J., Yasmin, E., & Balen, A. H. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub5 · Cited by 698 · see citing works
Witchel, S. F., Oberfield, S. E., & Peña, A. S. (2019) · Journal of the Endocrine Society · doi:10.1210/js.2019-00078 · Cited by 653 · see citing works
Stener-Victorin, E., Teede, H., Norman, R. J., Legro, R., Goodarzi, M. O., Dokras, A., Laven, J., Hoeger, K., & Piltonen, T. T. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00511-3 · Cited by 495 · see citing works
Self-citationIbáñez, L., Oberfield, S. E., Witchel, S., Auchus, R. J., Chang, R. J., Codner, E., Dabadghao, P., Darendeliler, F., Elbarbary, N. S., Gambineri, A., et al. (2017) · Hormone Research in Paediatrics · doi:10.1159/000479371 · Cited by 463 · see citing works
Osibogun, O., Ogunmoroti, O., & Michos, E. D. (2020) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2019.08.010 · Cited by 423 · see citing works
Long-term cardiometabolic disease risk in women with PCOS: a systematic review and meta-analysis
Wekker, V, van Dammen, L., Koning, A., Heida, K. Y., Painter, R. C., Limpens, J., Laven, J. S. E., Roeters van Lennep, J. E., Roseboom, T. J., & Hoek, A. (2020) · Human Reproduction Update · doi:10.1093/humupd/dmaa029 · Cited by 425 · see citing works
Cassar, S., Misso, M. L., Hopkins, W. G., Shaw, C. S., Teede, H. J., & Stepto, N. K. (2016) · Human Reproduction · doi:10.1093/humrep/dew243 · Cited by 415 · see citing works
Self-citationThe Potential Implications of a PCOS Diagnosis on a Woman's Long-Term Health Using Data Linkage
Hart, R., & Doherty, D. A. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3886 · Cited by 391 · see citing works
Kakoly, N. S., Khomami, M. B., Joham, A. E., Cooray, S. D., Misso, M. L., Norman, R. J., Harrison, C. L., Ranasinha, S., Teede, H. J., & Moran, L. J. (2018) · Human Reproduction Update · doi:10.1093/humupd/dmy007 · Cited by 384 · see citing works
Self-citationNaderpoor, N., Shorakae, S., de Courten, B., Misso, M. L., Moran, L. J., & Teede, H. J. (2015) · Human Reproduction Update · doi:10.1093/humupd/dmv025 · Cited by 334 · see citing works
Self-citationLim, S. S., Kakoly, N. S., Tan, J. W. J., Fitzgerald, G., Bahri Khomami, M., Joham, A. E., Cooray, S. D., Misso, M. L., Norman, R. J., Harrison, C. L., et al. (2019) · Obesity Reviews · doi:10.1111/obr.12762 · Cited by 316 · see citing works
Self-citationMorley, L. C., Tang, T., Yasmin, E., Norman, R. J., & Balen, A. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003053.pub6 · Cited by 296 · see citing works
He, F.-F., & Li, Y.-M. (2020) · Journal of Ovarian Research · doi:10.1186/s13048-020-00670-3 · Cited by 289 · see citing works
Complications and challenges associated with polycystic ovary syndrome: current perspectives
Palomba, S., Santagni, S., Falbo, A., & La Sala, G. B. (2015) · International Journal of Women's Health · doi:10.2147/ijwh.s70314 · Cited by 287 · see citing works
Metabolic risk in PCOS: Phenotype and adiposity impact
Moran, L. J., Norman, R. J., & Teede, H. J. (2015) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2014.12.003 · Cited by 245 · see citing works
Self-citationDumesic, D. A., Akopians, A. L., Madrigal, V. K., Ramirez, E., Margolis, D. J., Sarma, M. K., Thomas, A. M., Grogan, T. R., Haykal, R., Schooler, T. A., et al. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2586 · Cited by 222 · see citing works
Sex, microbes, and polycystic ovary syndrome
Thackray, V. G. (2019) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2018.11.001 · Cited by 203 · see citing works
Insulin resistance and PCOS: chicken or egg?
