Skip to main content
SpringerLink
Log in

Hyperandrogenism and Insulin Resistance

  • Conference paper
New Trends in Reproductive Medicine

  • 110 Accesses

Abstract

The association between hyperandrogenism and insulin resistance in women has been known since 1921 [1]. This so-called Archard-Thiers syndrome has also been referred to as “diabetes of bearded women”. Although these original findings were repeatedly observed [2–5], the cause and effect relationship between hyperandrogenism and hyperinsulinemia has not been clearly delineated. The current literature on the pathophysiology of hyperandrogenism-insulin resistance and the clinical implications of this association are reviewed below.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Archard C, Thiers J (1921) Le virilisme pilaire et son association a l’insuffisance glycolytique (diabete a femmes de barbe). Bull Acad Natl Med (Paris) 86:51

    Google Scholar 

  2. Barbieri RL, Ryan KJ (1983) Hyperandrogenism, insulin resistance and acanthosis nigricans syndrome: a common endocrinopathy and distinct pathophysiologic features. Am J Obstet Gynecol 147:90

    PubMed  CAS  Google Scholar 

  3. Chang RJ, Geffner ME (1985) Associated non-ovarian problems of polycystic ovarian disease: insulin resistance. Clin Obstet Gynaecol 12:675

    PubMed  CAS  Google Scholar 

  4. Poretsky L, Kalin MF (1987) The gonadotropic function of insulin. Endocr Rev 8:132

    Article  PubMed  CAS  Google Scholar 

  5. Barbieri RL, Smith S, Ryan KJ (1988) The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism. Fertil Steril 50:197

    PubMed  CAS  Google Scholar 

  6. Krauth MC, Schillinger E (1977) Changes in insulin receptor concentration in rat fat cells following treatment with the gestagens clomegestone acetate and cyproterone acetate. Acta Endocrinol (Copenh) 86:667

    CAS  Google Scholar 

  7. Tuffier B (1914) Le virilisme surrenal. Bull Acad Natl Med (Paris) 71:726

    Google Scholar 

  8. Cole C, Kitabchi AE (1978) Remission of insulin resistance with Orthonovum in a patient with polycystic ovarian disease and acanthosis nigricans. Clin Res 26:412A

    Google Scholar 

  9. Pederson O, Hjollund E, Lindskov HO (1982) Insulin binding and action on fat cells from young healthy females and males. Am J Physiol 243, 158

    Google Scholar 

  10. Billiar RB, Richardson D, Schwartz R, Posner B, Little B (1987) Effect of chronically elevated androgen or estrogen on the glucose tolerance test and insulin response in female rhesus monkeys. Am J Obstet Gynecol 157, 1297

    PubMed  CAS  Google Scholar 

  11. Imperato-McGinley J, Peterson RE; Sturla E, Dawood Y, Bar RS (1978) Primary amenorrhea associated with hirsutism, acanthosis nigricans, dermoid cysts of the ovaries, and a new type of insulin resistance. Am J Med 65:389

    Article  PubMed  CAS  Google Scholar 

  12. Geffner ME, Kaplan SA, Bersch N, Golde DW, Landaw EM, Chang RJ (1986) Persistence of insulin resistance in polycystic ovarian disease after inhibition of ovarian steroid secretion. Fertil Steril 45:327

    PubMed  CAS  Google Scholar 

  13. Shoupe D, Lobo RA (1984) The influence of androgens in insulin resistance. Fertil Steril 41:385

    PubMed  CAS  Google Scholar 

  14. Singer F, Bhargava G, Poretsky L Persistent insulin resistance after normalization of androgen levels in a woman with congenital adrenal hyperplasia. J Reprod Med 6:921

    Google Scholar 

  15. Dunaif A, Green G, Futterweit W, Dobrjansky A (1990) Suppression of hyperandrogenism does not improve peripheral or hepatic insulin resistance in the polycystic ovary syndrome. J Clin Endocrinol Metab 70:699

    Article  PubMed  CAS  Google Scholar 

  16. Annos T, Taymor ML (1981) Ovarian pathology associated with insulin resistance and acanthosis nigricans. Obstet Gynecol 58:662

    PubMed  CAS  Google Scholar 

  17. Scully RE, Mark EJ, McNeely BU (1982) Case records of the Massachusetts General Hospital: case no 25-1982. N Engl J Med 306:1537

    Article  Google Scholar 

  18. Poretsky L, Smith D, Seibel M, Pazianos A, Moses AC, Flier JS (1984) Specific insulin binding sites in human ovary. J Clin Endocrinol Metab 59:809

