Deciphering the Insulin Link: Exploring Metabolic Interplay in Polycystic Ovary Syndrome

Zulfkar Qadrie; Humaira Ashraf; Mudasir Maqbool

doi:10.61280/tjpls.v13i4.285

Zulfkar Qadrie Department of Pharmacology, Government Medical College Rajouri, J&K, India
Humaira Ashraf Department of Animal Nutrition, SKUAST-K, Srinagar, J&K, India
Mudasir Maqbool Department of Pharmacology, Government Medical College Baramulla, J&K, India

DOI: https://doi.org/10.61280/tjpls.v13i4.285

Keywords:

Infertility, Obesity, Insulin, Resistance

Abstract

One of the most prevalent endocrine illnesses in women, polycystic ovarian syndrome (PCOS), has a prevalence of 2.2% to 26% in India. Menstrual irregularities, hirsutism (excessive hair growth), acne, weight issues, and infertility are challenges that PCOS sufferers face. A significant player in the world of PCOS is the emergence of persistent, mild inflammation. Elevated blood sugar levels appear to trigger oxidative stress, inciting an abnormal response from specialized cells (mononuclear cells or MNCs) in females affected by PCOS, even though these cells typically don't depend on fat for fuel. This phenomenon becomes particularly significant since MNC-derived macrophages stand as primary culprits behind cytokine production in large fat tissues, further exacerbating the release of inflammatory substances from fat cells. In essence, the evidence underscores the notable perils posed by insulin resistance, particularly in the context of PCOS-afflicted individuals who are also battling obesity. The insights gleaned from this specific study underscore that those conforming to the classic PCOS profile often exhibit obesity, elevated insulin levels, and insulin resistance, irrespective of potential differences in Body Mass Index (BMI) compared to other PCOS phenotypes. This body of information conclusively underscores that insulin resistance takes precedence as the foremost pathological hallmark within the PCOS population.

Downloads

Download data is not yet available.

References

MOGHETTI P., TOSI F. J. J. O. E. I. Insulin resistance and PCOS: chicken or egg?, 2021: 44: 233-244.

ZHAO H., ZHANG J., CHENG X., NIE X., HE B. J. J. O. O. R. Insulin resistance in polycystic ovary syndrome across various tissues: An updated review of pathogenesis, evaluation, and treatment, 2023: 16: 9.

ARMANINI D., BOSCARO M., BORDIN L., SABBADIN C. J. I. J. O. M. S. Controversies in the pathogenesis, diagnosis and treatment of PCOS: focus on insulin resistance, inflammation, and hyperandrogenism, 2022: 23: 4110.

AMISI C. A. J. W. J. O. D. Markers of insulin resistance in Polycystic ovary syndrome women: An update, 2022: 13: 129.

SHANG Y., ZHOU H., HU M., FENG H. J. T. J. O. C. E., METABOLISM. Effect of diet on insulin resistance in polycystic ovary syndrome, 2020: 105: 3346-3360.

STEPTO N. K., MORENO-ASSO A., MCILVENNA L. C., WALTERS K. A., RODGERS R. J. J. T. J. O. C. E., METABOLISM. Molecular mechanisms of insulin resistance in polycystic ovary syndrome: unraveling the conundrum in skeletal muscle?, 2019: 104: 5372-5381.

CALCATERRA V., VERDUCI E., CENA H., MAGENES V. C., TODISCO C. F., TENUTA E. et al. Polycystic ovary syndrome in insulin-resistant adolescents with obesity: the role of nutrition therapy and food supplements as a strategy to protect fertility, 2021: 13: 1848.

SHIRAZI F. K. H., KHODAMORADI Z., JEDDI M. J. B. E. D. Insulin resistance and high molecular weight adiponectin in obese and non-obese patients with Polycystic Ovarian Syndrome (PCOS), 2021: 21: 1-7.

KRUSZEWSKA J., LAUDY-WIADERNY H., KUNICKI M. J. I. J. O. E. R., HEALTH P. Review of Novel Potential Insulin Resistance Biomarkers in PCOS Patients—The Debate Is Still Open, 2022: 19: 2099.

ZENG B., LAI Z., SUN L., ZHANG Z., YANG J., LI Z. et al. Structural and functional profiles of the gut microbial community in polycystic ovary syndrome with insulin resistance (IR-PCOS): a pilot study, 2019: 170: 43-52.

