Polycystic ovary syndrome (PCOS) is a complex endocrine disorder associated with a long term lack of ovulation and an excess of androgens (male hormones). The presentation of PCOS can vary but often includes either type 2 diabetes with insulin resistance or hyperinsulinemia. The link between type 2 diabetes and PCOS was first studied in the 1930s but it wasn't until the 1980s that the correlation between the two diseases was aggressively pursued.

The statistical linkage between PCOS and type 2 diabetes is staggering, according to Dr. Marcelle Cedars, MD, Director of the UCSF Center for Reproductive Health. First, it is important to realize that between 5 and 10% of reproductive age women may have PCOS. Then, beween 50 and 70% of women with PCOS also experience insulin resistance. At first it was thought that obesity might be a contributory factor, however, even normal weight women can have both disorders. In addition, approximately 20-40% of obese young women with PCOS have insulin resistance or type 2 diabetes. However, the instigator of PCOS isn't clear - what comes first, the increased androgens or the insulin resistance? Also of interest, recent information from Dr. Cedars's group suggests PCOS disease progression varies between caucasian and black women.

Previously, Dr. Cedars was involved in an observational study that tracked 800 girls for 10 years in order to shed light on the causes of PCOS and identify possible markers to identify very young women most at risk. She expects the study will help identify a gene that affects both androgen and insulin levels and may predispose young women to PCOS and insulin resistance. The importance of environmental issues such as diet may allow for the development of new treatment strategies.

Dr. Cedars is in the process of setting up a multidisciplinary and cross-generational PCOS Clinic at UCSF to effectively serve this growing population of women. She is also assembling an esteemed group of UCSF endocrine and diabetes specialists to assist in further research involving PCOS and type 2 diabetes. Stay tuned...