Insulin Resistance In Polycystic Ovary Syndrome Patients Research Articles

Can triglyceride related indices be reliable markers in the assessment of polycystic ovarian syndrome?

Abstract Objectives This study aimed to evaluate the diagnostic utility of the triglyceride glucose (TyG), triglyceride glucose–body mass (TyG-BMI), and lipid accumulation product (LAP) indices for both screening polycystic ovary syndrome (PCOS) and diagnosing insulin resistance (IR) in women diagnosed with PCOS. Methods Retrospective data from medical records of 124 women were analyzed, with 71 in the PCOS group and 53 in the non-PCOS group. The PCOS diagnosis followed the 2003 Rotterdam criteria. Basic clinical and biochemical parameters were compared. The TyG index was computed using the formula ln [triglyceride (TG) (mmol/L) × fasting plasma glukose (FPG) (mg/dL)/2]. TyG-BMI value was derived as TyG × BMI. LAP was calculated as (waist circumference (WC-58) × TG (mmol/L). IR was identified if Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was >2.7. Results TyG-BMI (AUC=0.62) and LAP indices (AUC=0.61) did not demonstrate statistically significant diagnostic performance for PCOS. Regarding IR in PCOS patients, the highest AUC was for TyG-BMI (0.84, 95 % CI: 0.73–0.93, p<0.001) with a cutoff at 116.15, showing 80 % sensitivity and 86 % specificity. LAP had an AUC of 0.86 with a cutoff of 30.21 (sensitivity 80 %, specificity 81 %), while TyG showed an AUC of 0.78 (95 % CI: 0.67–0.89, p<0.001) with a cutoff of 4.47, demonstrating a sensitivity of 70 % and specificity of 72 %. Conclusions Numerous biochemical markers have been explored for PCOS detection, however, many are expensive, not universally available, and necessitate specific test kits. TyG, TyG-BMI, and LAP indices might not serve as reliable markers for PCOS screening but could offer utility in identifying IR in Turkish women diagnosed with PCOS.

Differential Expression of Insulin Resistance Genes in Polycystic Ovary Syndrome

Introduction: Polycystic ovary syndrome (PCOS) is a common hormonal disorder worldwide among women of reproductive age. It is characterized by endocrine, reproductive, and metabolic abnormalities. Insulin resistance (IR) is one of its most important clinical features, which has been associated with metabolic disorders and increased risk of type 2 diabetes (T2D). This study aimed to explore the whole blood gene expression profiling related to IR in PCOS patients compared to controls. Methods: Blood RNA was extracted from 5 PCOS and 5 non-PCOS women with matched age and BMI. Homeostasis model assessment (HOMA-IR) was used to estimate the IR. The expression of IR genes was analyzed by Profiler PCR array. Results: Both groups have similar levels of HOMA-IR (p>0.05). However, differential expression levels were observed between them. Fourteen genes were upregulated and 26 genes were downregulated in PCOS samples. Among the upregulated genes (>2 fold-change, p-value<0.05) are ADIPOQ, ADIPOR1, OLR, IGF-1, and APOE. Downregulated genes (>-2 fold-change, p-value<0.05) include HK-2, IRS1, and SERPINE1. These genes are involved in insulin and adipokines signaling, commonly dysregulated in T2D. They are also involved in innate immunity and inflammatory processes and are important for lipid and carbohydrate metabolism. Conclusion: Our finding suggests that despite both groups having no difference in IR level, there are differentially expressed genes involved in the IR pathway.

Alpha Lipoic Acid Efficacy in PCOS Treatment: What Is the Truth?