EZEH U., CHEN I. Y., CHEN Y.-H., AZZIZ R. J. T. J. O. C. E., METABOLISM. Adipocyte insulin resistance in PCOS: relationship with GLUT-4 expression and whole-body glucose disposal and β-cell function, 2020: 105: e2408-e2420.

GREENWOOD E. A., HUDDLESTON H. G. J. F., STERILITY. Insulin resistance in polycystic ovary syndrome: Concept versus cutoff, 2019: 112: 827-828.

ZENG X., XIE Y.-J., LIU Y.-T., LONG S.-L., MO Z.-C. J. C. C. A. Polycystic ovarian syndrome: correlation between hyperandrogenism, insulin resistance and obesity, 2020: 502: 214-221.

SUHRON M., ZAINIYAH Z. J. S. R. I. P. How were stress family and INSR (Insulin Receptor) expression in polycystic ovary syndrome (PCOS) insulin resistant in madurese tribe?: Indonesia, 2021: 12: 170-175.

BAHADUR A., VERMA N., MUNDHRA R., CHAWLA L., AJMANI M., SRI M. S. et al. Correlation of homeostatic model assessment-insulin resistance, anti-Mullerian hormone, and BMI in the characterization of polycystic ovary syndrome, 2021: 13.

GRASSI G., POLLEDRI E., FUSTINONI S., CHIODINI I., CERIOTTI F., D’AGOSTINO S. et al. Hyperandrogenism by liquid chromatography tandem mass spectrometry in PCOS: focus on testosterone and androstenedione, 2020: 10: 119.

ART E. W. G. O. U. I., D’ANGELO A., PANAYOTIDIS C., AMSO N., MARCI R., MATORRAS R. et al. Recommendations for good practice in ultrasound: oocyte pick up, 2019: 2019: hoz025.

RODOLAKIS A., SCAMBIA G., PLANCHAMP F., ACIEN M., DI SPIEZIO SARDO A., FARRUGIA M. et al. ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma, 2023: 2023: hoac057.

LONG J., LI L., WANG F., YANG G., CHENG W., WEI J. et al. Screening for a simple and effective indicator of insulin resistance in Chinese Reproductive-Aged women, with the insulin clamp technique as a reference, 2019: 17: 423-429.

DAR M. A., MAQBOOL M., ARA I. J. J. O. E. O. M., SCIENCES D. Patterns of drug use in geriatric patients at a tertiary care teaching hospital in Jammu and Kashmir, 2023: 182-186.

UNLUHIZARCI K., KARACA Z., KELESTIMUR F. J. W. J. O. D. Role of insulin and insulin resistance in androgen excess disorders, 2021: 12: 616.

ARA I., MAQBOOL M., ZEHRAVI M. J. O. H. Psychic consequences of infertility on couples: A short commentary, 2022: 3: 114-119.

EZEH U., EZEH C., PISARSKA M. D., AZZIZ R. J. F., STERILITY. Menstrual dysfunction in polycystic ovary syndrome: association with dynamic state insulin resistance rather than hyperandrogenism, 2021: 115: 1557-1568.

ZEHRAVI M., MAQBOOL M., ARA I. J. I. J. O. A. M., HEALTH. Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview, 2021: 33: 339-345.

ETHIRAJULU A., ALKASABERA A., ONYALI C. B., ANIM-KORANTENG C., SHAH H. E., BHAWNANI N. et al. Insulin resistance, hyperandrogenism, and its associated symptoms are the precipitating factors for depression in women with polycystic ovarian syndrome, 2021: 13.

DAR M. A., MAQBOOL M., GANI I., ARA I. J. I. J. O. C. R. I. P., PHARMACOLOGY. Menstruation hygiene and related issues in adolescent girls: A brief commentary, 2023: 1-5.

XING L., XU J., WEI Y., CHEN Y., ZHUANG H., TANG W. et al. Depression in polycystic ovary syndrome: Focusing on pathogenesis and treatment, 2022: 13: 1001484.

MAQBOOL R., MAQBOOL M., ZEHRAVI M., ARA I. J. I. J. O. A. M., HEALTH. Menstrual distress in females of reproductive age: a literature review, 2021: 34: 11-17.

