Advertisement

The Role of Leptin in Polycystic Ovary Syndrome

  • Denis A. Magoffin
  • Priya S. Duggal
  • Robert J. Norman
Chapter

Abstract

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disease in women of reproductive age. Within the infertile population, approximately three quarters of women with anovulatory infertility have PCOS, thus accounting for approximately one third of women with secondary amenorrhea and approximately 90 percent of women with oligomenorrhea (Franks and White, 1993). It is clear that PCOS affects a large number of women and accounts for a major proportion of women with menstrual irregularities.

Keywords

Luteinizing Hormone Polycystic Ovary Polycystic Ovary Syndrome Congenital Adrenal Hyperplasia Follicular Fluid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Agarwal, S. K., Vogel, K., Weitsman, S. R., and Magoffin, D. A. (1999). Leptin antagonizes the insulin-like growth factor-I augmentation of steroidogenesis in granulosa and theca cells of the human ovary. J. Clin. Endocrinol. Metab., 84, 1072-1076.PubMedCrossRefGoogle Scholar
  2. Baranowska, B., Radzikowska, M., Wasilewska-Dziubinska, E., Kaplinski, A., Roguski, K., and Plonowski, A. (1999). Neuropeptide Y, leptin, galanin and insulin in women with polycystic ovary syndrome. Gynecol. Endocrinol., 75, 344-351.CrossRefGoogle Scholar
  3. Barbieri, R. L., Makris, A., Randall, R. W., Daniels, G., Kistner, R. W., and Ryan, K. J. (1986). Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. J. Clin. Endocrinol. Metab., 62, 904-910.PubMedCrossRefGoogle Scholar
  4. Barbieri, R. L., Smith, S., and Ryan, K. J. (1988). The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism. Fertil. Steril., 50, 197-212.PubMedGoogle Scholar
  5. Bergh, C., Carlsson, B., Olsson, J.-H., Selleskog, U., and Hillensjo, T. (1993). Regulation of androgen production in cultured human thecal cells by insulin-like growth factor I and insulin. Fertil. Steril., 59, 323-331.PubMedGoogle Scholar
  6. Brannian, J. D., Schmidt, S. M., Kreger, D. O., and Hansen, K. A. (2001). Baseline non-fasting serum leptin concentration to body mass index ratio is predictive of IVF outcomes. Hum. Reprod., 16, 1819-1826.PubMedCrossRefGoogle Scholar
  7. Brannstrom, M. (1993). In vitro perfused rat ovary. Meth. Toxicol., 3B, 160-169.Google Scholar
  8. Brannstrom, M., Johansson, B., Sogn, J., and Janson, P. O. (1987). Characterisation of an in vitro perfused rat ovary model: ovulation rate, oocyte maturation, steroidogenesis and influence of PMSG priming. Acta. Physiol. Shand, 130, 107-114.CrossRefGoogle Scholar
  9. Brzechffa, P. R., Jakimiuk, A. J., Agarwal, S. K., Weitsman, S. R., Buyalos, R. P., and Magoffin, D. A. (1996). Serum immunoreactive leptin concentrations in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 81, 4166-4169.PubMedCrossRefGoogle Scholar
  10. Burghen, G. A., Givens, J. R., and Kitabchi, A. E. (1980). Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J. Clin. Endocrinol. Metab., 50, 113-116.PubMedCrossRefGoogle Scholar
  11. Carmina, E., Ferin, M., Gonzalez, F., and Lobo, R. A. (1999). Evidence that insulin and androgens may participate in the regulation of serum leptin levels in women. Fertil. Steril., 72, 926-931.PubMedCrossRefGoogle Scholar
  12. Carmina, E., Koyama, T., Chang, L., Stanczyk, F. Z., and Lobo, R. A. (1992). Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome? Am. J. Obstet. Gynecol., 167, 1807-1812.PubMedGoogle Scholar
  13. Caro, J. F, Sinha, M. K., Kolaczynski, J. W., Zhang, P. L., and Considine, R. V. (1996). Leptin: the tale of an obesity gene. Diabetes, 45, 1455-1462.PubMedGoogle Scholar
