Hormonal
Hyperinsulinemia in obese PCOS women is primarily driven by reduced hepatic insulin extraction and skeletal muscle insulin resistance, rather than solely by increased pancreatic insulin secretion.
High insulin levels in PCOS are not just because your pancreas is working too hard; your liver is also clearing insulin less efficiently, and your muscles are resisting its effects. This combination leads to high circulating insulin, which can further drive androgen production and weight gain.
Early phase insulin secretion but not the early phase C-peptide secretion was increased in PCOS subjects compared to controls, suggesting that peripheral hyperinsulinaemia in PCOS women was mainly due to the observed lowered hepatic insulin extraction and insulin resistance in skeletal muscle.
Why this rating
Relies on C-peptide measurements to distinguish secretion from clearance, a robust methodological approach.
Source
Insulin sensitivity, insulin secretion, and metabolic and hormonal parameters in healthy women and women with polycystic ovarian syndrome
Laure Morin‐Papunen et al. · Human Reproduction · 2000
DOI 10.1093/humrep/15.6.1266
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