scholarly journals A COMPARATIVE STUDY OF INSULIN RESISTANCE IN PATIENTS OF POLYCYSTIC OVARY SYNDROME

2021 ◽  
Vol 71 (5) ◽  
pp. 1746-50
Author(s):  
Amena Arif ◽  
Palvasha Waheed ◽  
Robina Anees ◽  
Amir Rashid ◽  
Saleem Ahmed Khan

Objective: To assess the relationship between obesity and insulin resistance in polycystic ovary syndrome affected women. Study Design: Cross sectional comparative study. Place and Duration of Study: Multidisciplinary Lab-I of Department of Biochemistry, Army Medical College, Rawalpindi, in collaboration with Pakistan Naval Ship Hafeez Hospital, Islamabad from Feb 2018 to Jan 2019. Methodology: One hundred and five selected females (puberty till 25 years of age) were divided into three groups of 35 each. Blood samples were collected an overnight fast (from 8-11 AM). Serum level of insulin was measured and insulin resistance was calculated based on HOMA-IR. Results: HOMA-IR concentrations correlated directly with Basal Metabolic Index, fasting plasma glucose and serum insulin levels. Mean serum insulin level was also elevated in patients with polycystic ovary syndrome (normal weight & overweight) as compared to control subjects (7.4 ± 1.2 mIU/L & 9.1 ± 0.8 mIU/L vs 6.3 ± 1.1 mIU/L; p as 0.003). The insulin resistance was slightly higher in patients with polycystic ovary syndrome as compared to the control subjects (1.4 ± 0.3 & 1.7 ± 0.2 vs. 1.1 ± 0.3; p<0.001). Conclusion: HOMA-IR levels are positively associated with BMI, the intensity of peripheral insulin resistance in polycystic ovary syndrome-affected females, indicating that normal weight, and overweight patients with polycystic ovary syndrome have tendency towards insulin resistance.

2018 ◽  
Vol 1 (1) ◽  
pp. 72-81
Author(s):  
Mehmet CALAN ◽  
Merve Bicer ◽  
Murat Alan ◽  
Pinar Alarslan ◽  
Asli Guler ◽  
...  

Alarin is a newly identified peptide hormone. It is implicated that alarinplays roles in regulation of energy metabolism and hypothalamo-pituitary-gonadal axis. Polycystic Ovary Syndrome (PCOS) is a common reproductive and metabolic disease in women during reproductive ages. Over-secretion of Luteinizing Hormone (LH) causes hyperandrogenism in women with PCOS. The purpose of the study was to determine the comparison of alarin levels in women with or without PCOS as well as to investigate the relationship between alarin and LH. Eighty-four women with PCOS and 84 age- and BMI- matched controls were recruited in this cross-sectional study. Circulating alarin levels were assessed via ELISA method. The hormonal and metabolic parameters of the recruited subjects were also determined. The circulating levels of alarin in PCOS subjects were higher than controls (6.11 ± 1.91 vs. 3.93 ± 1.60 ng/ml, P <0.001). Alarin showed a positive correlation with insulin resistance marker, BMI, LH and androgens. Moreover, alarin levels were elevated in women with PCOS having insulin resistance compared to those PCOS women without insulin resistance. In both control and PCOS groups, overweight subjects showed an elevation in circulating levels of alarin with respect to normal weight subjects. In the present study, Alarin level with the highest tertile dosage comparing to alarin level with the lowest tertile dosage could highly increase the probability of PCOS risk prevalence in women. Elevated alarin levels in women with PCOS were associated with not only LH and metabolic parameters but also high probability of having PCOS risk independently.


2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110317
Author(s):  
Chenyun Miao ◽  
Qingge Guo ◽  
Xiaojie Fang ◽  
Yun Chen ◽  
Ying Zhao ◽  
...  

Objective This meta-analysis evaluated the effect of probiotics and synbiotics on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods A systematic search was performed to identify all relevant publications listed on the electronic databases (PubMed®, Web of Science, Embase® and China National Knowledge Infrastructure) between inception and 30 October 2020. All statistical analyses were performed on randomized controlled trials (RCTs) using RevMan version 5.3 software provided by the Cochrane Collaboration. Results A total of 486 patients from seven RCTs were included in the meta-analysis. Probiotic and synbiotic supplementation appeared to improve levels of homeostatic model assessment of insulin resistance (mean difference = –0.37; 95% confidence interval –0.69, –0.05) and serum insulin (standardized mean difference = –0.66; 95% confidence interval –1.19, –0.12). The results failed to show any influence of probiotic and synbiotic supplementation on body mass index, waist circumference, hip circumference and fasting blood sugar. Conclusions Probiotics and synbiotics appear to have a partially beneficial effect on indices of insulin resistance in patients with PCOS.