  14. Chapman, I. M., Wittert, G. A., and Norman, R. J. (1997). Circulating leptin concentrations in polycystic ovary syndrome: relation to anthropometric and metabolic parameters. Clin. Endocrinol. (Oxf.), 46, 175-181.CrossRefGoogle Scholar
  15. Cioffi, J. A., Van Blerkom, J., Antczak, M., Shafer, A., Wittmer, S., and Snodgrass, H. R. (1997). The expression of leptin and its receptors in pre-ovulatory human follicles. Mol. Hum. Reprod., 3, 467-472.PubMedCrossRefGoogle Scholar
  16. Cizza, G., Dorn, L. D., Lotsikas, A., Sereika, S., Rotenstein, D., and Chrousos, G. P. (2001). Circulating plasma leptin and IGF-1 levels in girls with premature adrenarche: potential implications of a preliminary study. Horm. Metab. Res., 33, 138-143.PubMedCrossRefGoogle Scholar
  17. Cnop, M., Landchild, M. J., Vidal, J., Havel, P. J., Knowles, N. G., Carr, D. R., Wang, F., Hull, R. L., Boyko, E. J., Retzlaff, B. M., Walden, C. E., Knopp, R. H., and Kahn, S. E. (2002). The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations: distinct metabolic effects of two fat compartments. Diabetes, 51, 1005-1015.PubMedCrossRefGoogle Scholar
  18. Conn, J. J., Jacobs, H. S., and Conway, G. S. (2000). The prevalence of polycystic ovaries in women with type 2 diabetes mellitus. Clin. Endocrinol. (Oxf.), 52, 81-86.CrossRefGoogle Scholar
  19. Considine, R. V., Sinha, M. K., Heiman, M. L., Kriauciunas, A., Stephens, T. W., Nyce, M. R., Ohannesian, J. P., Marco, C. C., McKee, L. J., Bauer, T. L., and Caro, J. F. (1996). Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N. Engl. J. Med., 334, 292-295.PubMedCrossRefGoogle Scholar
  20. Conway, G. S., Agrawal, R., Betteridge, D. J., and Jacobs, H. S. (1992). Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin. Endocrinol., 37, 119-125.CrossRefGoogle Scholar
  21. Conway, G. S. and Jacobs, H. S. (1997). Leptin: a hormone of reproduction. Hum. Reprod., 12, 633-635.PubMedCrossRefGoogle Scholar
  22. Dagogo-Jack, S., Fanelli, C., Paramore, D., Brothers, J., and Landt, M. (1996). Plasma leptin and insulin relationships in obese and nonobese humans. Diabetes, 45, 695-698.PubMedCrossRefGoogle Scholar
  23. Dahlgren, E., Janson, P. O., Johansson, S., Lapidus, L., and Oden, A. (1992). Polycystic ovary syndrome and risk for myocardial infarction: evaluated from a risk factor model based on a prospective population study of women. Acta Obstet. Gynecol. Scand., 71, 599-604.PubMedCrossRefGoogle Scholar
  24. De Souza, M. and Metzger, D. (1991). Reproductive dysfunction in amenorrheic athletes and anorexic patients: a review. Med. Sci. Sports Exerc, 23, 995-1007.PubMedGoogle Scholar
  25. Duggal, P. S., Ryan, N. K., Van der Hoek, K. H., Ritter, L. J., Armstrong, D. T., Magoffin, D. A., and Norman, R. J. (2002). The effects of leptin administration and feed restriction on thecal leukocytes in the pre-ovulatory rat ovary and the effects of leptin on meiotic maturation, granulosa cell proliferation, steroid hormone and prostaglandin E2 release using rat ovarian follicle culture. Reproduction, 123, 899-905.PubMedCrossRefGoogle Scholar
  26. Duggal, P. S., Van der Hoek, K. H., Milner, C., Ryan, N. K., Armstrong, D. T., Magoffin, D. A., and Norman, R. J. (2000). The in vivo and in vitro effects of exogenous leptin on ovulation in the rat. Endocrinology, 141, 1971-1976.PubMedCrossRefGoogle Scholar
  27. Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrinol. Rev., 18, 774-800.CrossRefGoogle Scholar
