One study found not only that all subjects with PCOS with familial diabetes had higher insulin plasma levels in baseline conditions after overnight fasting, but that they also showed higher HIE than subjects with PCOS without familial diabetes.84 In addition, patients with PCOS with familial diabetes also showed ALT and AST plasma levels at the upper limit of normality and higher than in patients with PCOS without familial diabetes.85 These data let us infer that a specific impairment might be induced by a familial predisposition to diabetes affecting hepatocyte functions. This evidence concerns the gene INS and polycystic ovary syndrome.