THE ROLE OF INSULIN-RESISTANCE IN POLYCYSTIC-OVARY-SYNDROME

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenic c hronic anovulation and is the most common endocrinopathy among reprodu ctive-age women, The syndrome is not to be confused with the presence of polycystic ovaries (PCO), which has a varied etiology and is not sp ecific to the syndrome. PCOS is associated with significant insulin re sistance as well as with defects in insulin secretion,A defect in insu lin mediated receptor autophosphorylation has been found in a substant ial proportion of PCOS women. This defect is unique to PCOS and is not found in other common states of insulin resistance, These abnormaliti es, combined with obesity, predispose PCOS women to developing non-ins ulin dependent diabetes mellitus, Another long term sequelae that may be related to insulin resistance is cardiovascular disease. There is u nfortunately no readily available clinical test at present to diagnose insulin resistance in PCOS women. Treatment considerations for improv ing insulin sensitivity in PCOS women should focus on weight loss regi mens and the avoidance of interventions that worsen insulin sensitivit y. The initial investigational use of insulin sensitizing agents in th ese women has shown favorable responses.