Figure 6.

(a) Schematic representation of the proposed mechanistic link between AE, insulin resistance, and lipotoxicity in PCOS, and (b) graphical representation of the major human androgen biosynthesis pathways. AKR1C3 plays a central gatekeeping role in androgen activation in the classic androgen synthesis pathway and the alternative (backdoor) pathway to 5α-DHT and the 11-oxygenated androgen synthesis pathway. Active androgens capable of activating the androgen receptor highlighted in blue boxes and white font.