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Insulin Resistance and the Polycystic Ovary Syndrome: Mechanism and Implications for Pathogenesis¹

Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033

I. Introduction

A. Background and historical perspective

B. Definition of PCOS

II. Insulin Action in PCOS

A. Glucose tolerance

B. Insulin action in vivo in PCOS

C. Insulin secretion in PCOS

D. Insulin clearance in PCOS

E. Cellular and molecular mechanisms of insulin resistance

F. Constraints of insulin action studies in PCOS

G. PCOS as a unique NIDDM subphenotype

III. Hypotheses Explaining the Association of Insulin Resistance and PCOS

A. Causal association

B. Possible genetic association of PCOS and insulin resistance

IV. Clinical Implications of Insulin Resistance in PCOS

A. Clinical diagnosis of insulin resistance

B. Other metabolic disorders in PCOS

C. Therapeutic considerations

V. Summary