Assessing and treating insulin resistance in women with polycystic ovarian syndrome

Traub, Michael

doi:10.4239/wjd.v2.i3.33

Cited by 57 publications

(56 citation statements)

References 179 publications

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“…Insulin also stimulates the theca cells of the ovary to produce excessive testosterone, which is responsible for the clinical symptoms of hyperandrogenism (acne, hirsutism, alopecia). 8 Cardiovascular risk is also elevated in women who are chronic smokers, as demonstrated in a recent work by Marotti et al…”

mentioning

confidence: 54%

The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

Bednarska¹,

Siejka²

2017

Adv Clin Exp Med

228

148

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Polycystic ovary syndrome (PCOS) is currently the leading cause of menstrual complications in women. It is characterized by clinical and/or biochemical hyperandrogenism, ovulation abnormalities and the presence of enlarged and/or polycystic ovaries in ultrasound images (12 or more small bubbles located circumferentially and/or ovarian volume > 10 mL). It is often comorbid with hyperinsulinemia, dyslipidemia, overweight or obesity, and is a risk factor for the development of diabetes and cardiovascular diseases (CVDs). The treatment of patients with PCOS depends on the prevailing symptoms. The aim of this paper is to present the etiopathogenesis, clinical and biochemical implications, and non-pharmacological and pharmacological treatment options -those approved by worldwide scientific organizations as well as new therapies whose initial results are encouraging enough to prompt researchers to explore them further.

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mentioning

confidence: 54%

The pathogenesis and treatment of polycystic ovary syndrome: What’s new?

Bednarska¹,

Siejka²

2017

Adv Clin Exp Med

228

148

View full text Add to dashboard Cite

show abstract

“…This may impair activity of the MTHFR or CBS enzymes, leading to abnormal deposition of homocysteine in plasma [24] [51] [52]. This explains that insulin resistance may be the most important mark-er of metabolic disease in PCOS women [53]. Hence, metformin has always been the mainstay treatment for PCOS women with insulin resistance.…”

Section: Influence On Hcy Level Post Pcos Therapymentioning

confidence: 99%

The Effects of Plasma Homocysteine in PCOS Women: A Review

Maharjan¹,

Hong²

2018

OJOG

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Homocysteine is an intermediate substance formed during the breakdown of the amino acid methionine and may undergo remethylation to methionine or trans-sulfuration to cystathionine or cysteine. The metabolism occurs via two pathways: remethylation to methionine, which requires folate and vitamin B12; and transsulfuration to cystathionine, which requires pyridoxal-5'-phosphate. The disturbances in the metabolic pathways lead to the accumulation of Hcy, either by insufficient transsulfuration (through CBS mutations or vitamin B6 deficiency) or by a blockage of remethylation. In the latter case, folate or vitamin B12 deficiency may be involved, as well as MTHFR. High levels of Hcy induce sustained injury of arterial endothelial cells, proliferation of arterial smooth muscle cells and enhance activity of key participants in vascular inflammation, atherogenesis, and vulnerability of the established atherosclerotic plaque. Hyperhomocysteinemia has become the topic of interest in recent years. It has been highly associated with increased risk for cardiovascular disorders, such as, atherosclerosis, thromboembolism and dyslipidemia. Women with PCOS show constellation of metabolic syndromes. Obesity, hyperandrogenemia and type 2 diabetes mellitus is the hallmark of PCOS which later becomes the risk factors for cardiovascular disease. Various studies had revealed the presence of increased Hcy level in PCOS women which may or may not be associated with other biochemical parameters. Intense treatment for PCOS can influence homocysteine levels.

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“…Os mecanismos envolvidos na RI são complexos, com contribuições genética e ambiental. As anormalidades no metabolismo da insulina identificadas na SOP são específicas e incluem redução na secreção, excreção hepática e na sinalização dos receptores de insulina 4 . A RI pode ser definida como um estado metabólico, no qual o mecanismo de homeostase da glicose normal falha em funcionar de forma adequada 4 .…”

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