How cigarette smoke causes insulin resistance and thereby contributes to polycystic ovaries (PCOS)

  • "Come to Where Insulin Resistance Is, Come to AMPK Country", says a recent research paper, paraphrasing the famous cigarette brand advertising slogan (http://www.ncbi.nlm.nih.gov/m/pubmed/25955203/).
  • It is well known that cigarette smoking contributes to insulin resistance, i.e. the inability of body cells to properly recognise insulin. Insulin resistance in partially responsible for diabetes, heart disease and a host of other diseases, including polycystic ovary syndrome (PCOS).
  • Insulin resistance is usually found on overweight people, so the fact that smoking causes both weight reduction and insulin resistance perplexed scientists. Now scientists have discovered how smoking does that.
  • Nicotine, found in cigarette smoke,  activates a protein called AMP-activated protein kinase α2 (AMPKα2) which ultimately ends up blocking the anti-lipolytic effect of insulin. This has the positive effect of increased lipolysis - and consequently fat reduction - but also increased release of free fatty acids from fat cells into the circulation. Free fatty acids are known to cause insulin resistance. This explains how smoking keeps people slim yet makes them more prone to insulin resistance and associated conditions, such as PCOS, which can cause acne, scalp hair loss and body & face hair growth in women.
  • The most common treatment for PCOS is the contraceptive pill, which blocks the testosterone production caused by PCOS. However, the pill also causes cellulite, weight gain, mood issues and low sex drive - and in combination with smoking it can cause blood clots and breast cancer.
  • Furthermore, smoking causes cellulite due to poor circulation, glycation and collagen degradation. 
  • Moral of the story: ladies, if you suffer from PCOS, quit smoking now! Smoking may keep you slim but it also gives you body and face hair growth, scalp hair loss, acne and of course it is not the best thing for your ovaries either. Alternatively, if you want to continue smoking and avoid PCOS by taking the pill, you may end up with cellulite, weight gain and blood clots - not to mention the increased risk of breast cancer. Is it worth it?
  • Source: Activation of AMPKα2 in adipocytes is essential for nicotine-induced insulin resistance in vivo, http://www.nature.com/nm/journal/v21/n4/full/nm.3826.html