Polycystic ovary syndrome (PCOS) is among the most common female endocrinopathies, affecting about 4-25% of women of reproductive age. Women affected by PCOS have an increased risk of developing metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, and endometrial cancer. Given the pivotal role of insulin resistance (IR) in the pathogenesis of PCOS, in the last years, many insulin-sensitizing factors have been proposed for PCOS treatment. The first insulin sensitizer recommended by evidence-based guidelines for the assessment and treatment of PCOS was metformin, but the burden of side effects is responsible for treatment discontinuation in many patients. Inositols have insulin-mimetic properties and contribute to decreasing postprandial blood glucose, acting by different pathways. ALA is a natural amphipathic compound with a very strong anti-inflammatory and antioxidant effect and a very noteworthy role in the improvement of insulin metabolic pathway. Given the multiple effects of ALA, a therapeutic strategy based on the synergy between inositols and ALA has been recently proposed by many groups with the aim of improving insulin resistance, reducing androgen levels, and ameliorating reproductive outcomes in PCOS patients. The purpose of this study is to review the existing literature and to evaluate the existing data showing the efficacy and the limitation of a treatment strategy based on this promising molecule. ALA is a valid therapeutic strategy applicable in the treatment of PCOS patients: Its multiple actions, including antinflammatory, antioxidant, and insulin-sensitizing, may be of utmost importance in the treatment of a very complex syndrome. Specifically, the combination of MYO plus ALA creates a synergistic effect that improves insulin resistance in PCOS patients, especially in obese/overweight patients with T2DM familiarity. Moreover, ALA treatment also exerts beneficial effects on endocrine patterns, especially if combined with MYO, improving menstrual regularity and ovulation rhythm. The purpose of our study is to review the existing literature and to evaluate the data showing the efficacy and the limitations of a treatment strategy based on this promising molecule.

Investigation of the relationship between glucose potassium ratio and insulin resistance in polycystic ovary syndrome infertile women

Aim: The aim of this study was to evaluate the relationships between glucose potassium (Glu/K+) ratio and insulin resistance (IR) in infertile women with polycystic ovary syndrome (PCOS). It is necessary to identify a new diagnostic parameter such as Glu/K+ ratio for IR in PCOS patients.
 Methods: A total of 198 reproductive-aged women were included in this retrospective case–control study. Women aged 20-39 years diagnosed with infertility and PCOS constituted the PCOS group. Women who were diagnosed with infertility but not PCOS formed the control group. 
 Result: The participants’ age and body mass index (BMI) were 30.31±4.68 and 26.53±4.80, respectively. Fasting blood glucose was found to be higher in those with a diagnosis of PCOS (p

Serum asprosin levels are increased and associated with insulin resistance in patients with polycystic ovary syndrome: A retrospective case-control study.

Dysregulation of adipokines may play a role in the development of polycystic ovary syndrome (PCOS). This was a retrospective case-control study to investigate the relationship between asprosin and insulin resistance in patients with PCOS patients. The study enrolled 213 PCOS patients and 213 age-matched and body mass index-matched controls. The serum asprosin levels and the relationship between asprosin and PCOS with IR were compared between the 2 groups. In the current study, it was found that the serum asprosin level and hemostasis of model assessment-insulin resistance of PCOS were significantly higher than those of the control group, and asprosin was independently correlated with hemostasis of model assessment-insulin resistance and CRP (P < .05). Asprosin was found to be statistically significant in the analysis of receiver operating characteristics, and the specific result was 0.826 (0.724-0.879). This study emphasizes that increased levels of asprosin are independently associated with PCOS, and asprosin may be a new indicator for evaluating insulin resistance in PCOS patients.

The Value of Insulin Resistance indices For detecting Insulin Resistance in Polycystic Ovarian Syndrome Patients

Polycystic Ovarian Syndrome (PCOS) is characterized by increased ovarian and androgen hormone secretion. Patients with PCOS are said to be at high risk for insulin resistance(IR). IR is a sign of PCOS that comprises impaired glucose tolerance and elevated insulin production. HOMA-IR is a test that assesses insulin resistance by measuring blood glucose and insulin levels. There are other indexes that are also available for determining IR such as the quantitative insulin sensitivity check index(QUICKI) and McAuley index. Hence, in this study HOMA-IR, QUICKI and McAuley index were used to determine the IR among PCOS individuals. This case-control cross sectional study included 62 participants between the age group of 20-40 years. They were divided into two groups such as Group B which includes 31 PCOS patients diagnosed based on Rotterdam criteria and Group A includes 31 healthy age-matched female participants. After obtaining informed consent, fasting blood sample was collected from all the participants. Based on the analyzed biochemical parameters IR was assessed using HOMA-IR, QUICKI and McAuley index. For statistical analysis student t-test, ROC curve and bivariate regression analysis were done. In this study, it is observed that an increase in BMI was at a higher risk of developing PCOS. It is seen that fasting glucose, insulin and lipid profile (except HDL-C) were significantly elevated in PCOS individuals. The HOMA-IR was significantly increased and QUICKI and McAuley’s index were significantly decreased in PCOS which shows that PCOS patients are at higher risk of developing IR. Crude odds were calculated which shows that increase in HOMA-IR levels has an 86.25% increase risk of developing IR in PCOS patients when compared with the other indexes.HOMA-IR has a higher predictor % of developing IR in PCOS individuals, but still QUICKI and McAuley index can also be used as a predictor of risk.

