Correlation between elevated homocysteine levels and insulin resistance in infertile women with or without polycystic ovary syndrome in North Indian population

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting about 5 to 10% women of reproductive age group worldwide. This study was designed to examine the relationship between elevated homocysteine levels and insulin resistance (IR) in infertile women with or without PCOS. This cross sectional case control study was conducted in Department of Obstetrics and Gynaecology, Pathology and Medicine, CSM Medical University (Erstwhile KGMU), Lucknow, UP India. After informed consent, a total 90 infertile women were enrolled which included 50 diagnosed cases of PCOS according to Rotterdam consensus meeting 2003 and 40 healthy non PCOS as controls. Mean plasma homocysteine levels were significantly higher in PCOS women (11.8796±5.5) as compared to non PCOS women (7.8095±2.2). Obesity was found in 64% PCOS women and 37.5% of non PCOS women which was significant. Serum testosterone levels were elevated in 42% of PCOS women, but none of the women of non PCOS group had elevated testosterone levels. Amongst the PCOS patients (32/50), 64% were IR and (18/50) 36% were non insulin resistance (NIR) PCOS group which was stratified by HOMA-IR. Thirty-two women had mean HOMA-IR (5.95±1.27) designated PCOS IR and 18 had mean HOMA-IR (1.86±0.028) designated PCOS NIR. Elevated body mass index (BMI) was not significantly associated with IR in PCOS patients. BMI in PCOS IR was 27.43±3.096 and BMI in PCOS NIR was 25.728±2.609 (P<0.07). Homocysteine levels were significantly elevated in PCOS patients (mean 11.87±5.5) (All PCOS), IR PCOS (13.82±5.69 pmol/q) versus controls (7.80±2.29 pmol/L) (P<0.001). In conclusion, obesity is not an independent risk factor to increase plasma homocysteine levels in PCOS women. Key words: Homocysteine, polycystic ovary syndrome, insulin resistance, infertility.