Abstract: Women with polycystic ovary syndrome (PCOS) were well known to have high prevalence of obesity and androgen levels. Androgen is a well-known anabolic hormone; therefore, according to previous studies, androgen may not only contribute to the polycystic ovary morphology and ovulatory dysfunction, but also lead to the higher risk of metabolic disturbances including aggravated insulin resistance, endothelial dysfunction, dyslipidemia, hypertension, hepatic steatosis and metabolic syndrome in women with PCOS. However, although up to 40-50% women with PCOS were obese, while not all women with PCOS and hyperandrogenism were obese, especially in young adolescent and Asian women with PCOS. In addition, even though the androgen level was comparable, the prevalence of obesity and metabolic disturbance still different among women with PCOS of different study population and ethnicities. The main source of androgen in women with PCOS include both ovary and adrenal gland as testosterone and dehydroepiandrosterone sulfate (DHEAS), respectively. Though the ovarian and adrenal androgens were ever reported to have contradictory effect among the body weight and insulin levels in women with PCOS, it is still controversial. Our preliminary study has showed that the DHEAS as one of the dominant adrenal androgen has opposite relationship with the risk of obesity form the ovarian androgen. Therefore, we might propose that the differential levels of ovarian and adrenal levels may lead to different phenotypes and severity of metabolic disturbances in women with PCOS. Studies regarding to the pathogenesis of the differential role of ovarian and adrenal androgen levels in women with PCOS with the effects on obesity, insulin resistance and ovulatory function are not yet available. Therefore, we design this 3-year study including genetic studies and in-vivo animal studies to elucidate the differential role of ovarian and adrenal androgens play in the pathogenesis of polycystic ovary syndrome.
Polycystic ovary syndrome