Abstract
IntroductionAdiponectin, a beneficial adipokine has insulin sensitizing effect and plays a prime role in human reproductive process. Obesity is associated with hormonal derangements and is found to affect the hypothalamic-pituitary-ovarian axis that results in ovulatory dysfunction and poor reproductive outcome. ObjectiveThe aim of our study was to investigate the role of Adiponectin and Insulin resistance in android and gynoid overweight infertile women. Materials & methodsThe cross-sectional observational study was conducted in women with BMI ≥23 in the reproductive age group of 20–40 yrs attending the infertility clinic and classified as: Group A control (n = 120) women with one or more children through natural conception and Group B with 120 infertile women (n = 120). Based on waist circumference and waist hip ratio the infertile women were sub classified as 60 android and 60 gynoid obese individuals.After overnight fasting, blood samples were collected and analyzed for plasma glucose, serum insulin and adiponectin levels. Adiponectin was estimated by ELISA using Bio vendor Human adiponectin kit. HOMA-IR, HOMA-adiponectin and Glucose-to-insulin ratio was calculated to assess the insulin resistant state. ResultAdiponectin levels were significantly decreased in infertile women. Based on the routine markers of insulin resistance such as fasting insulin levels, glucose to insulin ratio and HOMA-IR; 46.7%, 43%, 55% of infertile females were found to be insulin resistant respectively. Android infertile women were found to be insulin resistant as compared to the gynoid participants. Calculation of HOMA-adiponectin, an adipokine based IR marker was found to assess the severity of insulin resistance between android (0.24) and gynoid infertile (0.98) obese women. With Linear regression analysis, adiponectin presented strong significant correlation with waist circumference, LH, HOMA-IR and HOMA-adiponectin as compared to the gynoid infertile women. ConclusionAdiponectin, the beneficial adipokine levels are found to be decreased in obese infertile females due to visceral adiposity that results in insulin resistance. HOMA-adiponectin is an adipokine based insulin resistance marker that discriminates android from gynoid infertile females. Life style modifications benefit the overweight infertile women that modulate in reducing the visceral fat mass and thereby increase adiponectin levels.
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