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Polycystic ovary syndrome, BMI, leptin, Insulin resistance
Background: Polycystic ovary syndrome (PCOS) is a well-globally-occurred heterogeneous endocrine disorder, affecting 5–10% of females with hyperandrogenism and prolonged anovulation.
Objective: This work was done to understand the serum leptin role in women with PCOS in a link with the body mass index (BMI) and insulin resistance (IR).
Patients and methods: This one-year-study was conducted in the Departments of Obstetrics and Gynecology as well as Infertility Unite in AL-Diwaniyah Maternity and Pediatrics Teaching Hospital, Iraq, in which 40 patients with PCOS as a (study group), and 40 healthy non PCOS patients as the (control group), after BMI assessment, both the study and control groups will further stratified into subgroups as normal weight and overweight patients’. Blood samples were obtained for all patients for the serum leptin level (SLL) and fasting blood glucose (FBG) and serum insulin level, then HOMA-IR equation have been used to estimate insulin resistance for all patients.
Results: SLL of the PCOS women (mean ±SD, 22.29±10.96 ng/ml) was significantly (p<0.05) higher in a comparison with that (17.89±8.29 ng/ml) from the control group. Insulin level was significantly elevated in the obese control and PCOS women (16.87±3.52) µ UI/L and (15.09 ±5.27) µUI, respectively, compared to normal BMI control and PCOS patients (p≤0.01). Insulin resistance was significantly higher in obese (control and PCOS) patients (2.47±0.40) and (2.30±0.43) respectively, compared to normal BMI (control and PCOS) patients (p≤0.01).
Conclusions: In the obese patients, serum leptin was insignificant correlation with BMI with the presence of hyperinsulinemia and elevated insulin resistance.
1- The Rotterdam ESHRE/ASRM_sponsored pcos consensus Group.Revised 2003 consensus to polycystic ovary syndrome .Hum Reprod.2004;19:41-47
2- Yadav A, Jyoti P, Jain SK, et al . Correlation of adiponectin and leptin with insulin resistance: A pilot study in healthy North Indian population. Indian J Clin Biochem. 2011;26:193–6. )
3- Brennan AM, Mantzoros CS .Drug Insight: The role of leptin in human physiology and pathophysiology – emerging clinical applications. Nat Clin Pract Endocrinol Meta . 2006 ; 2 (6): 318–27.
4-Insulin Resistance & Prediabetes. National Institute of Diabetes and Digestive and Kidney Diseases. May 2018.
5- Isganaitis E, Lustig RH. Fast food, central nervous system insulin resistance, and obesity. Arteriosclerosis, Thrombosis, and Vascular Biology. December 2005 ; 25 (12): 2451–62. 46 )
6- Brennan AM, Mantzoros CS .Drug Insight: The role of leptin in human physiology and pathophysiology – emerging clinical applications. Nat Clin Pract Endocrinol Meta . 2006 ; 2 (6): 318–27. (52)
7- Diamanti-Kandarakis E, Bartzis MI , Kouli CR, et al. A survey of the Polycystic Ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab .2009; 84:4006–4011
8- Mohiti-Ardekani J, Taarof N. Comparison of leptin blood levels and correlation of leptin with LH and FSH in PCOS patients and normal individuals. JSSU. 2010;17:353–7.
9- Baig M, Rehman R, Tariq S, et al. Serum Leptin levels in Polycystic Ovary Syndrome and its relationship with metabolic and hormonal profile in Pakistani females. Int J Endocrinol . 2014;132908.
10- Daghestani MH. Evaluation of Biochemical, Endocrine, and Metabolic biomarkers for the early diagnosis of Polycystic Ovary Syndrome among non - obese Saudi women. Int J Gynaecol Obstet. 2018; May 10.
11- Turner HE, Wass J.Oxford Handbook of Endocrinology and Diabetes. 1st edn. Oxford: Oxford University Press, 2003.
12- Zhang J , Hu J, Zhang C , et al . Analyses of risk factors for polycystic ovary syndrome complicated with non-alcoholic fatty liver disease .Exp Ther Med.2018 May;15(5):4259-4264.
13- Tomlinson J, Millward A , Stenhouse E ,etal. Type 2 diabetes and cardiovascular disease in polycystic ovary syndrome. Diabet Med. 2010, vol. 27 (pg. 498 _515)
14- Ludwig A, Weiss J, Tauchert S, et al.. Influence of hypo-and hyperglycaemia on plasma leptin concentrations in healthy women and in women with polycystic ovary syndrome. Hum Reprod. 2007;22:1555–1561.
15- Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: purposes and pitfalls. Obstet Gynecol Surv. 2004;59:141–154.
16- Glintborg D, Andersen M, Hagen C, et al. Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls. Eur J Endocrinol.2006; 155: 337-345.
17- Olszanecka-Glinianowicz M, Madej P , et al. Circulating apelin level in relation to nutritional status in polycystic ovary syndrome and its association with metabolic and hormonal disturbances. Clin Endocrinol (Oxf). 2013;79:238–4.
18-Ramanand SJ, Ramanand JB, Jain SS, et al. Leptin in non PCOS and PCOS women: A comparative study. Int J Basic Clin Pharmacol. 2014 ; 3:186–93.
19- Moran C, Garcia-Hernandez E, Barahona E ,et al. Relationship between insulin resistance and gonadotropin dissociation in obese and nonobese women with polycystic ovary syndrome. Fertil Steril. 2003 Dec ; 80(6):1466–72.
20- Kiddy, D. S., Sharp, P. S., White, et al. Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: an analysis of 263 consecutive cases. Clin Endocrinol (Oxf).2009; 32(2), 213-20.
21- Dinka P. B, Lana Š, Zrinka B ,et al . Hyperandrogenemia Association with Acne and Hirsutism Severity in Croatian Women with Polycystic Ovary Syndrome. Acta dermatovenerologica Croatica. 2013; 21(2)
22- Park, K. H. et al. Polycystic Ovarian Syndrome (PCOS) and insulin resistance. International Journal of Gynecology & Obstetrics.2001; 74, 261–267
23- Telli MH , Yilidrim M , Noyan V :serum leptin levels in patients with polycystic ovary syndrome.Fertil Steril . 2002;77:932-935.
24- Crowther, N. J., Ferris, W. F., Ojwang,et al .The effect of abdominal obesity on insulin sensitivity and serum lipid and cytokine concentrations in African women. Clin Endocrinol (Oxf) 64.2006; 535–541
25- DE Moller, JS Flier .Detection of an alteration in the insulin receptor gene in a patient with insulin resistance, acanthosis nigricans and the polycystic ovary syndrome N Eng J Med.319 .2008 ; pp. 1526-1529.
26- B Cohen, D Novich, M RubinsteinModulation of insulin activities by leptin.Science, 274 (2011); pp. 1185-1188.
27- Cheng X, Guo J, Xie J. Association between levels of serum leptin and insulin resistance in patients with polycystic ovary syndrome Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35:1389–1391.