PCOS

Question 1

Genetic factors PCOS

Answer 1

women with PCOS are likely to have family members with PCOS, diabetes, or insulin resistance

Question 2

Environmental factors PCOS

Answer 2

prenatal androgen exposure may influence neuronal transmission to HPO axis as well as cause dysfunction of pancreatic beta cells

Question 3

obesity PCOS

Answer 3

obesity can cause alterations in adipose endocrine function as well as influence insulin sensitivity

Question 4

prenatal androgen exposure and HPO axis

Answer 4

suppress induction of hypothalamic progesterone receptors (PR) by estrogen

Question 5

hypothalamic PR suppression is associated with

Answer 5

increased LH levels and pulsatility –> absent LH surges –> disrupted estrous cycles –> hyperandrogenemia

Question 6

prenatal androgen exposure can induce pancreatic beta cell dysfunction

Answer 6

hyperinsulinemia
insulin alters synthesis and release of several hormones
Increased LH
Increased Insulin like growth factor (IGF-1)
Increased conversation of cholesterol to androgens in theca cells
Decreased SHBG by liver

Question 7

Overall, Hyperinsulinaemia as a result of prenatal androgen exposure can lead to

Answer 7

increased bioavailable (free) androgens
Arrests granulosa cells proliferation –> decreased follicle growth
peripheral insulin resistance

Question 8

insulin resistance and adipocytes

Answer 8

insulin resistance –> alteration in enzymatic activity of adipocytes –> increased peripheral conversion to testosterone –> increased lipogenesis –> further insulin resistance

insulin resistance decreases adipocyte lipolysis –> increased triglycerides

Question 9

increased leptin by adipocytes and sex hormones

Answer 9

leptin causes reduced ovarian response
leptin increases LH –> ANOVULATION

Question 10

androgens favor what type of FSH

Answer 10

FSH with terminal sialic acid (increased acidic FSH production)

Question 11

LH and theca cells

Answer 11

LH stimulates theca cells to produce androgens –> more LH = more androgen conversion

Question 12

FSH decreased in PCOS

Answer 12

lower FSH –> decreased granulosa cells –> decreased estrogen

Question 13

effects of acidic FSH

Answer 13

increases inhibit synthesis
decreases affinity for FSH receptor
Ineffective antrum formation of follicle

Question 14

granulosa cells produce —- which are —

Answer 14

VEGF and ANGPT1
they are angiogenic

Question 15

theca cell produce —- which are —–

Answer 15

ANGPT2
angiolytic > angiogenic