Journal
FERTILITY AND STERILITY
Volume 77, Issue 6, Pages 1095-1105Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0015-0282(02)03111-4
Keywords
diabetes; polycystic ovary syndrome; androgen excess; glucose intolerance; insulin resistance
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Funding
- NICHD NIH HHS [R01-HD29364] Funding Source: Medline
- PHS HHS [K24-D01346] Funding Source: Medline
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Objective: To review the definition and prevalence of two insulin resistance (IR)-associated phenotypes, polycystic ovary syndrome (PCOS) and type 2 diabetes mellitus, as well as the risk and nature of their simultaneous presentation. Design: Review of published literature. Result(s): Insulin resistance affects between 10% and 25% of the general population. Two common disorders frequently associated with IR are PCOS, affecting 4% to 6% of reproductive-aged women, and type 2 diabetes mellitus, which is observed in about 2% to 6% of similarly aged women. Overall, about 50% to 70% of women with PCOS and 80% to 100% of patients with type 2 diabetes mellitus have variable degrees of IR. Insulin resistance and its secondary hyperinsulinemia appear to underlie many of the endocrine features of PCOS in a large proportion of such patients. The risk of type 2 diabetes mellitus among PCOS patients is 5- to 10-fold higher than normal. In turn, the risk of PCOS among reproductive-aged type 2 diabetes mellitus patients appears to be similarly increased. Conclusion(s): It remains to be determined whether PCOS and type 2 diabetes mellitus represent no more than different clinical manifestations of the same IR syndrome, with their phenotypic differences due to the presence or absence of a coincidental genetic defect at the level of the ovary or pancreas, respectively, or representing the result of etiologically different subtypes of IR syndromes. (Fertil Steril(R) 2002;77:1095-1105. (C)2002 by American Society for Reproductive Medicine.)
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