Moghetti, P., & Tosi, F. (2021) · Journal of Endocrinological Investigation · doi:10.1007/s40618-020-01351-0 · Cited by 209 · see citing works
The management of patients with polycystic ovary syndrome
Jayasena, C. N., & Franks, S. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.102 · Cited by 196 · see citing works
The Impact of Obesity on the Incidence of Type 2 Diabetes Among Women With Polycystic Ovary Syndrome
Kakoly, N. S., Earnest, A., Teede, H. J., Moran, L. J., & Joham, A. E. (2019) · Diabetes Care · doi:10.2337/dc18-1738 · Cited by 174 · see citing works
Self-citationEffect of Diet on Insulin Resistance in Polycystic Ovary Syndrome
Shang, Y., Zhou, H., Hu, M., & Feng, H. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa425 · Cited by 171 · see citing works
Ollila, M.-M. E., West, S., Keinänen-Kiukaanniemi, S., Jokelainen, J., Auvinen, J., Puukka, K., Ruokonen, A., Järvelin, M.-R., Tapanainen, J. S., Franks, S., et al. (2017) · Human Reproduction · doi:10.1093/humrep/dew329 · Cited by 165 · see citing works
Almenning, I., Rieber-Mohn, A., Lundgren, K. M., Shetelig Løvvik, T., Garnæs, K. K., & Moholdt, T. (2015) · PLOS ONE · doi:10.1371/journal.pone.0138793 · Cited by 155 · see citing works
Fernandez, R., Moore, V., Van Ryswyk, E., Varcoe, T., Rodgers, R., March, W., Moran, L., Avery, J., McEvoy, D., & Davies, M. (2018) · Nature and Science of Sleep · doi:10.2147/nss.s127475 · Cited by 137 · see citing works
Greff, D., Juhász, A. E., Váncsa, S., Váradi, A., Sipos, Z., Szinte, J., Park, S., Hegyi, P., Nyirády, P., Ács, N., et al. (2023) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-023-01055-z · Cited by 143 · see citing works
“According to a crosssectional study, IR is present in 75% of lean and 95% of overweight women with PCOS [8].”
BackgroundPhysical activity and mental health in women with Polycystic Ovary Syndrome
Banting, L. K., Gibson-Helm, M., Polman, R., Teede, H. J., & Stepto, N. K. (2014) · BMC Women's Health · doi:10.1186/1472-6874-14-51 · Cited by 121 · see citing works
Self-citationPundir, J., Psaroudakis, D., Savnur, P., Bhide, P., Sabatini, L., Teede, H., Coomarasamy, A., & Thangaratinam, S. (2018) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14754 · Cited by 115 · see citing works
Self-citationTeede, H. J., Misso, M. L., Boyle, J. A., Garad, R. M., McAllister, V., Downes, L., Gibson‐Helm, M., Hart, R. J., Rombauts, L., Moran, L., et al. (2018) · Medical Journal of Australia · doi:10.5694/mja18.00656 · Cited by 115 · see citing works
Self-citationPolycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment
parker, J., O'Brien, C., Hawrelak, J., & Gersh, F. (2021) · doi:10.20944/preprints202112.0088.v1 · Cited by 113 · see citing works
Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment
Parker, J., O’Brien, C., Hawrelak, J., & Gersh, F. L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031336 · Cited by 114 · see citing works
“Despite these limitations, it is hypothesised that IR is a significant proximate cause of PCOS and is intrinsic to the underlying pathophysiology (44,155).”
