Dewailly D, Cortet-Rudelli C, Nobels F, Henric B, Longelin C, Fossati P
Service d'Endocrinologie et de Diabétologie, USN A, CHRU de Lille.
Ann Endocrinol (Paris). 1992;53(1):1-7.
The causes and consequences of the insulin resistance that accompanies the polycystic ovary Syndrome (PCOS) are still controversial. The hyperandrogenism does not appear any more as a causal factor but on the contrary is likely to be a consequence, via the ovarian effects of hyperinsulinism. These are still not clearly understood in their molecular aspects, but their reality is undoubtful in view of some clinical studies which showed an improvement following by the reduction of hyperinsulinism. Therefore, the aetiopathogenic role of the insulin resistance in PCOS becomes more and more obvious but it cannot be split from the likely implication of the intra-ovarian growth factors, and more especially the IGF 1 which could act synergistically with it. Moreover, the presence of LH seems to be still a pre-requisite to the ovarian action of insulin. The therapeutical incidences of these hypothesis are obvious and should improve in the next future the medical management of PCOS.
多囊卵巢综合征（PCOS）所伴随的胰岛素抵抗的成因及后果仍存在争议。高雄激素血症不再被视为一个致病因素，相反，它很可能是高胰岛素血症对卵巢产生影响后的一个结果。这些影响在分子层面仍未被完全理解，但鉴于一些临床研究表明降低高胰岛素血症后情况有所改善，其实际存在是毋庸置疑的。因此，胰岛素抵抗在PCOS中的发病机制作用变得越来越明显，但它与卵巢内生长因子（尤其是可能与之协同作用的IGF - 1）的潜在关联不可分割。此外，促黄体生成素（LH）的存在似乎仍是胰岛素发挥卵巢作用的一个先决条件。这些假设对治疗的影响显而易见，未来有望改善PCOS的医疗管理。
