INS and polycystic ovary syndrome: It has been shown that the presence of chronic anovulation associated with higher androgen levels was associated with lower insulin sensitivity and higher prevalence of cardiovascular risk factors, such as IR, impaired glucose tolerance (IGT), type 2 diabetes mellitus, and dyslipidemia [22], However the presence of two PCOS phenotypes identified according to the Rotterdam criteria—hyperandrogenism and polycystic ovaries with ovulatory cycles and anovulation and polycystic ovaries without hyperandrogenism—have little or no evidence for IR using surrogate markers [22].