Study regarding the interrelation between subclinical hypothyroidism &amp; insulin resistance among PCOS women

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder (5-10%) in women of reproductive age. It is characterized by clinical and biochemical hyperandrogenism, menstrual irregularities, infertility and metabolic syndrome. Hypothyroidism is more common in PCOS. Subclinical hypothyroidism may aggravate insulin resistance. Objective: To find any relationship between subclinical hypothyroidism and Insulin resistance in PCOS patients. Materials and Methods: Study Design: A hospital based cross sectional study, Study Subjects: PCOS cases fulfilling the inclusion and exclusion criteria, SAMPLE SIZE: 100 PCOS cases attending to Gynaecology OPD, Study Setting: Gynaecology OPD of a Medical College hospital, Study Duration: January 2015 to August 2016. This included all PCOS patients, who had the criteria of Rotterdam for PCOS. Clinical examination, height, weight, BMI and lab data were measured including thyroid hormone and biochemical profile. Data were analysed by SPSS software version 21. Results: Out of 100 study subjects 52 were Euthyroid (TSH &lt; 5) and 48 were SCH (TSH ≥ 5). Fasting serum Insulin, and HOMA IR were significantly elevated in SCH group compared to Euthyroid group (p = &lt; 0.05.).

Putative Complementary Compounds to Counteract Insulin-Resistance in PCOS Patients.

Polycystic ovary syndrome (PCOS) is the most frequent endocrine-metabolic disorder among women at reproductive age. The diagnosis is based on the presence of at least two out of three criteria of the Rotterdam criteria (2003). In the last decades, the dysmetabolic aspect of insulin resistance and compensatory hyperinsulinemia have been taken into account as the additional key features in the etiopathology of PCOS, and they have been widely studied. Since PCOS is a complex and multifactorial syndrome with different clinical manifestations, it is difficult to find the gold standard treatment. Therefore, a great variety of integrative treatments have been reported to counteract insulin resistance. PCOS patients need a tailored therapeutic strategy, according to the patient’s BMI, the presence or absence of familiar predisposition to diabetes, and the patient’s desire to achieve pregnancy or not. The present review analyzes and discloses the main clinical insight of such complementary substances.

Bone morphogenetic protein-9 maybe an important factor which improves insulin resistance in PCOS

Background Polycystic ovary syndrome (PCOS) is closely related to insulin resistance (IR). Bone morphogenetic protein-9 (BMP-9) plays an important role in maintaining glucose homeostasis, but an association between BMP-9 and PCOS has not been reported. Here, we report the changes in BMP-9 and the influence of this protein on IR in PCOS. Methods 57 PCOS patients were selected (among them 25 received interventional treatment with exenatide (EX) for 3 months, and 32 received no treatment). 22 normal control individuals and 30 IR patients were also recruited. We evaluated IR with the euglycaemic-hyperinsulinaemic clamp (EHC) technique. IR and the glucose metabolism rate were assessed by EHC and [3-3H]glucose tracer experiments. We determined the protein expression levels of BMP-9, p-AKT (protein kinase B) and androgen receptor in the ovaries and liver by Western blotting. Results We found that circulating BMP-9 levels were significantly decreased in PCOS with IR patients. Circulating BMP-9 levels and p-AKT levels were decreased in HFD and PCOS rats and increased after MF and EX treatment. The glucose infusion rate, glucose disappearance rate and suppression of hepatic glucose production decreased in the HFD and PCOS groups, the opposite results were found for HGP. AR protein expression levels increased in the HFD and PCOS groups and decreased in the MF and EX groups. Conclusions Our study results suggest that BMP-9 is an independent factor that influences IR in PCOS patients. The decrease in BMP-9 levels in the liver and ovaries may be involved in IR through the PI3K/AKT signaling pathway in PCOS rats.

The Apolipoprotein B/A1 Ratio is Associated With Metabolic Syndrome Components, Insulin Resistance, Androgen Hormones, and Liver Enzymes in Women With Polycystic Ovary Syndrome.

