In fact, IR and hyperinsulinemia in PCOS patients may result in hyperandrogenism via several pathways [28], including promotion of androgen synthesis from theca cells, decrease in hepatic production of SHBG, interference with GnRH signaling or adrenal androgen production; on the other hand, evidence for the converse situation, i.e., androgens adversely influencing insulin action, has been also described [29]. Here, INS is linked to hyperinsulinism.