Researchers in the United Kingdom have uncovered a new link between increased male hormones and a higher risk of metabolic complications such as diabetes and fatty liver disease among women with polycystic ovary syndrome (PCOS), ScienceDaily reports.

The new study, published in the Journal of Clinical Endocrinology and Metabolism, builds off previous research showing that in addition to irregular periods, acne, increased body hair and, often, impaired fertility, women with PCOS also regularly have high levels of male hormones called androgens in their blood. Until now, the metabolic effects and functions of these androgens — or the cause of these raised levels — had not yet been thoroughly investigated.

Now, researchers are suggesting that abdominal fat tissue could be a major source of these increased male hormones in women with PCOS. Study authors at the University of Birmingham identified an enzyme called AKR1C3 as being responsible for activating an increase in the buildup of androgen in the fat tissue of women with PCOS.

According to the study, this activation of androgens appears to lead to an increased build-up of lipids in the fat cells, which eventually leads to the overspill of fatty acids into the blood. Finally, this spillage made the women’s body’s cells less responsive to insulin, which caused them to produce more insulin and in turn more AKR1C3 and on and on in a vicious circle. Researchers theorized that this could be a major driver of the metabolic changes that ultimately render these women more likely to develop diabetes and fatty liver disease. 

The findings could potentially open up new avenues of treatment for the disorder. Further research will be needed to investigate whether blocking the ARK1C3 enzyme would lead to a decrease in metabolic issues among these at-risk women.