  28. Ehrmann, D. A., Sturis, J., Byrne, M. M., Karrison, T., Rosenfield, R. L., and Polonsky, K. S. (1995). Insulin secretory defects in polycystic ovary syndrome. Relationship to insulin sensitivity and family history of non-insulin-dependent diabetes mellitus. J. Clin. Invest., 96, 520-527.PubMedCrossRefGoogle Scholar
  29. El Orabi, H., Ghalia, A. A., Khalifa, A., Mahfouz, H., El Shalkani, A., and Shoieb, N. (1999). Serum leptin as an additional possible pathogenic factor in polycystic ovary syndrome. Clin. Biochem., 32, 71-75.PubMedCrossRefGoogle Scholar
  30. El-Roeiy, A., Chen, X., Roberts, V. J., Shimasaki, A., Ling, N., LeRoith, D., Roberts, C. T., and Yen, S. S. C. (1994). Expression of the genes encoding the insulin-like growth factors (IGF-I and II), the IGF and insulin receptors, and IGF-binding proteins-1-6 and the localization of their gene products in normal and polycystic ovary syndrome ovaries. J. Clin. Endocrinol. Metob., 78, 1488-1496.CrossRefGoogle Scholar
  31. Erickson, G. F. (1994). Polycystic ovary syndrome: normal and abnormal steroidogenesis. In R. Schats, and J. Schoemaker (Eds.). Ovarian Endocrinopathies, pp. 103-115. Parthenon Publishing Group: New York.Google Scholar
  32. Erickson, G. F., Magoffin D. A., and Jones, K. L. (1989). Theca function in polycystic ovaries of a patient with virilizing congenital adrenal hyperplasia. Fertil. Steril., 51, 173-176.PubMedGoogle Scholar
  33. Ezzell, C. (1996). The molecular link between fat and female fertility. J. NIH Res., 8, 24-25.Google Scholar
  34. Fedorcsak, P., Storeng, R., Dale, P. O., Tanbo, T., Torjesen, P., Urbancsek, J., and Abyholm, T. (2000). Leptin and leptin binding activity in the preovulatory follicle of polycystic ovary syndrome patients. Scand. J. Clin. Lab. Invest., 60, 649-655.PubMedCrossRefGoogle Scholar
  35. Franks, S., Gilling-Smith, C., Watson, H., and Willis, D. (1999). Insulin action in the normal and polycystic ovary. Endocrinol. Metab. Clin. N. Am., 28, 361-378.CrossRefGoogle Scholar
  36. Franks, S. M. and White, D. M. (1993). Prevalence of and etiological factors in polycystic ovarian syndrome. Ann. NYAcad. Sci., 687, 112-114.CrossRefGoogle Scholar
  37. Freemark, M. and Bursey, D. (2001). The effects of metformin on body mass index and glucose tolerance in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes. Pediatrics, 107, E55.PubMedCrossRefGoogle Scholar
  38. Futterweit, W. and Deligdisch, L. (1986). Histopathological effects of exogenously administered testosterone in 19 female to male transsexuals. J. Clin. Endocrinol. Metab, 62, 16-21.PubMedCrossRefGoogle Scholar
  39. Gennarelli, G., Holte, J., Wide, L., Berne, C., and Lithell, H. (1998). Is there a role for leptin in the endocrine and metabolic aberrations of polycystic ovary syndrome? Hum. Reprod., 13, 535-541.PubMedCrossRefGoogle Scholar
  40. Gilling-Smith, C., Story, H., Rogers, V, and Franks, S. (1997). Evidence for a primary abnormality of thecal cell steroidogenesis in the polycystic ovary syndrome. Clin. Endocrinol. (Oxf.), 47, 93-99.CrossRefGoogle Scholar
  41. Gilling-Smith, C., Willis, D. S., Beard, R. W., and Franks, S. (1994). Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries. J. Clin. Endocrinol. Metab, 79, 1158-1165.PubMedCrossRefGoogle Scholar
  42. Goldzieher, J. W. (1981). Polycystic ovarian disease. Fertil. Steril., 35, 371-394.PubMedGoogle Scholar
  43. Goldzieher, J. W. and Axelrod L. R. (1963). Clinical and biochemical features of polycystic ovarian disease. Fertil. Steril., 14, 631-653.PubMedGoogle Scholar