    Article  PubMed  CAS  Google Scholar 

  19. Poretsky L, Grigorescu F, Seibel M, Moses AC, Flier JS (1985) Distribution and characterization of insulin and insulin-like growth factor-I receptors in normal human ovary. J Clin Endocrinol Metab 61:728

    Article  PubMed  CAS  Google Scholar 

  20. Poretsky L, Bhargava G, Kalin MF, Wolf SA (1988) Regulation of insulin receptors in the human ovary: in vitro studies. J Clin Endocrinol Metab 67:774

    Article  PubMed  CAS  Google Scholar 

  21. Barbieri RL, Markris A, Ryan KJ (1983) Effects of insulin on steroidogenesis in cultured porcine ovarian theca. Fertil Steril 40:237

    PubMed  CAS  Google Scholar 

  22. Hernandez ER, Resnick CE, Holtzclaw WD, Payne DW, Adashi EY (1988) Insulin as a regulator of androgen biosynthesis by cultured rat ovarian cells: cellular mechanism(s) underlying physiologic and pharmacologic hormonal actions. Endocrinology 122:2034

    Article  PubMed  CAS  Google Scholar 

  23. Nestler JE, Clore JN, Strauss JF III, Blackard WG (1987) The effects of hyperinsulinemia on serum testosterone, progesterone, dehydroepiandrosterone sulfate, and Cortisol levels in normal women and in women with hyperandrogenism, insulin resistance, and acanthosis nigricans. J Clin Endocrinol Metab 64:180

    Article  PubMed  CAS  Google Scholar 

  24. Kahn CR, Flier JS, Bar RS et al (1976) The syndromes of insulin resistance and acanthosis nigricans. N Engl J Med 294:739

    Article  PubMed  CAS  Google Scholar 

  25. Flier JS, Eastman RC, Minaker KL, Matteson P, Rowe JW (1985) Acanthosis nigricans in obese women with hyperandrogenism. Diabetes 34:101

    Article  PubMed  CAS  Google Scholar 

  26. Van Houten M, Posner BI, Kopriwa BM et al (1980) Insulin binding sites localized to nerve terminals in rat median eminence and arcuate nucleus. Science 207:1081

    Article  PubMed  Google Scholar 

  27. Adashi EY, Hsueh AJW, Yen D (1981) Insulin enhancement of luteinizing hormone and follicle-stimulating hormone release by cultured pituitary cells. Endocrinology 108:1441

    Article  PubMed  CAS  Google Scholar 

  28. Barbieri RL (1990) Hyperandrogenic disorders. Clin Onstet Gynecol 33:640

    Article  CAS  Google Scholar 

  29. Burghen GA, Givens JR, Kitabcni AE (1980) Correlation of hyperandrogenism and hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab 50:113

    Article  PubMed  CAS  Google Scholar 

  30. Dunaif A, Graf M, Manaeli J, Laumas V, Dobrjansky A (1987) Characterization of groups of hyperandrogenic women with acanthosis nigricans, impaired glucose tolerance and/or hyperinsulinemia. J Clin Endocrinol Metab 65:499

    Article  PubMed  CAS  Google Scholar 

  31. Dunaif A, Segal KR, Futterweit W, Dobrjansky A (1989) Profound peripheral insulin resistance, independent of obesity, in the polycystic ovary syndrome. Diabetes 38:1165

    Article  PubMed  CAS  Google Scholar 

  32. Dunaif A, Segal KR, Shelley DR, Green G, Dobrjansky A, Licholai T (1992) Evidence for distinctive and intrinsic defects in insulin action in the polycystic ovary syndrome. Diabetes 41:1257

    Article  PubMed  CAS  Google Scholar 

  33. Pasquali R, Casimirri F, Venturoli S et al (1983) Insulin resistance in patients with polycystic ovaries: its relationship to body weight and androgen levels. Acta Endocrinol (Copenh) 104:110

    CAS  Google Scholar 

  34. Chang RJ, Nakamura RM, Judd HL, Kaplan SA (1983) Insulin resistance in non-obese patients with polycystic ovarian disease. J Clin Endocrinol Metab 57:356

    Article  PubMed  CAS  Google Scholar 

  35. Jialal I, Reddi NK, Moodley J, Joubert SM (1987) Evidence for insulin resistance in nonobese patients with polycystic ovarian disease. J Clin Endocrinol Metab 64:1066

    Article  PubMed  CAS  Google Scholar 

  36. Ciaraldi TP, El-Roeiy A, Madar Z, Reichart D, Olefsky JM, Yen SSC (1992) Cellular mechanisms of insulin resistance in polycystic ovarian syndrome. J. Clin Endocrinol Metab 75:577

