INSULIN AND POLYCYSTIC-OVARY-SYNDROME - A NEW LOOK AT AN OLD SUBJECT

In recent years the metabolic implications of polycystic ovary syndrom e (PCOS) have received a great deal of attention; in fact 50% of women with PCOS are obese and a similar percentage of subjects was found to show exaggerated insulin secretion and reduced insulin-stimulated glu cose uptake. The presence of these features in women with PCOS has pro found clinical implications in terms of morbidity due to diabetes mell itus, dyslipidemia, hypertension and cardiovascular disease. Moreover, hyperinsulinemia has recently been proposed as a possible independent risk factor for endometrial and breast cancer. In the light of these considerations, the importance of metabolic screening in patients with PCOS in order to improve their quality of life cannot be underestimat ed. In this review we analyze all the clinical pathologies in which hy perinsulinemia of PCOS could be involved. Furthermore, in order to cla rify the possible mechanisms leaning to the insulin disorders of the s yndrome, we review the available data about the insulin receptor abnor malities, as well as those concerning the insulin resistance and the e xaggerated insulin secretion. Finally, we examine the main therapeutic strategies to ameliorate the insulinemic status of PCOS patients in o rder to potentially be able to prevent the long-term consequences of t his syndrome.