  44. Gonzalez, R. R., Simon, C., Caballero-Campo, P., Norman, R., Chardonnens, D. Devoto, L., and Bischof, P. (2000). Leptin and reproduction. Hum. Reprod. Update, 6, 290-300.PubMedCrossRefGoogle Scholar
  45. Green, B. B., Weiss, N. S., and Daling, J. R. (1988). Risk of ovulatory infertility in relation to body weight. Fertil. Steril., 50, 721-726.PubMedGoogle Scholar
  46. Huber-Buchholz, M. M., Carey, D. G., and Norman, R. J. (1999) Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J. Clin. Endocrinol. Metab., 84, 1470-1474.PubMedCrossRefGoogle Scholar
  47. Hughesdon, P. E. (1982). Morphology and morphogenesis of the Stein-Levinthal ovary and so called “hyperthecosis”. Obstet. Gynecol. Surv., 37, 59-77.PubMedCrossRefGoogle Scholar
  48. Imani, B., Eijkemans, M. J., de Jong, F. H., Payne, N. N., Bouchard, P., Giudice, L. C., and Fauser, B. C. (2000). Free androgen index and leptin are the most prominent endocrine predictors of ovarian response during clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility. J. Clin. Endocrinol. Metab., 85, 676-682.PubMedCrossRefGoogle Scholar
  49. Jacobs, H. S. and Conway, G. S. (1999). Leptin, polycystic ovaries and polycystic ovary syndrome. Hum. Reprod. Update, 5, 166-171.PubMedCrossRefGoogle Scholar
  50. Karlsson, C., Lindell, K., Svensson, E., Bergh, C., Lind, P., Billig, H., Carlsson, L. M., and Carlsson B. (1997). Expression of functional leptin receptors in the human ovary. J. Clin. Endocrinol. Metab., 82, 4144-4148.PubMedCrossRefGoogle Scholar
  51. Kowalska, I., Kinalski, M., Straczkowski, M., Wolczyski, S., and Kinalska, I. (2001). Insulin, leptin, IGF-I and insulin-dependent protein concentrations after insulin-sensitizing therapy in obese women with polycystic ovary syndrome. Eur. J. Endocrinol., 144, 509-515.PubMedCrossRefGoogle Scholar
  52. Kowalska, I., Kinalski, M., Wolczynski, S., Straczkowski, M., Kinalska, I., and Szamatowicz, M. (1999). The influence of obesity on ovarian function. II. Plasma leptin concentration in women with polycystic ovary syndrome. Ginekol. Pol, 70, 428-432.PubMedGoogle Scholar
  53. Krassas, G. E., Kaltsas, T. T., Pontikides, N., Jacobs, H., Blum, W., and Messinis, I. (1998). Leptin levels in women with polycystic ovary syndrome before and after treatment with diazoxide. Eur. J. Endocrinol., 139, 184-189.PubMedCrossRefGoogle Scholar
  54. Laughlin, G. A., Morales, A. J., and Yen, S. S. C. (1997). Serum leptin levels in women with polycystic ovary syndrome: the role of insulin resistance/hyperinsulinemia. J. Clin. Endocrinol. Metab., 82, 1692-1696.PubMedCrossRefGoogle Scholar
  55. Legro, R. S., Finegood, D., and Dunaif, A. (1998). A fasting glucose to insulin ratio is a useful measure of insulin sensitivity in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 83, 2694-2698.PubMedCrossRefGoogle Scholar
  56. Lindheim, S. R., Sauer, M. V., Carmina, E., Chang, P. L., Zimmerman, R., and Lobo, R. A. (2000). Circulating leptin levels during ovulation induction: relation to adiposity and ovarian morphology. Fertil. Steril., 73, 493-498.PubMedCrossRefGoogle Scholar
  57. Lobo, R. A. (1995). A disorder without identity: “HCA,” “PCO,” “PCOD,” “PCOS,” “SLS.” What are we to call it?! Fertil. Steril., 63, 1158-1160.PubMedGoogle Scholar
  58. Lobo, R. A., Kletzky, O. A., Campeau, J. D., and diZerega, G. S. (1983). Elevated bioactive luteinizing hormone in women with the polycystic ovary syndrome (PCO). Fertil. Steril., 39, 674-678.PubMedGoogle Scholar
  59. Maffei, M., Halaas, J., Ravussin, E., Pratley, R. E., Lee, G. H., Zhang, Y., Fei, H., Kim, S., Lallone, R., Ranganathan, S., Kern, P. A., and Friedman, J. M. (1995). Leptin levels in human and rodent: measurement of plasma leptin and ob RNA in obese and weight-reduced subjects. Nat. Med., 1, 1155-1161.PubMedCrossRefGoogle Scholar
