Androgens and Severe Insulin Resistance States: Basic and Clinical Aspects.

2区医学 Q2 Medicine

Frontiers of Hormone Research Pub Date : 2019-01-01 DOI:10.1159/000494911

A. Gambineri, L. Zanotti, D. Ibarra-Gasparini

引用次数: 1

Abstract

Hyperandrogenism with or without polycystic ovary syndrome can be sustained by an extreme form of insulin resistance (IR), and is thus a secondary form of hyperandrogenism, which may be due to a defect in insulin signal transduction or in the adipose tissue. Severe IR due to adipose tissue dysfunction is the most frequent form, which may be the result of a deficiency in the adipose tissue, that is, the lipodystrophies, or to the unrestrained accumulation of adipose tissue. These forms are in some cases produced by a single-gene defect. The diagnosis remains predominantly clinical by examining patients in their underwear and looking out for clinical hallmarks, supported by biochemical biomarkers. Gene screening is necessary to corroborate the diagnosis of some forms. Clinicians who deal with hyperandrogenic disorders should be alerted to the forms that are secondary to severe IR, as they are not as uncommon as often imagined and frequently respond to tailored therapies.

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雄激素和严重胰岛素抵抗状态:基础和临床方面。

伴有或不伴有多囊卵巢综合征的高雄激素症可由胰岛素抵抗(IR)的极端形式维持，因此是高雄激素症的继发性形式，这可能是由于胰岛素信号转导或脂肪组织的缺陷。由脂肪组织功能障碍引起的严重IR是最常见的形式，这可能是脂肪组织缺陷(即脂肪营养不良)或脂肪组织无限制积累的结果。这些形式在某些情况下是由单基因缺陷产生的。在生化生物标志物的支持下，对穿着内衣的患者进行检查，寻找临床特征，这仍然是主要的临床诊断。基因筛查是必要的，以证实某些形式的诊断。处理高雄激素紊乱的临床医生应该警惕继发于严重IR的形式，因为它们并不像通常想象的那样罕见，而且经常对量身定制的治疗有反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers of Hormone Research 医学-内分泌学与代谢

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期刊介绍： A series of integrated overviews on cutting-edge topics New sophisticated technologies and methodological approaches in diagnostics and therapeutics have led to significant improvements in identifying and characterizing an increasing number of medical conditions, which is particularly true for all aspects of endocrine and metabolic dysfunctions. Novel insights in endocrine physiology and pathophysiology allow for new perspectives in clinical management and thus lead to the development of molecular, personalized treatments. In view of this, the active interplay between basic scientists and clinicians has become fundamental, both to provide patients with the most appropriate care and to advance future research.