NEW APPROACHES TO INSULIN-RESISTANCE IN POLYCYSTIC OVARIAN SYNDROME

The aetiology of the polycystic ovarian syndrome together with new adv ances in the molecular genetics and possible candidate genes for the i nheritance of the syndrome is discussed. The possible role of leptin i n the obesity of polycystic ovarian syndrome is reviewed. Hyperinsulin aemia acts not only as the trigger for hyperandrogenaemia and infertil ity, but also by stimulating plasminogen activator inhibitor type 1; h yperinsulinaemia may also promote atherogenesis in polycystic ovarian syndrome. The long-term effects of the metabolic derangements accompan ying hyperinsulinaemia are reviewed. Special emphasis is placed on the use of novel insulin sensitizers such as troglitazone which promise n ew treatment opportunities in polycystic ovarian syndrome for both fer tility and long-term disease prevention. (C) 1998 Lippincott-Raven Pub lishers.