  60. Mantzoros, C. S., Cramer, D. W., Liberman, R. F., and Barbieri, R. L. (2000). Predictive value of serum and follicular fluid leptin concentrations during assisted reproductive cycles in normal women and in women with the polycystic ovarian syndrome. Hum. Reprod., 15, 539-544.PubMedCrossRefGoogle Scholar
  61. Mantzoros, C. S., Dunaif, A., and Flier, J. S. (1997). Leptin concentrations in the polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 82, 1687-1691.PubMedCrossRefGoogle Scholar
  62. Michelmore, K., Ong, K., Mason, S., Bennett, S., Perry, L., Vessey, M., Balen, A., and Dunger, D. (2001). Clinical features in women with polycystic ovaries: relationships to insulin sensitivity, insulin gene VNTR and birth weight. Clin. Endocrinol., 55, 439-446.CrossRefGoogle Scholar
  63. Micic, D., Macut, D., Popovic, V., Sumarac-Dumanovic, M., Kendereski, A., Colic, M., Dieguez, C., and Casanueva, F. F. (1997). Leptin levels and insulin sensitivity in obese and non-obese patients with polycystic ovary syndrome. Gynecol. Endocrinol., 11, 315-320.PubMedCrossRefGoogle Scholar
  64. Morin-Papunen, L. C., Koivunen, R. M., Tomas, C., Ruokonen, A., and Martikainen, H. K. (1998). Decreased serum leptin concentrations druting metformin therapy in obese women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 83, 2566-2568.PubMedCrossRefGoogle Scholar
  65. Ng, E. H., Wat, N. M., and Ho, P. C. (2001). Effects of metformin on ovulation rate, hormonal and metabolic profiles in women with clomiphene-resistant polycystic ovaries: a randomized, double-blinded placebocontrolled trial. Hum. Reprod., 16, 1625-1631.PubMedCrossRefGoogle Scholar
  66. Norman, R. J., Masters, S. C., Hague, W., Beng, C., Pannall, P., and Wang, J. X. (1995). Metabolic approaches to the subclassification of polycystic ovary syndrome. Fertil. Steril., 63, 329-335.PubMedGoogle Scholar
  67. Oksanen, L., Tiitinen, A., Kaprio, J., Koistinen, H. A., Karonen, S., and Kontula, K. (2000). No evidence for mutations of the leptin or leptin receptor genes in women with polycystic ovary syndrome. Mol Hum. Reprod., 6, 873-876.PubMedCrossRefGoogle Scholar
  68. Panidis, D. K., Rousso, D. H., Matalliotakis, I. M., Kourtis, A. I., Stamatopoulos, P., and Koumantakis, E. (2000). The influence of long-term administration of conjugated estrogens and antiandrogens to serum leptin levels in women with polycystic ovary syndrome. Gynecol. Endocrinol., 14, 169-172.PubMedCrossRefGoogle Scholar
  69. Pasquali, R., Gambineri, A., Biscotti, D., Vicennati, V., Gagliardi, L., Colitta, D., Fiorini, S., Cognigni, G. E., Filicori, M., and Morselli-Labate, A. M. (2000). Effect of long-term treatment with metformin added to hypocaloric diet on body composition, fat distribution, and androgen and insulin levels in abdominally obese women with and without the polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 85, 2767-2774.CrossRefGoogle Scholar
  70. Pirwany, I. R., Fleming, R., Sattar, N., Greer, I. A., and Wallace, A. M. (2001). Circulating leptin concentrations and ovarian function in polycystic ovary syndrome. Eur. J. Endocrinol., 145, 289-294.PubMedCrossRefGoogle Scholar
  71. Roberts, D. W. and Haines, M. (1960). Is there a Stein-Leventhal syndrome? Br. Med. J., 5187, 1709-1711.CrossRefGoogle Scholar
  72. Rouru, J., Anttila, L., Koskinen, P., Penttila, T. A., Irjala, K., Huupponen, R., and Koulu, M. (1997). Serum leptin concentrations in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab., 82, 1697-1700.PubMedCrossRefGoogle Scholar