BackgroundThe effect of acute exercise on undercarboxylated osteocalcin and insulin sensitivity in obese men
Levinger, I., Jerums, G., Stepto, N. K., Parker, L., Serpiello, F. R., McConell, G. K., Anderson, M., Hare, D. L., Byrnes, E., Ebeling, P. R., et al. (2014) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.2285 · Cited by 101 · see citing works
Self-citationBenelli, E., Del Ghianda, S., Di Cosmo, C., & Tonacchera, M. (2016) · International Journal of Endocrinology · doi:10.1155/2016/3204083 · Cited by 100 · see citing works
Teede, H., Gibson-Helm, M., Norman, R. J., & Boyle, J. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2978 · Cited by 93 · see citing works
Self-citationMoran, L. J., Tassone, E. C., Boyle, J., Brennan, L., Harrison, C. L., Hirschberg, A. L., Lim, S., Marsh, K., Misso, M. L., Redman, L., et al. (2020) · Obesity Reviews · doi:10.1111/obr.13046 · Cited by 84 · see citing works
Self-citationCree-Green, M., Rahat, H., Newcomer, B. R., Bergman, B. C., Brown, M. S., Coe, G. V., Newnes, L., Garcia-Reyes, Y., Bacon, S., Thurston, J. E., et al. (2017) · Journal of the Endocrine Society · doi:10.1210/js.2017-00192 · Cited by 82 · see citing works
Kazemi Jaliseh, H., Ramezani Tehrani, F., Behboudi-Gandevani, S., Hosseinpanah, F., Khalili, D., Cheraghi, L., & Azizi, F. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.09.004 · Cited by 80 · see citing works
Lin, K., Sun, X., Wang, X., Wang, H., & Chen, X. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.537809 · Cited by 81 · see citing works
Melin, J., Forslund, M., Alesi, S., Piltonen, T., Romualdi, D., Spritzer, P. M., Tay, C. T., Pena, A., Witchel, S. F., Mousa, A., et al. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad465 · Cited by 78 · see citing works
Self-citationVizza, L., Smith, C. A., Swaraj, S., Agho, K., & Cheema, B. S. (2016) · BMC Sports Science, Medicine and Rehabilitation · doi:10.1186/s13102-016-0039-8 · Cited by 74 · see citing works
Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success
Ee, C., Pirotta, S., Mousa, A., Moran, L., & Lim, S. (2021) · BMC Endocrine Disorders · doi:10.1186/s12902-021-00890-8 · Cited by 70 · see citing works
Melin, J., Forslund, M., Alesi, S., Piltonen, T., Romualdi, D., Spritzer, P. M., Tay, C. T., Pena, A., Witchel, S. F., Mousa, A., et al. (2023) · European Journal of Endocrinology · doi:10.1093/ejendo/lvad098 · Cited by 72 · see citing works
Self-citationResistance exercise impacts lean muscle mass in women with polycystic ovary syndrome
KOGURE, G. S., MIRANDA-FURTADO, C. L., SILVA, R. C., MELO, A. S., FERRIANI, R. A., DE SÁ, M. F. S., & REIS, R. M. D. (2016) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000822 · Cited by 68 · see citing works
Zhou, L., Qu, H., Yang, L., & Shou, L. (2023) · BMC Endocrine Disorders · doi:10.1186/s12902-023-01500-5 · Cited by 66 · see citing works
Complex diseases and co-morbidities: polycystic ovary syndrome and type 2 diabetes mellitus
Rodgers, R. J., Avery, J. C., Moore, V. M., Davies, M. J., Azziz, R., Stener-Victorin, E., Moran, L. J., Robertson, S. A., Stepto, N. K., Norman, R. J., et al. (2019) · Endocrine Connections · doi:10.1530/ec-18-0502 · Cited by 60 · see citing works
Self-citationCopp, T., Muscat, D. M., Hersch, J., McCaffery, K. J., Doust, J., Dokras, A., Mol, B. W., & Jansen, J. (2022) · Patient Education and Counseling · doi:10.1016/j.pec.2021.05.038 · Cited by 59 · see citing works
Moran, L. J., Noakes, M., Clifton, P., Buckley, J., Brinkworth, G., Thomson, R., & Norman, R. J. (2019) · Nutrients · doi:10.3390/nu11030492 · Cited by 57 · see citing works
Weight management interventions in women with and without PCOS: a systematic review
