Evidence mapPaperPMID 41315368Full record

Observational studyScientific reports2025

Insulin resistance in polycystic ovary syndrome phenotypes and the vicious cycle model in its etiology.

Piotr Szkodziak, Filip Szkodziak, Kamila Trzeciak, Sławomir Woźniak, Margaret Mlynarczyk, Tomasz Paszkowski

Abstract readObservational Study
In one paragraph

Observational study in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Piotr Szkodziak3rd Chair & Department of Gynecology, Medical University of Lublin, Lublin, Poland. piotr.szkodziak@gmail.com.ORCID http://orcid.org/0000-0002-3582-067X
Filip Szkodziak3rd Chair & Department of Gynecology, Medical University of Lublin, Lublin, Poland.
Kamila Trzeciak3rd Chair & Department of Gynecology, Medical University of Lublin, Lublin, Poland.
Sławomir Woźniak3rd Chair & Department of Gynecology, Medical University of Lublin, Lublin, Poland.
Margaret MlynarczykDepartment of Obstetrics & Gynecology, Eastern Virginia Medical School, Norfolk, USA.
Tomasz Paszkowski3rd Chair & Department of Gynecology, Medical University of Lublin, Lublin, Poland.

Funding

Uniwersytet Medyczny w Lublinie 329
6 · The paper itself

Abstract

Polycystic ovary syndrome (PCOS) is a multifactorial disorder driven by at least three pathophysiological components: hypothalamic, ovarian, and obesity-related mechanisms. Insulin resistance (IR) is a unifying feature. Reciprocal interactions among androgen excess, hyperinsulinemia, and reduced hepatic sex hormone-binding globulin production create a self‑sustaining "vicious cycle" that exacerbates PCOS manifestations, which vary in severity and define four clinical phenotypes. To evaluate insulin resistance across PCOS phenotypes A (HA + OD + PCOM), B (HA + OD), C (HA + PCOM), and D (OD + PCOM). A retrospective observational study (2018-2022) of 200 Caucasian women aged 18-36 diagnosed with PCOS according to the Rotterdam criteria. Insulin resistance was assessed using HOMA‑IR. Clinical and anthropometric variables, Free Androgen Index (FAI), and Ferriman‑Gallwey (mFG) scores were analyzed by phenotype. Insulin resistance was present in 57.5% of participants. HOMA‑IR showed no correlation with PCOS duration but differed significantly between phenotypes. Mean HOMA‑IR values exceeded reference thresholds in all phenotypes: A 3.59, B 2.59, C 2.05, D 2.73. Moderate to strong positive correlations were observed between HOMA‑IR and mean arterial pressure, pulse rate, and waist‑to‑hip ratio, indicating an association with cardiometabolic risk across phenotypes. Positive associations among FAI, HOMA‑IR, and mFG score support a contribution of ovarian androgens to insulin resistance and hirsutism. Insulin resistance predominated in this PCOS cohort and was phenotype‑dependent rather than related to syndrome duration. All phenotypes exhibited elevated HOMA‑IR, with phenotype A showing the highest and phenotype C the lowest mean values. The proposed "vicious cycle" model integrates hyperandrogenism and hyperinsulinemia in peripheral insulin resistance; further research into genetic and intracellular signaling mechanisms is warranted.

Indexed as

Insulin ResistancePolycystic Ovary SyndromeAdolescentAdultFemaleHumansPhenotypeRetrospective StudiesSex Hormone-Binding GlobulinYoung AdultSex Hormone-Binding GlobulinHyperandrogenemiaInsulin resistanceMetabolic syndromePolycystic ovary syndromeVicious cycle model

Identifiers

PMID41315368
PMCPMC12663220

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.