Plasma homocysteine and polycystic ovary syndrome: The missed link

Abstract

ObjectiveThe objective was to investigate the relationship between insulin resistance and increased serum homocysteine in women with polycystic ovarian syndrome (PCOS). DesignProspective controlled trial. SettingDepartment of Obstetrics & Gynecology, Mansoura Faculty of Medicine, Mansoura, Egypt. PatientsNinety PCOS women as a study group and 35 women with infertility due to other causes as a control group. Outcome measuresSerum homocysteine levels in the presence and absence of insulin resistance in PCOS patients. ResultsHomocysteine levels were significantly higher in PCOS patients than in the controls. Considering 11μmol/l as the cut-off level for a normal homocysteine level, 41.1% of PCOS patients (37 out of 90) and 2.9% of control group (1 out of 35) had high homocysteine levels. With regard to insulin resistance, 23% of PCOS patients without insulin resistance (9 out of 39) had a high homocysteine level, while 47% of PCOS patients with insulin resistance (24 out of 51) had this, thus demonstrating the effect of insulin resistance on the homocysteine level. ConclusionThere is a strong association between serum homocysteine and insulin resistance in women with PCOS that contributes to the long-term complications of PCOS.