Role hyperleptinemia, insulin resistance and hyperestrogenemia in the development of ovarian failure in women with obesity

Abstract

Actuality of the study. Ovarian insufficiency is present in more that 30% of reproductive age women. The role of leptine and insuin resistance in the pathogenesis of ovarian insufficiency is not yet established and has to be clarified. The aim of the study to investigate the role of hyperleptinemia, insulin resistance and hyperestrogenemia in the pathogenesis of ovarian insufficiency in obesity.Materials and methods. Fifty reproductive age women with BMI > 25,6 kg/m2 were studied. Ten healthy reproductive age women were included as controls. The plasma level of leprin, honadotropins, prolactin, insulin and sex steroid hormones assayed by immunoenzyme analysis, morning fasting blood glucose and the glucose level after glucose tolerance test, pelvic echography, “whole body” program of dual x-ray absorptiometry were studied in both patients and controls.Results. Thirty-six out of 50 women had signs of ovarian insufficiency. The presence and severity of ovarian insufficiency did not correlate with the level of leptin in blood or with insulin resistance. The positive correlation between oestradiol level and both presence and severity of ovarian insufficiency could be demonstrated.Conclusion. The results of our study do not support the hyperleptinemia and insulin resistance as the main cause of ovarian insufficiency in alimentary obesity. The most potential reason of anovulation in these women could be hyperoestrogenia due to increased conversion of androgens into oestrogenes in fat tissues and ovaria.