Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2022; 13(5): 417-419
Published online May 15, 2022. doi: 10.4239/wjd.v13.i5.417
Concomitant dysregulation of androgen secretion and dysfunction of adipose tissue induced insulin resistance
Marwan SM Al-Nimer
Marwan SM Al-Nimer, Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Diyala, Baqubah 32001, Diyala, Iraq
Author contributions: Al-Nimer MS wrote and revised the letter.
Conflict-of-interest statement: The author declares no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marwan SM Al-Nimer, MBChB, MD, PhD, Professor, Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Diyala, University Street, Baqubah 32001, Diyala, Iraq. alnimermarwan@ymail.com
Received: May 10, 2021
Peer-review started: May 10, 2021
First decision: September 5, 2021
Revised: September 7, 2021
Accepted: April 25, 2022
Article in press: April 25, 2022
Published online: May 15, 2022
Processing time: 367 Days and 14.2 Hours
Abstract

Hyperandrogenism and hyperinsulinemia have resulted from dysfunction of the theca cell of the ovary and adipose tissue and each one potentiates the other in patients with androgen excess disorders e.g., polycystic ovary disease and idiopathic hirsutism. Possible external and/or internal triggers can produce such cellular dysfunction. There is evidence that sodium valproate acts as a trigger of cellular dysfunction and produces both hyperinsulinemia and hyperandrogenism. Therefore, the elimination of these triggers can help the patients to recover from hyperinsulinemia, insulin resistance and hyperandrogenism.

Keywords: Hyperandrogenism; Hyperinsulinism; Central triggers; Polycystic ovary disease

Core Tip: There is a close relationship between hyperinsulinemia and androgen excess in patients with androgen excess disorders. These disorders result from the dysfunction of gonad and adipose cells under the influence of a specific trigger. Sodium valproate is an example of an external trigger that produces concomitant hyperinsulinemia and androgenism leading to polycystic ovary syndrome. Therefore, elimination of the triggers can lead to recovery from antiepileptic drugs while using insulin sensitizers and/or anti-androgens can help to solve this pathological problem.