Abstract
The aim of the present study, is to investigate the influence of obesity, with and without polycystic ovarian syndrome (PCOS), on the levels of kisspeptin, vitamin D (Vit D), and vascular endothelial growth factor (VEGF) and to explore the relationship between these parameters and endocrine and metabolic variables. The study group included 126 obese Saudi females. Of these 63 were suffering from PCOS while the rest were normo-ovulatory obese women (non-PCOS obese). In the obese PCOS, VEGF was almost four times as high as in the non-PCOS obese, while kisspeptin and Vit D did not differ. A highly significant elevation was recorded in the waist/hip (WHR), cholesterol, LDL-C, fasting glucose, LH, LH/FSH ratio, estradiol (E2), and testosterone, while hip circumference, leptin, progesterone, and sex hormone binding globulin (SHBG) were lower in the obese PCOS subjects. BMI, HDL-C, ghrelin, insulin, and FSH levels did not differ significantly between the two groups. The obese PCOS had the same level of insulin resistance as the non-PCOS group, as judged by QUICK Index. Correlation studies showed a significant negative correlation between kisspeptin and glucose and LH levels, and a positive correlation with LH/FSH ratio in obese PCOS while in the non-PCOS obese, the kisspeptin correlated positively with glucose, and there was no correlation with LH or LH/FSH. VEGF negatively correlated with FSH and positively with LH/FSH ratio in the non-PCOS obese but this was lost in the obese PCOS. PCOS had no effect on the correlation between Vit D and all studied parameters. Multiple regression analysis showed triglyceride as predictor variable for kisspeptin as a dependent variable, while, leptin is a predictor variable for VEGF as a dependent variable. ROC studies showed the highest sensitivity and specificity for VEGF (AOC=1.00), followed by LH/FSH ratio (AOC=0.979). In conclusion, our study shows that PCOS results in significant elevation of VEGF in obese females, while kisspeptin and Vit D levels are not affected. It also leads to elevation in several of the lipid and hormonal abnormalities in the obese females. In addition, PCOS influences relationship between Kisspeptin and VEGF and some parameters such as glucose, LH or FSH and LH/FSH ratio in obese females, but does not affect Vit D relationship with other parameter.
Highlights
Obesity is associated with several endocrine and metabolic abnormalities, which may result in serious complications such as heart diseases, diabetes mellitus, hypertension, metabolic syndrome and others
High waist/hip ratios were recorded in polycystic ovary syndrome (PCOS) patients compared to control group
Vitamin D levels were the same in both groups, while the levels of vascular endothelial growth factor (VEGF) were almost 4 times higher in the PCOS compared to the control group
Summary
Obesity is associated with several endocrine and metabolic abnormalities, which may result in serious complications such as heart diseases, diabetes mellitus, hypertension, metabolic syndrome and others. It is a predisposing factor for polycystic ovary syndrome (PCOS) in women of childbearing age, and the prevalence of obesity is as high as 80% in PCOS in some populations [1]. It is reported that puberty is regulated by the maturation of kisspeptin neurons and by interactions between kisspeptins and leptin This interaction initiates gonadotropin releasing hormone (GnRH) by the hypothalamus to induce the secretion of luteinising hormone (LH) and follicle stimulating hormone (FSH) [10]. Any dysregulation of kisspeptin signalling negatively affect the ovarian function, leading to female reproductive and infertility problems among which is PCOS [11]
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