AimTo evaluate the association between the apolipoprotein B/A1 ratio (ApoB/ApoA1) and metabolic and endocrine parameters in women with polycystic ovary syndrome (PCOS).MethodsThis study was a secondary analysis of the Acupuncture and Clomiphene for Chinese Women with Polycystic Ovary Syndrome trial (PCOSAct), and 957 subjects with available ApoB and ApoA1 measurements were included. Tests for linear trends and linear regression were used to assess the relation between the ApoB/ApoA1 ratio and metabolic and endocrine parameters. Logistic regression was used to estimate the association between the ratio and risk of metabolic syndrome (MetS) and insulin resistance (IR). The receiver operating characteristics (ROC) curve was used to determine the predictive value of the ApoB/ApoA1 ratio for MetS and IR.ResultsThe results showed that the ApoB/ApoA1 ratio was positively associated with waist circumference, systolic blood pressure, total cholesterol, triglycerides, low-density lipoprotein, fasting plasma glucose, fasting insulin, homeostatic model assessment-insulin resistance, high free testosterone, high free androgen index, alanine transferase, aspartate transferase, and higher prevalence of MetS and IR, but was negatively correlated with high-density lipoprotein and sex hormone-binding globulin after adjusting for age and body mass index. Logistic regression showed that compared with the ApoB/ApoA1 ratio in first quartile, those in the fourth quartile demonstrated a higher risk of MetS (OR: 24.48, 95%CI: 8.54–70.15, P trend <0.001) and IR (OR: 1.78, 95%CI: 1.10–2.87, P trend <0.05) after adjusting for confounding factors. ROC curve results showed that the AUCMetS was 0.84 (95%CI: 0.81–0.86) and had 86.8% sensitivity and 70.3% specificity with a threshold value of 0.64, and the AUCIR was 0.68 (95%CI: 0.64–0.71) and had 74.3% sensitivity and 58.2% specificity with a threshold value of 0.56.ConclusionsIncreased ApoB/ApoA1 ratio was associated with worse MetS components, IR, and elevated androgen hormones and liver enzymes. The ratio might be a useful tool to screen for MetS and IR in PCOS patients.

Role of Seed Cycling in Polycystic Ovaries Syndrome

Poly-cystic ovarian syndrome (PCOS) is described as an endocrine disorderliness emerging from hormonal inequality and low form of inflammation. PCOS is a metabolic syndrome which includes complex medical treatments which are expensive and has many side effects. The purpose of review is to extract a literature that proves that diet has significant role in treatment of PCOS. After going through the published literature and initially 150 articles were included, which were after reducing 98 the duplicates, 22 irrelevant diseases were excluded. However, title and abstract 30-full text articles were eligiblewere relevant to topic role of seeds cycling containing omega 3 fatty acids on Pcos.Different review papers which contained data the role of different seeds i.e. flax seeds,sesame seeds,pumpkin seeds,sunflower seeds seperately then we came to conclusion that n-3 fatty acids were the main component among these seeds from plant sources which improves hormonal disturbances and insulin resistance in PCOS patients. This review literature is assessed from the precious data from Medline/PubMed, google scholar until November 2020. The present review is aimed to investigate the influence of n-3 fatty acid in balancing hormones, testosterone, luteinizing hormone (LH) and insulin levels.

Decreased serum profile of the interleukin-36α in polycystic ovary syndrome

ObjectiveThe aim of this study was to determine the serum adiponectin and interleukin-36 alpha (IL-36α) levels in polycystic ovary syndrome (PCOS), and their relationship with obesity. Materials and methodsThis observatory study included 80 PCOS patients and 58 controls. The clinical, biochemical, and hormonal parameters, and serum adiponectin and IL-36α levels of the patients were evaluated. ResultsThe serum IL-36α levels of the PCOS patients were significantly lower when compared to the control group, despite a similar mean body mass index (BMI) (P = 0.000). The adiponectin levels were significantly lower in the obese PCOS group when compared to the obese control group (P = 0.03). The plasma IL-36α level was positively correlated with adiponectin level, but negatively correlated with the serum LH level (P = 0.000 and P = 0.004, respectively). Using receiver operating characteristic analysis, the cut-off value of IL-36α was calculated as 0.815 for PCOS. In the multiple binary logistic regression analysis, IL-36α (OR [95% CI] 0.432 [0.303, 0.616], P < 0.001) and adiponectin (OR [95% CI] 1.044 [1.005, 1.084], P = 0.028) were determined to be significantly associated with PCOS. ConclusionA reduced IL-36α level may play a role in the pathogenesis of ovulatory disfunction and insulin resistance in PCOS patients. Further studies are needed to understand the pathogenic and clinical significance of the IL-36 system in PCOS.

