Role of insulin and insulin resistance in androgen excess disorders

作     者：Kursad Unluhizarci Zuleyha Karaca Fahrettin Kelestimur 

作者机构：Department of EndocrinologyErciyes University Medical SchoolKayseri38039Turkey Department of EndocrinologyYeditepe University Medical SchoolIstanbul34755Turkey 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2021年第12卷第5期

页      面：616-629页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Insulin Insulin resistance Hyperinsulinemia Hyperandrogenism Androgen excess 

摘      要：Insulin has complex effects on cell growth,metabolism and differentiation,and these effects are mediated by a cell-surface bound receptor and eventually a cascade of intracellular signaling *** the several metabolic and growth-promoting effects of insulin,insulin resistance is defined as an attenuated effect of insulin on glucose metabolism,primarily the limited export of blood glucose into skeletal muscle and adipose *** the other hand,not all the signaling pathways and insulin-responsive tissues are equally affected,and some effects other than the metabolic actions of insulin are *** and the adrenal glands are two examples of tissues remaining sensitive to insulin actions where insulin may contribute to increased androgen *** ovary syndrome(PCOS)is the most common form of androgen excess disorder(AED),and its pathogenesis is closely associated with insulin *** with idiopathic hirsutism also exhibit insulin resistance,albeit lower than patients with *** it is not as evident as in PCOS,patients with congenital adrenal hyperplasia may have insulin resistance,which may be further exacerbated with glucocorticoid overtreatment and *** patients with severe insulin resistance syndromes,irrespective of the type of disease,hyperinsulinemia promotes ovarian androgen synthesis independently of *** is highly debated in whom and how insulin resistance should be diagnosed and treated among patients with AEDs,including *** is not suitable to administer an insulin sensitizer relying on only some mathematical models used for estimating insulin ***,the treatment decision should be based on the constellation of the signs,symptoms and presence of obesity;acanthosis nigricans;and some laboratory abnormalities such as impaired glucose tolerance and impaired fasting glucose.