Evaluation of different biochemical markers in prediction of metabolic syndrome in polycystic ovary syndrome patients
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20172554Keywords:
Homocysteine, Leptin, Polycystic ovary syndromeAbstract
Background: Polycystic ovary syndrome (PCOS) is the commonest cause of chronic hyperandrogenic anovulation. Insulin resistance and compensatory hyperinsulinemia are keys of the pathogenesis of PCOS. It is also considered as a metabolic disorder. Since the components of metabolic syndrome (MBS) namely obesity, glucose intolerance, dyslipidemia, and hypertension are the common features of this syndrome. The association between MBS and PCOS can be explained by different theories as insulin resistance, obesity, and related adipose tissue factors (adipocytokines) independent of insulin resistance are the main pathogenic contributors to both disorders.
Methods: A total of 143 women with PCOS were recruited as study subjects. All participants were subjected to anthropometric measurements, clinical assessment, and biochemical tests [fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance (HOMA-IR)]. Hormonal profile particularly leptin and homocysteine levels were also evaluated.
Results: 25 patients (17.4%) out of 143 women with PCOS met the criteria for MBS. Patients with MBS had significantly higher body mass index, blood pressure, HOMA-IR, leptin, and homocysteine levels compared to PCOS only patients. When HOMA-IR cut off was ≥4.3 sensitivity and specificity were 90%, 88.6%, but when leptin level was ≥34.5 the corresponding statistics were 79.6%, 75.5%.
Conclusions: Serum leptin, homocysteine, HOMA-IR as well as other biochemical markers are significantly higher in women with PCOS and MBS compared to PCOS only women. PCOS is associated with various factors like insulin resistance, obesity, and dyslipidemia. Consequently, adipocytokines and HOMA-IR play important role in the prediction of MBS in patients with PCOS.
References
Rosenfield RL. The polycystic ovary morphology-polycystic ovary syndrome spectrum. J Pediatr Adolesc Gynecol. 2015;28:412-9.
Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. J Clin Endocrinol Metab. 2015;100:911-9.
Dunaif A, Segal KR, Shelley DR, Green G, Dobrjansky A, Licholai T. Evidence for distinctive and intrinsic defects in insulin action in polycystic ovary syndrome. Diabetes.1992;41:1257-66.
Dunaif A. Insulin Resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997;18:774-800.
Varghese J, Kantharaju S, Thunga S, Joseph N, Singh PK. Prevalence and predictors of metabolic syndrome in women with polycystic ovarian syndrome: a study from Southern India. Int J Reprod Contracept Obstet Gynecol. 2015; 4:113-8.
Reaven GM. Role of insulin resistance in human disease. Diabetes. 1988;37:1595-1607.
Zimmet P, Alberti G, Shaw J. A new IDF worldwide definition of the metabolic syndrome: the rationale and the results. Diabetes Voice. 2005;50(3):31.
Third report on the National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-21.
Fırat E, Esra A, Aytül ÇE, Serdar A, Asuman G, Ali G et al. Prediction of metabolic syndrome in women with polycystic ovary syndrome. J Turk Ger Gynecol Assoc. 2012;13:178-83.
Aragonès G, Ardid-Ruiz A, Ibars M, Suárez M, Bladé C. Modulation of leptin resistance by food compounds. Mol Nutr Food Res. 2016;60:1789-803.
Zheng SH, Du DF, Li XL. Leptin Levels in Women with Polycystic Ovary Syndrome: A Systematic Review and a Meta-Analysis. Reprod Sci. 2016;1-15
Pehlivanov B, Mitkov M. Serum leptin levels correlate with clinical and biochemical indices of insulin resistance in women with polycystic ovary syndrome. European J Contracep Reprod Health Care. 2009;14:153-9.
Schachter M, Raziel A, Friedler S, Strassburger D, Bern O, Ron-El R. Insulin resistance in patients with polycystic ovary syndrome is associated with elevated plasma homocysteine. Hum Reprod. 2003;18:721-7.
Al- Gareeb A, Abd Al- Amieer WS, Alkuraishy H M, Al- Mayahi TJ. Effect of body weight on serum homocysteine level in patients with polycystic ovarian syndrome: A case control study. Int J Reprod Biomed (Yazd). 2016;14:81-8.
Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41-7.
Ferriman D, Gallwey JD. Clinical assessment of body hair in women. J Clin Endocrinol Meta. 1961;21:1440-7.
Balen AH, Laven JS, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary syndrome. International consensus definitions. Hum Reprod up to date. 2003;9:505-14
Legro Rs, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: purposes and pitfalls. Obstet Gynecol Surv. 2004;59:141-54.
Ford ES, Giles WH, Dietz WH.Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287:356-9.
Sharaf H, Saygili H, Kartal A. Realtion between insulin resistance and the clinical laboratory findings in the polycystic ovary syndrome patients. J Turkish German Gynecol Assoc. 2004;5:303-9.
Defronzo RA, Tobin JD, Andress R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol.1979;237:E214-23.
Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:48-53.
Cheung LP, Ma RC, Lam PM, Lok IH, Haines CJ, So WY et al. Cardiovascular risks and metabolic syndrome in Hong Kong Chinese women with polycystic ovary syndrome. Hum Reprod. 2008;23:1431-8.
Dokras A, Bochner M, Helinrake E, Markham S, Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome. Obstet Gynecol. 2005;106:131-7.
Apridonidze T, Essah PA, luorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:1929-35.
Mancini F, Cianciosi A, Reggiani GM, Facchinetti F, Battalgia C, de Aloysio D. Endothelial function and its relationship to leptin, hormocysteine, and insulin resistance in lean and overweight eumenorrheic women and PCOS patients: a pilot study. Fertil. 2009;91:2537-44.
Loverro G, Iorusso F, Mei L, Depalo R, Cormio G, Selvaggi L. The plasmahomocysteine levels are increased in polycystic ovary syndrome. Gynecol Obstet Invest. 2002;53:157-62.
Badawy A, Omnia S, ElGawad S Sh, Abd El Aziz O. Plasmahomocysteine and polycystic ovary syndrome: themissed link. European J Obstet Gynaecolo Reprod Biol. 2007;131:68-72.
Goverde Aj, van Koert AJ, Eijkemans MJ, Knauff EA, Westerveld HE, Fauser BC et al. Indicators for metabolic disturbances in anovulatory women with polycystic ovary syndrome diagnosed according to the Rotterdam consensus criteria. Hum Repord. 2009;24:710-7.
