Leme C E, Wajchenberg B L, Lerário A C, Goldman J, Borges J L
Clin Endocrinol (Oxf). 1982 Jul 1;17(1):43-9. doi: 10.1111/j.1365-2265.1982.tb02632.x.
A 24-year-old negress with the triad of acanthosis nigricans, hirsutism associated with polycystic ovaries and insulin resistance is reported. Metabolic studies were done 3 years after a bilateral ovarian wedge resection. Partial remission of the hirsutism and return of menstrual cycles occurred after surgery. Extreme resistance to endogenous and exogenous insulin was observed. Three studies of insulin receptors on circulating red blood cells (RBC) showed abnormal inhibition-competition curves, characterized by increased percentage insulin binding at higher unlabelled insulin levels. Scatchard plots suggested an apparent increase in the number of low affinity receptors. Despite the changes in receptor-insulin interaction, the defect does not seem to explain the insulin resistance since binding of insulin to a target tissue (RBC) appeared to be quantitatively normal at physiological insulin levels, suggesting a simultaneous post receptor defect.
报告了一名24岁患有黑棘皮症、多毛症伴多囊卵巢及胰岛素抵抗三联征的黑人女性。双侧卵巢楔形切除术后3年进行了代谢研究。术后多毛症部分缓解，月经周期恢复。观察到对内源性和外源性胰岛素有极强的抵抗。对循环红细胞（RBC）上胰岛素受体进行的三项研究显示抑制竞争曲线异常，其特征是在较高未标记胰岛素水平时胰岛素结合百分比增加。Scatchard图提示低亲和力受体数量明显增加。尽管受体-胰岛素相互作用发生了变化，但该缺陷似乎并不能解释胰岛素抵抗，因为在生理胰岛素水平下胰岛素与靶组织（RBC）的结合在数量上似乎正常，提示同时存在受体后缺陷。