Kataoka, J., Tassone, E., Misso, M., Joham, A., Stener-Victorin, E., Teede, H., & Moran, L. (2017) · Nutrients · doi:10.3390/nu9090996 · Cited by 58 · see citing works
Self-citationMizgier, M., Jarząbek-Bielecka, G., Wendland, N., Jodłowska-Siewert, E., Nowicki, M., Brożek, A., Kędzia, W., Formanowicz, D., & Opydo-Szymaczek, J. (2021) · Nutrients · doi:10.3390/nu13030896 · Cited by 56 · see citing works
Mario, F. M., Graff, S. K., & Spritzer, P. M. (2017) · Journal of Endocrinological Investigation · doi:10.1007/s40618-016-0570-1 · Cited by 47 · see citing works
Blackshaw, L. C. D., Chhour, I., Stepto, N. K., & Lim, S. S. (2019) · Medical Sciences · doi:10.3390/medsci7070076 · Cited by 40 · see citing works
Self-citationDietz de Loos, A. L. P., Jiskoot, G., Timman, R., Beerthuizen, A., Busschbach, J. J. V., & Laven, J. S. E. (2021) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2021.05.008 · Cited by 39 · see citing works
Marinkovic-Radosevic, J., Cigrovski Berkovic, M., Kruezi, E., Bilic-Curcic, I., & Mrzljak, A. (2021) · World Journal of Diabetes · doi:10.4239/wjd.v12.i7.932 · Cited by 35 · see citing works
Gastrointestinal hormone secretion in women with polycystic ovary syndrome: an observational study
Lin, T., Li, S., Xu, H., Zhou, H., Feng, R., Liu, W., Sun, Y., & Ma, J. (2015) · Human Reproduction · doi:10.1093/humrep/dev231 · Cited by 34 · see citing works
The impact of ageing and menopause in women with polycystic ovary syndrome
Helvaci, N., & Yildiz, B. O. (2022) · Clinical Endocrinology · doi:10.1111/cen.14558 · Cited by 32 · see citing works
Juhász, A. E., Stubnya, M. P., Teutsch, B., Gede, N., Hegyi, P., Nyirády, P., Bánhidy, F., Ács, N., & Juhász, R. (2024) · Reproductive Health · doi:10.1186/s12978-024-01758-5 · Cited by 32 · see citing works
Actkins, K. V., Singh, K., Hucks, D., Velez Edwards, D. R., Aldrich, M., Cha, J., Wellons, M., & Davis, L. K. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa675 · Cited by 27 · see citing works
Weight gain and lifestyle factors in women with and without polycystic ovary syndrome
Awoke, M. A., Earnest, A., Joham, A. E., Hodge, A. M., Teede, H. J., Brown, W. J., & Moran, L. J. (2021) · Human Reproduction · doi:10.1093/humrep/deab239 · Cited by 30 · see citing works
Pirotta, S., Joham, A., Grieger, J. A., Tay, C. T., Bahri-Khomami, M., Lujan, M., Lim, S. S., & Moran, L. J. (2020) · Seminars in Reproductive Medicine · doi:10.1055/s-0041-1726866 · Cited by 29 · see citing works
Self-citationJohnson, L. K., Holven, K. B., Nordstrand, N., Mellembakken, J. R., Tanbo, T., & Hjelmesæth, J. (2015) · Endocrine Connections · doi:10.1530/ec-15-0047 · Cited by 24 · see citing works
Jiskoot, G., de Loos, A. D., Timman, R., Beerthuizen, A., Laven, J., & Busschbach, J. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00593-y · Cited by 23 · see citing works
Normal Metabolic Flexibility despite Insulin Resistance Women with Polycystic Ovary Syndrome
Adamska, A., Karczewska-Kupczewska, M., Nikolajuk, A., Otziomek, E., Górska, M., Kowalska, I., & Straczkowski, M. (2013) · Endocrine Journal · doi:10.1507/endocrj.ej13-0115 · Cited by 17 · see citing works
Cowan, S., Grassi, A., Monahan Couch, L., Jeanes, Y., Lim, S., Pirotta, S., Harris, J., McGirr, C., & Moran, L. (2023) · Nutrients · doi:10.3390/nu15030589 · Cited by 16 · see citing works
Htet, T., Cassar, S., Kuczynska-Burggraf, M., Gibson-Helm, M., Chiu, W.-L., Stepto, N., Moran, L., & Boyle, J. (2018) · Seminars in Reproductive Medicine · doi:10.1055/s-0038-1667309 · Cited by 16 · see citing works
Cardiometabolic risk in patients with polycystic ovary syndrome.
