INS and hyperinsulinism: O'Reilly et al. [32] found that concentrations of 11OHA4 and 11KA4 were positively correlated with insulin and insulin resistance among healthy women and those with PCOS, and Walzer et al. [33] observed that, in women with lipodystrophy, 11OHA4, 11KA4, and 11KT, but not 11OHT, were associated with increased insulin signalling due to hyperinsulinemia as a response to insulin resistance.