Author(s):  
Daniel A Dumesic ◽  
Ayli Tulberg ◽  
Megan McNamara ◽  
Tristan R Grogan ◽  
David H Abbott ◽  
...  

Abstract Context Increased aldo-keto reductase 1C3 (AKR1C3)-mediated conversion of androstenedione (A4) to testosterone (T) promotes lipid storage in subcutaneous (SC) abdominal adipose in overweight/obese polycystic ovary syndrome (PCOS) women. Objective To examine whether an elevated serum T/A4 ratio, as a marker of enhanced AKR1C3 activity in SC abdominal adipose, predicts metabolic function in normal-weight PCOS women. Design Prospective cohort study. Setting Academic center. Patients Nineteen normal-weight PCOS women; 21 age- and body mass index-matched controls. Intervention(s) Circulating hormone/metabolic determinations, intravenous glucose tolerance testing, total body dual-energy x-ray absorptiometry, SC abdominal fat biopsy. Main Outcome Measure(s) Serum T/A4 ratios, hormone/metabolic measures and AKR1C3 expression of adipocytes matured in vitro were compared between female types; serum T/A4 ratios were correlated with serum lipids, adipose insulin resistance (adipose-IR), homeostatic model assessment of insulin resistance (HOMA-IR) and insulin sensitivity (Si). Results Increased serum T/A4 ratios (P=0.040) and log adipose-IR values (P=0.002) in PCOS women versus controls were accompanied by AKR1C3 mRNA overexpression of PCOS adipocytes matured in vitro (P=0.016). Serum T/A4 ratios in PCOS women, but not controls, negatively correlated with log triglycerides (TG: R=-0.65, P=0.002) and the TG index (R=-0.57, P=0.011). Adjusting for serum free T, serum T/A4 ratios in PCOS women remained negatively correlated with log TG (R=-0.57, P=0.013) and TG index (R=-0.50, P=0.036), respectively, without significant relationships with other metabolic measures. Conclusion An elevated serum T/A4 ratio, as a marker of enhanced AKR1C3 activity in SC abdominal adipose, predicts healthy metabolic function in normal-weight PCOS women.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Luis Hoyos ◽  
Karen Leung ◽  
Tristan Grogan ◽  
David Abbott ◽  
Gregorio Chazenbalk ◽  
...  

Author(s):  
Cristina Benetti-Pinto ◽  
Vanessa Piccolo ◽  
Daniela Yela ◽  
Heraldo Garmes

Objective This study analyzed the effectiveness of the thyroid-stimulating hormone (TSH) as a predictor of insulin resistance (IR) and its association with the clinical and metabolic parameters of women with polycystic ovary syndrome (PCOS) without overt hypothyroidism. Study Design A cross-sectional study was performed. Women with PCOS and without overt hypothyroidism (n = 168) were included. Methods Receiver operating characteristic (ROC) curve was used to determine the cut-off point for TSH that would maximize sensitivity and specificity for a diagnosis of IR using homeostatic model assessment of insulin resistance (HOMA-IR) ≥ 2.71. Clinical and metabolic parameters were compared as a function of the TSH cut-off limit and the presence of IR. Results Thyroid-stimulating hormone ≥ 2.77 mIU/L was associated with a diagnosis of IR, with sensitivity of 47.9% and specificity of 65.3%. There were no differences in clinical, hormonal or metabolic parameters between TSH < 2.77 and TSH of 2.77 – 10 mIU/L. Conclusion In women with PCOS without overt hypothyroidism, TSH ≥ 2.77 mIU/L is associated with IR; however, with poor sensibility, showing TSH to be a poor predictor of IR in this population. No clinical or metabolic alterations were found that would justify a change in clinical management. Thus, the IR should be investigated in all women with PCOS irrespective of TSH level.


2009 ◽  
Vol 1 (2) ◽  
pp. 22-25
Author(s):  
Ferdousi Begum

ABSTRACT Objectives The objectives of the study were to find out the clinical features, biochemical and hormonal profile of patients with polycystic ovary syndrome (PCOS) in Bangladesh. Material and Methods A case control and cross-sectional study was undertaken among 78 PCOS patients attending infertility clinic and 33 controls at BIRDEM Hospital, Dhaka. Inclusion criteria for cases were oligo/amenorrhea, transvaginal sonography suggesting PCO and/ or features of hyperandrogenemia with exclusion of other causes. Controls were women with regular menstrual cycle. Results Age and height of cases and controls were similar. BMI >25 was 67% among cases and 19% among controls (P<0.001); waist hip ratio >0.8 was 64% among cases and 29% among controls (P<0.001). Mean BMI of cases was 28.2 + 4.5 and that of cases was 21.05 + 4.1; mean fasting glucose among cases was 5.93 + 1.08 and among controls was 4.4 + 1.11 mmol/L (P<0.01); mean fasting serum insulin level was 32.15+ 12.13 among cases was 11.32 +10.02 ìU/ml among controls(P<.001); insulin resistance (fasting HOMA-IR>6.8) was 42.32% in cases and 12% in control (P<.001). Patients with PCOS had following clinical and biochemical parameters: oligomenorrhea- 74%, amenorrhea- 26%, mean Ferriman-Galaway score -19.89 + 5.06. At day 3 of menstrual cycle meanserum LH was 12.79+7.1 mmol/L, serum FSH was 5.23 + 2.5 miu/ml and serum prolactin was 415.15+180.5 mmol/L; 30% had biochemical hyperandrogenemia. Conclusions PCOS patient in Bangladesh are usually overweight, hirsute (grade I and II), hyperandrogenemic, insulin resitant and have altered LH to FSH ratio.