GU Y., ZHOU G., ZHOU F., WU Q., MA C., ZHANG Y. et al. Life modifications and PCOS: Old story but new tales, 2022: 13: 808898.

RODRIGUEZ PARIS V., BERTOLDO M. J. J. M. S. The mechanism of androgen actions in PCOS etiology, 2019: 7: 89.

ARA I., MAQBOOL M., GANI I. J. I. J. O. C. R. I. P., PHARMACOLOGY. Reproductive Health of Women: implications and attributes, 2022: 8-18.

DELLA CORTE L., FORESTE V., BARRA F., GUSTAVINO C., ALESSANDRI F., CENTURIONI M. G. et al. Current and experimental drug therapy for the treatment of polycystic ovarian syndrome, 2020: 29: 819-830.

ZEHRAVI M., MAQBOOL M., ARA I. J. I. J. O. A. M., HEALTH. Polycystic ovary syndrome and reproductive health of women: a curious association, 2021: 33: 333-337.

SINGH S., PAL N., SHUBHAM S., SARMA D. K., VERMA V., MAROTTA F. et al. Polycystic ovary syndrome: etiology, current management, and future therapeutics, 2023: 12: 1454.

ZEHRAVI M., MAQBOOL M., ARA I. J. I. J. O. A. M., HEALTH. Polycystic ovary syndrome and infertility: an update, 2021: 34: 1-9.

PAPADAKIS G., KANDARAKI E. A., GARIDOU A., KOUTSAKI M., PAPALOU O., DIAMANTI-KANDARAKIS E. et al. Tailoring treatment for PCOS phenotypes, 2021: 16: 9-18.

MAQBOOL M., ARA I., GANI I. J. I. J. O. C. R. I. P., PHARMACOLOGY. The Story of Polycystic Ovarian Syndrome: A Challenging Disorder with Numerous Consequences for Females of Reproductive Age, 2022: 19-31.

CIGNARELLA A., MIONI R., SABBADIN C., DASSIE F., PAROLIN M., VETTOR R. et al. Pharmacological approaches to controlling cardiometabolic risk in women with PCOS, 2020: 21: 9554.

RANI R., HAJAM Y. A., KUMAR R., BHAT R. A., RAI S., RATHER M. A. J. P. P. A landscape analysis of the potential role of polyphenols for the treatment of Polycystic Ovarian Syndrome (PCOS), 2022: 2: 100161.

WANG L., ZHOU J., GOBER H.-J., LEUNG W. T., HUANG Z., PAN X. et al. Alterations in the intestinal microbiome associated with PCOS affect the clinical phenotype, 2021: 133: 110958.

DAR M. A., MAQBOOL M., ARA I. J. I. J. O. A. M., HEALTH. The PCOS puzzle: putting the pieces together for optimal care, 2023.

OZGEN SAYDAM B., YILDIZ B. O. J. E. R. O. E., METABOLISM. Weight management strategies for patients with PCOS: current perspectives, 2021: 16: 49-62.

MOHD M., MAQBOOL M., DAR M. A., MUSHTAQ I. J. J. O. D. D., THERAPEUTICS. Polycystic ovary syndrome, a modern epidemic: an overview, 2019: 9: 641-644.

BARREA L., FRIAS-TORAL E., VERDE L., CERIANI F., CUCALÓN G., GARCIA-VELASQUEZ E. et al. PCOS and nutritional approaches: Differences between lean and obese phenotype, 2021: 12: 100123.

ZEHRAVI M., MAQBOOL M., ARA I. J. O. H. Healthy lifestyle and dietary approaches to treating polycystic ovary syndrome: a review, 2022: 3: 60-65.

CHEN W., PANG Y. J. M. Metabolic syndrome and PCOS: Pathogenesis and the role of metabolites, 2021: 11: 869.

BJEKIĆ-MACUT J., VUKAŠIN T., VELIJA-AŠIMI Z., BUREKOVIĆ A., ZDRAVKOVIĆ M., ANDRIĆ Z. et al. Polycystic ovary syndrome: a contemporary clinical approach, 2021: 27: 3812-3820.

ZEHRAVI M., MAQBOOL M., ARA I. J. I. J. O. A. M., HEALTH. Depression and anxiety in women with polycystic ovarian syndrome: a literature survey, 2021: 33: 367-373.