Abstract
BackgroundPolycystic ovary syndrome (PCOS) is considered as one of the most frequently encountered hormonal pathologies in women during their reproductive years. Leptin and ghrelin, peptide hormones with adipostatic and orexigenic effect, respectively, seem to be involved in the metabolic changes that occur in PCOS. The aim of this study was to determine serum ghrelin and leptin levels in obese and lean Saudi women with PCOS and to investigate their relationship to the metabolic profiles in these women.MethodsThis study was conducted as a prospective, observational, cross-sectional, case-control study, at the Department of Obstetrics and Gynecology, Al-Noor Hospital, Makkah, Kingdom of Saudi Arabia. The study population included 252 women [130 women with PCOS (diagnosed according to the Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus, 2003) and 122 normo-ovulatory women as matched controls] attending the outpatient Gynecology Clinic. Demographic details were recorded, blood was extracted following overnight fast and serum was used for the determination of serum ghrelin and leptin levels and other hormonal and biochemical parameters including total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, and insulin. Insulin resistance and sensitivity were calculated as HOMA-IR and HOMA-S.ResultsNo significant differences in ghrelin (P = 0.1830) and leptin (P = 0.8329) levels were detected between the PCOS and control groups. However, ghrelin levels were significantly lower; and leptin levels were significantly higher in obese PCOS patients in comparison with lean patients (P = 0.0001 for both). In the PCOS group, there were significant correlations between ghrelin and leptin levels with Body Mass Index (BMI), waist-hip ratio, total cholesterol, triglycerides, HDL, LDL and insulin levels. Multiple regression analysis demonstrated that insulin was the main determinant for ghrelin (R2 = 0.316) and leptin (R2 = 0.352) levels (P = 0.0001 for both).ConclusionsAlthough serum ghrelin and leptin levels were found to be normal in women with PCOS; yet, there is a relationship, possibly linked to obesity, hyperinsulinemia and insulin resistance between these levels and metabolic profile of Saudi PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is considered as one of the most frequently encountered hormonal pathologies in women during their reproductive years
The results of this study showed that the PCOS group had significantly higher levels of insulin, insulin resistance, glucose, all plasma lipids except high-density lipoprotein (HDL)-C, compared to the healthy controls, while insulin secretion was not different
On the other hand, when the obese PCOS were compared to the obese control, the significant differences were lost between the two groups in Body mass index (BMI), leptin, ghrelin, insulin, HDL-C and HOMA-S, but the differences persisted in all the lipids, in glucose level and insulin resistance. These results demonstrate that PCOS is associated with hyperinsulinemia, insulin resistance and elevated glucose and lipids, but as the BMI increases the differences in leptin, ghrelin, insulin, HDL-C, and insulin secretion are lost, indicating that BMI, plays a major role in relating to these abnormalities even in the control group
Summary
Polycystic ovary syndrome (PCOS) is considered as one of the most frequently encountered hormonal pathologies in women during their reproductive years. PCOS is considered as one of the most frequently encountered hormonal pathologies in women during their reproductive years, occurring in most populations of the World [2, 3] and prevalence as high as 15–20% has been reported in some studies [4] It is a heterogeneous complex genetic trait of multifactorial nature where both genetic and environmental factors contribute to the underlying pathophysiological mechanisms [5]. It stimulates growth hormone secretion, regulates glucose metabolism, appetite, body weight, endocrine pancreatic, and ovarian functions [28, 29] It exhibits a negative correlation with androstenedione, and in obese women with PCOS, it may contribute to modification of factors such as insulin resistance and androgens, producing a negative effect on fertility [12]. Ghrelin levels are shown to be lower in PCOS, and this decrease has been associated with the negative correlation shown between body mass index (BMI) and ghrelin [30]
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