  73. Sir-Petermann, T., Piwonka, V., Perez, F., Maliqueo, M., Recabarren, S. E., and Wildt, L. (1999). Are circulating leptin and luteinizing hormone synchronized in patients with polycystic ovary syndrome? Hum. Reprod., 14, 1435-1439.PubMedCrossRefGoogle Scholar
  74. Sir-Petermann, T., Recabarren, S. E., Lobos, A., Maliqueo, M., and Wildt, L. (2001). Secretory pattern of leptin and LH during lactational amenorrhoea in breastfeeding normal and polycystic ovarian syndrome women. Hum. Reprod., 16, 244-249.PubMedCrossRefGoogle Scholar
  75. Smyczek-Gargya, B. and Geppert, M. (1992). Endometrial cancer associated with polycystic ovaries in young women. Path. Res. Pract., 188, 946-948.PubMedCrossRefGoogle Scholar
  76. Spritzer, P. M., Poy, M., Wiltgen, D., Mylius, L. S., and Capp, E. (2001). Leptin concentrations in hirsute women with polycystic ovary syndrome or idiopathic hirsutism: influence on LH and relationship with hormonal, metabolic, and anthropometric measurements. Hum. Reprod., 16, 1340-1346.PubMedCrossRefGoogle Scholar
  77. Stein, I. F. and Leventhal, M. L. (1935). Amenorrhea associated with bilateral polycystic ovaries. Am. J. Obstet. Gynecol., 29, 181-186.Google Scholar
  78. Takeuchi, T. and Tsutsumi, O. (2000). Basal leptin concentrations in women with normal and dysfunctional ovarian conditions. Int. J. Gynaecol. Obstet., 69, 127-133.PubMedCrossRefGoogle Scholar
  79. Unkila-Kallio, L., Andersson, S., Koistinen, H. A., Karonen, S. L., Ylikorkala, O., and Tiitinen, A. (2001). Leptin during assisted reproductive cycles: the effect of ovarian stimulation and of very early pregnancy. Hum. Reprod., 16, 657-662.PubMedCrossRefGoogle Scholar
  80. van Cappellen, W. A., Meijs-Roelofs, H. M. A., Kramer, P., van Leeuwen, E. C. M., de Leeuw, R., and de Jong, F. H. (1995). Recombinant FSH (Org32489) induces follicle growth and ovulation in the adult cyclic rat. J. Endocrinol., 144, 39-47.PubMedCrossRefGoogle Scholar
  81. Veldhuis, J. D., Pincus, S. M., Garcia-Rudaz, M. C., Ropelato, M. G., Escobar, M. E., and Barontini, M. (2001). Disruption of the synchronous secretion of leptin, LH, and ovarian androgens in nonobese adolescents with the polycystic ovarian syndrome. J. Clin. Endocrinol. Metab., 86, 3772-3778.PubMedCrossRefGoogle Scholar
  82. Vicennati, V., Gambineri, A., Calzoni, F., Casimirri, F., Macor, C., Vettor, R., and Pasquali, R. (1998). Serum leptin in obese women with polycystic ovary syndrome is correlated with body weight and fat distribution but not with androgen and insulin levels. Metabolism, 47, 988-992.PubMedCrossRefGoogle Scholar
  83. Wong, I. L., Morris, R. S., Lobo, R. A., Paulson, R. J., and Sauer, M. V. (1995). Isolated polycystic morphology in ovum donors predicts response to controlled hyperstimulation. Hum. Reprod., 10, 524-528.PubMedGoogle Scholar
  84. Woods, S. C. and Seeley R. J. (2001). Insulin as an adiposity signal. Int. J. Obes. Relat. Metab. Disord., 25(Suppl. 5), S35-S38.PubMedCrossRefGoogle Scholar
  85. Yen, S. S. C. (1980). The polycystic ovary syndrome. Clin. Endocrinol., 12, 177-208.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Denis A. Magoffin
    • 1
  • Priya S. Duggal
    • 2
  • Robert J. Norman
    • 2
  1. 1.Cedars-Sinai Burns and Allen Research InstituteThe David Geffen School of Medicine at UCLAUSA
  2. 2.Reproductive Medicine Unit, Department of Obstetrics & GynaecologyUniversity of Adelaide, The Queen Elizabeth HospitalAustralia

Personalised recommendations