Effects of atorvastatin on the insulin resistance in women of polycystic ovary syndrome: A systematic review and meta-analysis.

Background:Atorvastatin treatment has been suggested as a therapeutic method for women with polycystic ovary syndrome (PCOS) in many clinical studies. Nonetheless, the effects of atorvastatin on insulin resistance in PCOS patients still remain controversial.Objective:The aim of this report was to evaluate the effects of atorvastatin therapy on the insulin resistance in the treatment of PCOS compared to that of placebo, in order to confer a reference for clinical practice.Methods:Randomized controlled trials (RCTs) of atorvastatin for PCOS published up to August, 2020 were searched. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated, and heterogeneity was measured by the I2 test. Sensitivity analysis was also carried out. The outcomes of interest were as follows: fasting glucose concentration, fasting insulin level, homeostasis model assessment of insulin resistance (HOMA-IR) or body mass index (BMI) value.Results:Nine RCTs with 406 participants were included. The difference of fasting glucose concentration in PCOS patients between atorvastatin group and placebo group was not statistically significant (8 trials; SMD −0.06, 95% CI −0.31 to 0.20, P = .66). PCOS patients in atorvastatin group had lower fasting insulin level than those in placebo group (7 trials; SMD −1.84, 95% CI −3.06 to −0.62, P < .003). The homeostasis model assessment of insulin resistance (HOMA-IR) value showed significant decrease in the atorvastatin therapy compared to placebo (6 trials; SMD −4.12, 95% CI −6.00 to −2.23, P < .0001). In contrast to placebo, atorvastatin therapy did not decrease the BMI value significantly in PCOS patients (7 trials; SMD 0.12, 95% CI −0.07 to 0.31, P = .22).Conclusions:Atorvastatin therapy can reduce insulin resistance in the treatment of patients with PCOS. In addition, further large-sample, multi-center RCTs are needed to identify these findings.

Evaluation of the Efficacy of Sex Hormone-Binding Globulin in Insulin Resistance Assessment Based on HOMA-IR in Patients with PCOS.

This study aimed to evaluate the efficacy of SHBG in predicting insulin resistance (IR) in newly diagnosed, untreated patients with polycystic ovary syndrome (PCOS). Hundred newly diagnosed, untreated patients with PCOS and 61 subjects without PCOS (41 healthy volunteers with normal BMI and 20 subjects with overweight/obese) were included in the study. Receiver-operating characteristic (ROC) analysis was used to assess the effectiveness of SHBG in predicting IR in overweight/obese and non-overweight PCOS patients and the optimal cut-off values of SHBG. The results showed negative correlations between log-SHBG and log-I0 (r = - 0.372, P < 0.001) and log-SHBG and log-Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (r = - 0.393, P < 0.001) after adjusting for blood pressure, serum lipid, age, and body mass index (BMI) in all of the PCOS patients. In patients with IR (defined as HOMA-IR ≥2.29), the area under the ROC curves (AUCs) of the SHBG for ROC analysis in the non-overweight group, overweight/obese group, and all PCOS patients were 0.774 (P = 0.0001), 0.922 (P = 0.0001), and 0.885 (P = 0.0001), respectively. The optimal cut-off value of SHBG was 37 nmol/L with a sensitivity of 97.62% and specificity of 80.85% in the overweight group. In patients with IR (HOMA-IR ≥2.5), the AUCs of SHBG for ROC analysis in the non-overweight group, overweight/obese group, and all PCOS patients were 0.741 (P = 0.0003), 0.928 (P = 0.0001), and 0.880 (P = 0.0001), respectively. The optimal cut-off value of SHBG was 30.2 nmol/L with a sensitivity of 97.44% and specificity of 82.69% in the overweight/obese group. In conclusion, this study observed a negative correlation between SHBG and HOMA-IR in PCOS patients after adjustment of confounding factors. SHBG was an independent influential factor of HOMA-IR and can be used as a positive predictive marker for IR in PCOS patients, especially in those who are overweight/obese.