    Article  PubMed  CAS  Google Scholar 

  37. Rosenbaum D, Haber RS; Dunaif A (1993) Insulin resistance in polycystic ovary syndrome: decreased expression of GLUT-4 glucose transporters in adipocytes. Am J Physiol (Endocrinol Metab 27):E197

    Google Scholar 

  38. Insler V, Shoham Z, Barash A, Koistinen R, Seppala M, Hen M, Lunenfeld B, Zadik Z (1993) Polycystic ovaries in non-obese and obese patients: possible pathophysiological mechanisms based on new interpretation of facts and findings. Hum Reprod 8:379

    PubMed  CAS  Google Scholar 

  39. Heidenreich KA; Brandenburg D (1986) Oligosaccharide heterogeneity of insulin receptors: comparison of N-linked glycosylation of insulin receptors in adipocytes and Drain. Endocrinology 118:1835

    Article  PubMed  CAS  Google Scholar 

  40. Lowe W Jr, Le Roith D (1986) Insulin receptors from guinea pig liver and brain: structural and functional studies. Endocrinology 118:1669

    Article  PubMed  CAS  Google Scholar 

  41. Swanson ML, Dudley DT, Walker PS, Boyle TR, Pessin JE (1988) Functional differences in insulin receptors in rat adipocyte and human placental membranes. Endocrinology 122:967

    Article  PubMed  CAS  Google Scholar 

  42. Fradkin JE, Eastman RC, Lesniak MA, Roth J (1989) Specificity spillover at the hormone receptor; exploring its role in human disease. N Engl J Med 320:640

    Article  PubMed  CAS  Google Scholar 

  43. Poretsky L, Glover B, Laumas V, Kalin M, Dunaif A (1988) The effects of experimental hyperinsulinemia on steroid secretion, ovarian (125I) insulin binding, and ovarian (125I) insulin-like growth factor I binding in the rat. Endocrinology 122:581

    Article  PubMed  CAS  Google Scholar 

  44. Hernandez ER, Resnick CE, Svoboda ME, Van Wyk JJ, Payne DW; Adashi EY (1988) Somatomedin-C/insulin-like growth factor I as an enhancer of androgen biosynthesis by cultured rat ovarian cells. Endocrinology 122:1603

    Article  PubMed  CAS  Google Scholar 

  45. Massague J, Freidenberg GF, Olefsky JM, Czech MP (1983) Parallel decreases in the expression of receptors for insulin and insulin-like growth factor I in a mutant human fibroblast line. Diabetes 32:541

    Article  PubMed  CAS  Google Scholar 

  46. Mattson LA, Cullberg G, Hamberger L, Samsioe G, Silferstope G (1984) Lipid metabolism in women with polycystic ovary syndrome: possible implications for an increased risk of coronary heart disease. Fertil Steril 42:579

    Google Scholar 

  47. Rebuffe-Scrive M, Cullberg G, Lundberg PA, Lindstedt G, Bjorntorp P (1989) Anthropometric variables and metabolism in polycystic ovarian disease. Hormone Metab Research 21:391

    Article  CAS  Google Scholar 

  48. Dahlgren E, Johansson S, Lindstedt G, Knutsson F, Oden A, Janson PO, Mattson LA, Crona N, Lundberg PA (1992) Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Fertil Steril 57:505

    PubMed  CAS  Google Scholar 

  49. Dahlgren E, Janson PO, Johansson S, Lapidus L, Oden A (1992) Polycystic ovary syndrome and risk for myocardial infarction. Acta Obstet Gynecol Scand 71:599

    Article  PubMed  CAS  Google Scholar 

  50. Pasquali R, Antenucci D, Casimirri F, Venturoli S, Paradisi R, Fabbri R et al. (1989) Clinical and hormonal characteristics of obese amenorrheic women before and after weight loss. J Clin Endocrinol Metab 68:173

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. T. Gürgan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Yarah
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Chefarzt Frauenklinik Krankenhaus Porz am Rhein, Akademisches Lehrkrankenhaus der Universität Köln, Urbacher Weg 19, 51149, Köln, Germany

    Karl Heinz Broer

  2. Dürener Straße 209, 50931, Köln, Germany

    Ismet Turanli (Frauenarzt) (Frauenarzt)

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Gürgan, T., Yarah, H. (1996). Hyperandrogenism and Insulin Resistance. In: Broer, K.H., Turanli, I. (eds) New Trends in Reproductive Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60961-9_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60961-9_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64630-0

  • Online ISBN: 978-3-642-60961-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation