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[DOI] [PMC free article] [PubMed] [Google Scholar] 208.Guarnieri T

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Hyperinsulinemia resulting from insulin resistance stimulates excessive androgen production by the ovaries and adrenal glands, exacerbating hyperandrogenemia and ovulatory dysfunction ( e.g ., diet and exercise) and pharmacological treatments ( e.g ., metformin, GLP-1 receptor agonists) can ameliorate insulin resistance and improve metabolic outcomes in PCOS ( 2.3 Hormonal imbalance Hyperandrogenemia is a defining feature of PCOS, characterized by elevated serum testosterone, androstenedione, and dehydroepiandrosterone (DHEA) levels, leading to clinical manifestations such as hirsutism, acne, and alopecia

These results suggest the significance and effectiveness of exceeding the supply of the precursors to overproduce ERG, but at the same time, implying the requirement of the further improvement of metabolic engineering to supply His and Met

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