Waist-to-height ratio and BMI as predictive markers for insulin resistance in women with PCOS in Kolkata, India

Polycystic ovarian syndrome (PCOS) is most commonly presented with insulin resistance (IR). Simple anthropometric indices may serve as surrogate markers of these conditions with population-based cut-off values. The present study suggests the cut-off values of waist-to-height ratio (WHtR) and body mass index (BMI) in early prediction of PCOS and IR in PCOS women based in Kolkata, a major metropolitan city in India. This cross-sectional study included 66 women (aged 16-30 years) from Kolkata, India, with confirmed PCOS, using Rotterdam criteria. IR was defined following the homeostasis model assessment (HOMA). Anthropometric and biochemical data were obtained using standard protocol and compared among the PCOS subjects grouped as per IR prevalence, BMI, and WHtR values. The receiver operating characteristics (ROC) curve was applied to evaluate and compare the cut-off values of WHtR and BMI in the prediction of PCOS and IR in women with PCOS. As per ROC analysis, WHtR showed significantly higher AUC in the detection of PCOS and IR in PCOS subjects respectively, than that of BMI. The cut-off values of WHtR and BMI for PCOS were 0.560 and 28.47 respectively, and for IR in PCOS patients, were 0.620 and 29.14 respectively. The present study suggests a cut-off value of WHtR to be used as an inexpensive and noninvasive screening tool for early prediction of PCOS and IR among PCOS afflicted women based in Kolkata, India and for this prediction, the study also claims WHtR as a better index than BMI.

Polycystic Ovary Syndrome: Dietary Approaches to Counteract Insulin Resistance

Background: Polycystic ovary syndrome (PCOS) is a prevalent hormonal disorder connected to ovulatory infertility and recent research indicates that different diets alter the risk of developing PCOS. Insulin resistance (IR) is one of the key pathologies which classifies PCOS. Understanding the etiology leading to IR in PCOS patients and the disorders associated with IR can allow for a therapeutic measure to be put in place to counteract the etiology and even reduce the risk of developing the disorder. Objective: The objective of this review is to identify the key factors that lead to IR so that diet and other lifestyle aspects can be used to counteract PCOS Symptoms.Design: A total of 679 studies were taken into consideration for this review, however, I performed a literature review of 75 primary papers. Data and findings from these studies were used to gain a better understanding of the dietary etiology of IR in PCOS, and this information can be used to describe a specific diet to counteract its etiology.Results: Many symptoms and disorders in the biological pathway of PCOS is associated with IR. Clinical studies have established that an increase in carbohydrates, low-density lipoproteins, and triglycerides is associated with IR in PCOS patients. Similar studies have found that a decrease in dietary proteins (especially branched chain amino acid intake), lactate, phosphatidylcholine, high-density lipoproteins, and long-chain fatty acids are also associated with PCOS patients. The drug metformin has also been associated with ameliorating many of the negative impacts imposed by IR in PCOS patients. Addressing these factors and changing diet and lifestyle (such as increased exercise) can help reduce the IR-related effects in PCOS patients.

Study the C/T Single Nucleotide Polymorphism at Tyrosine Kinase Domain of Insulin Receptor Gene in Patients with Polycystic Ovary Syndrome in Babylon Province

Polycystic ovary syndrome (PCOS) is the commonest gynecological endocrinopathy, is characterizedby chronic anovulation and hyperandrogenism and is also associated with increase insulin secretion andmetabolic disease and insulin resistance. Present study aims to examine the association between the singlenucleotide polymorphism (rs1799817) of exon 17 of the insulin receptor (INSR) gene and polycystic ovarysyndrome (PCOS) in a Babylon women. Fifty women with PCOS and fifty healthy Iraqi women, age andBMI matching were achieved between study groups. Biochemical parameters that estimated were fastingglucose, fasting insulin, luteinizing hormone, testosterone. His 1058 C/T polymorphism at the tyrosinekinase domain in the INSR gene was analyzed by restriction fragment length polymorphism (RFLPPCR). Significant increase in the levels of fasting glucose fasting insulin, HOMA-IR, LH, testosteronewere noticed in patient when compared with control. TT genotype frequency was higher in PCOS patientswhereas CC genotype was higher in control women. All parameters that estimate in this study were higherin TT genotype of patient group. In conclusion there are an association of C/T polymorphism at His1058 ofINSR in patients women with PCOS in Babylon Province. Insulin resistance in PCOS patients might differfrom these that result from obesity.

