Association of insulin resistance in women with polycystic ovarian syndrome, its familial transmission and effect of rising body mass index

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorder. The clinical and biochemical features of this syndrome are heterogeneous. Obesity is one of the factors which directly modifies the clinical, biochemical and metabolic expression of this syndrome. Recently a genetic association of PCOS with intrafamily marriages has been postulated. New developments in research into the pathophysiology of PCOS have focused on the role of genetics, insulin resistance (IR) and interrelationship with obesity. Genetic studies have identified a link between PCOS and disordered insulin metabolism This indicates that a complex integrated mechanism is working between obesity, IR, hyperinsulinemia and hyperandrogenemia which are commonly seen in this syndrome Various factors influence ovarian function and studies have clearly demonstrated that fertility is adversely affected in overweight women and in women with raised insulin and LH levels. Obesity lowers the chances of successful conception and even lowers the success rate of assisted reproduction technique cycles. This chapter aims to review the association of environmental factors such as Body Mass Index (BMI)and intrafamily marriages with the clinical, biochemical and hormonal features of this syndrome. Our objective for performing relevant studies and reviewing literature was to determine the relationship of different clinical, biochemical parameters and hormonal assay with the Body mass index BMI of women who are known to have PCOS, and to investigate the association of intrafamily marriages in propagation of insulin resistance in women with PCOS.. Literature search was done on Medline and Pubmed; articles relevant to PCOS / insulin Resistance and association with interfamily marriages were selected. The literature review revealed a dearth of studies on PCOS / insulin resistance and its association with family marriages. Although in the field of PCOS major research is being performed in western countries, however on this subject there was sparse information. At the end of our study and search we have concluded that there is a linear relationship of high BMI and family marriages, with insulin resistance and impaired glycemic control. We strongly recommend high quality research in this field of PCOS which not only has fertility concerns but also long term metabolic issues as well