PPARA and polycystic ovary syndrome: In particular, we need to consider the role of low serum adiponectin levels in causing IR in women with PCOS as adiponectin (i) decreases muscle triglyceride content, (ii) regulates the insulin receptor, (iii) activates peroxisome proliferator-activated receptor α (PPARα) to increase fatty acid oxidation, (iv) reduces hepatic glucose production by activating protein kinases, (v) increases fat oxidation in muscle, and (vi) inhibits the expression of gluconeogenic enzymes (35).