Chemerin level in a sample of Egyptian females with PCOS and its relation to insulin resistance

BackgroundChemerin a novel adipokine is linked to insulin resistance and adiposity which are major characteristics of polycystic ovary syndrome (PCOS).ResultsChemerin level was found to be significantly higher in PCOS group than in control group (94.99 ± 12.52 ng/dl vs 73.41 ± 6.95 ng/dl) (P < 0.001) being the highest in obese PCO group, also chemerin positively correlated with BMI, fasting insulin, and HOMA-IR (P < 0.001), Multivariate linear regression analysis for factors affecting chemerin level in both PCO groups showed that the most important factor was fasting insulin (P = 0.042).ConclusionChemerin correlates with insulin resistance and may be involved in the pathogenesis of insulin resistance in PCOS patients.

The relation of visceral adiposity index and lipid accumulation product with metabolic, anthropometric, and hormonal parameters in patients with polycystic ovary syndrome

Amaç: Polikistik over sendromu (PKOS) üreme çağında en sık görülen endokrinopati olup santral obezite, glukoz intoleransı, dislipidemi ve hipertansiyon ile ilişkilidir. Visseral adipozite indeksi (VAI) ve lipid birikim ürünleri (LAP) insülin duyarlılığı dışında kardiyovasküler ve serebrovasküler olaylar ile de ilişkili olduğu saptanmıştır. Bizler de, bu çalışmamızda PKOS ve kontrol grubu hastalarımızda VAI ve LAP ile metabolik, antropometrik ve hormonal parametreler arasındaki ilişkileri değerlendirdik. Yöntemler: Çalışmaya 18-35 yaş aralığında 106’sı Rotterdam kriterlerine göre PKOS grubunda olmak üzere toplam 172 hasta dahil edildi. Diabetes mellitus, Cushing sendromu, hiperprolaktinemi, konjenital adrenal hiperplazi, hipertansiyon ve tiroid bozukluğu olan hastalar çalışmaya dahil edilmedi. LAP ve VAI indekslerinin hesaplanması için HDL ve trigliserid düzeylerine bakıldı. Bulgular: PKOS’lu hasta grubunda LAP ile HDL-C (r=-0,644) arasında anlamlı negatif korelasyon saptanırken, trigliserid (r=0,706) ve kalça çevresi (r=0,872) arasında pozitif korelasyon saptandı. Yine VAI ile bel çevresi (r=0,625) ve HOMA-IR (r=0,462) arasında pozitif korelasyon saptandı. Sonuç: Bu çalışmada PKOS hasta grubunda VAI’nın insülin direncini belirlemede yararlı bir indeks olduğu sonucuna varıldı.

Phenotype and genotype of polycystic ovary syndrome in Asia: Ethnic differences.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women, and ethnic diversity has been reported in its manifestation. This review addressed phenotype and genetic studies in Asian women with PCOS. Generally, East Asians are less hirsute, and the hirsutism score cutoff is lower than the Caucasian counterpart. It is not clear whether there are any significant differences in the prevalence or severity of irregular menstruation (IM) or characteristics of polycystic ovary (PCO) across ethnicities. Interestingly, the IM/PCO subgroup is a relatively common phenotype in East Asian patients but not in Caucasian patients. The prevalence of insulin resistance in PCOS patients varies depending on the index used and the cutoff, but women with PCOS showed a higher degree of insulin resistance than those of controls across ethnicities. Lower body mass index (BMI) and lower prevalence of metabolic syndrome were reported in East Asian patients, but despite lower BMI, a comparative study reported that Asian women with PCOS were more likely to have diabetes compared with Caucasian patients, suggesting they also have metabolic complications. Unlike East Asian patients, South Asian patients showed an increased degree of hirsutism, early onset of symptoms, and severe insulin resistance and metabolic risks compared with Caucasians. Genetic components play important roles in the pathogenesis of PCOS, and genome-wide association studies of PCOS suggest that similar genetic risk factors exist between Asian and Caucasian patients. Continuous comparative studies are needed to standardize the diagnosis and management of PCOS across different ethnicities.