Ozegowska, K., & Pawelczyk, L. (2015) · Polish Gynaecology · doi:10.17772/gp/59131 · Cited by 15 · see citing works
Scannell, N., Villani, A., Moran, L., & Mantzioris, E. (2025) · Proceedings of the Nutrition Society · doi:10.1017/s0029665124007584 · Cited by 12 · see citing works
“IR is a hallmark feature of PCOS and occurs in at least 75% of cases, independent of body weight, resulting in impaired glucose metabolism (38) .”
Emanuel, R. H. K., Docherty, P. D., Lunt, H., & Campbell, R. E. (2023) · JMIR Formative Research · doi:10.2196/44810 · Cited by 9 · see citing works
Insulin, ghrelin and early return of hunger in women with obesity and polycystic ovary syndrome
Japur, C. C., Diez-Garcia, R. W., de Oliveira Penaforte, F. R., das Graças Pena, G., de Araújo, L. B., & de Sá, M. F. S. (2019) · Physiology & Behavior · doi:10.1016/j.physbeh.2019.03.013 · Cited by 8 · see citing works
Polycystic Ovary Syndrome and Exercise: Evaluation of YouTube Videos
Atigan, A., & Atigan, A. (2023) · Cureus · doi:10.7759/cureus.35093 · Cited by 7 · see citing works
- Authors
- Stepto, N. K., Cassar, S., Joham, A. E., Hutchison, S. K., Harrison, C. L., Goldstein, R. F., & Teede, H. J.
- Affiliations
- Monash Medical Centre (AU)
- Victoria University (AU)
- Corresponding author
- Teede, H. J.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-01-12
- Volume
- 28
- Issue
- 3
- Pages
- 777-784
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2115437409
- Semantic Scholar
- 53f5d1516964e1dd22703f53886fc8c247b08b8e
- Cited by
- 747
- References
- 34
- Citations by year
- 2026: 63 · 2025: 58 · 2024: 66 · 2023: 79 · 2022: 65 · 2021: 74 · 2020: 65 · 2019: 48 · 2018: 43 · 2017: 56 · 2016: 45 · 2015: 38 · 2014: 31 · 2013: 15 · 2012: 1
- FWCI
- 51.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Australian Government
- Monash University
- Medical Research Council
- National Health and Medical Research Council (606553)
- 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 › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Keywords
- polycystic ovary syndrome, insulin resistance, hyperinsulinemic-euglycemic clamp, glucose infusion rate, Rotterdam criteria, body mass index, lean PCOS, overweight women, insulin sensitizers, type 2 diabetes risk, gestational diabetes risk
- MeSH terms
- Academic Medical Centers, Adult, Cross-Sectional Studies, Female, Follicular Phase, Humans, Insulin Resistance, Obesity, Outpatient Clinics, Hospital, Polycystic Ovary Syndrome, Prediabetic State, Victoria, Glucose Clamp Technique, Cohort Studies, Body Mass Index, Prevalence, Practice Guidelines as Topic, Overweight, Young Adult
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