The role of insulin resistance in the pathogenesis of PCOS has been extensively reviewed in Chapter 24. Briefly, insulin resistance is an intrinsic and virtually universal feature of PCOS. Insulin resistance exists in PCOS independent of obesity, as evidenced by the presence of insulin resistance even in lean women with PCOS (1). In addition, about 50-80% of women with PCOS are obese.
Hence, in PCOS obesity further induces an added burden of insulin resistance and hyperinsulinemia in addition to the component of insulin resistance that is intrinsic to the disorder (2).
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