1997 ◽  
Vol 82 (6) ◽  
pp. 1697-1700 ◽  
Author(s):  
Juha Rouru ◽  
Leena Anttila ◽  
Pertti Koskinen ◽  
Tuula-Anneli Penttilä ◽  
Kerttu Irjala ◽  
...  

Abstract The role of gonadotropins, androgens, and insulin in the regulation of circulating leptin levels is obscure. In order to clarify the relationships of these parameters we studied serum leptin levels in 19 healthy control subjects and in 35 hyperandrogenic and hyperinsulinemic patients with polycystic ovary syndrome (PCOS). Serum leptin concentrations did not differ significantly between PCOS patients and control subjects. When PCOS and control groups were analyzed together by univariate analysis, serum leptin was positively correlated with body mass index (BMI), body weight, serum insulin, serum triglyceride, and serum free testosterone concentrations. Serum leptin was inversely correlated with serum sex hormone binding globulin (SHBG) concentrations. There were no significant correlations between serum leptin and testosterone, androstenedione, or gonadotropin concentrations. Serum insulin, triglyceride, and free testosterone concentrations were positively correlated, and serum SHBG was negatively correlated with BMI. However, when BMI on one hand and serum insulin, triglyceride, free testosterone, or SHBG on other hand were used as independent variables in the partial correlation analysis with leptin, BMI turned out to be the variable primarily responsible for all of the correlations with leptin. In conclusion, the concept that circulating leptin levels would be different in PCOS patients than in regularly menstruating control subjects is not supported by our data.


2009 ◽  
Vol 64 (6) ◽  
pp. 388-389 ◽  
Author(s):  
Iris J. G. Ketel ◽  
Coen D. A. Stehouwer ◽  
Erik H. Serné ◽  
Ted J. M. Korsen ◽  
Peter G. A. Hompes ◽  
...  

2019 ◽  
Vol 9 (1-s) ◽  
pp. 433-436 ◽  
Author(s):  
Mudasir Maqbool ◽  
Mohmad Amin Dar ◽  
Imran Gani ◽  
Mohammad Ishaq Geer

Polycystic Ovary Syndrome (PCOS) is the most common, yet complex, endocrine disorder affecting women in their reproductive years and is a leading cause of infertility. This disease appears to be multifactorial and polygenic in nature involving multisystem dysfunction, namely reproduction, endocrine and metabolic. Hyperandrogenism and insulin resistance appear to be central cause to the pathophysiology of the disease. The glucose and insulin metabolism pathways have been studied and debated to understand whether Insulin Resistance is due to a defect in insulin action or a primary defect in β-cell function or decreased hepatic clearance of insulin, or a combination of all these factors. Numerous studies have demonstrated that obese, normal weight and thin women with PCOS have a form of insulin resistance that is unique and intrinsic to the disorder. Moreover obese women with PCOS possess an additional burden of insulin resistance resulting from their excess adiposity. Hyperinsulinemia leads to increase in androgen production directly by acting as a co-gonadotropin, augmenting Luteinizing Hormone activity within the ovary, and indirectly by increasing serum LH pulse amplitude. Whereas Androgens may in turn contribute at least partially to the insulin resistance state linked with PCOS.  In this review, we will briefly study the role of insulin resistance in polycystic ovary syndrome. Keywords: Polycystic ovary syndrome, insulin resistance, Hyperandrogenism.


2020 ◽  
Author(s):  
Asma Kheirollahi ◽  
Maryam Teimouri ◽  
Mehrdad Karimi ◽  
Nariman Moradi ◽  
Asie Sadeghi ◽  
...  

Abstract Background: Insulin resistance has a key role in the pathophysiology of polycystic ovary syndrome (PCOS). Previous investigations have informed that some lipid ratios could be a simple clinical indicator of insulin resistance (IR) in some disorders and ethnicities. We aimed to examine the correlation between triglyceride to HDL-cholesterol (TG/HDL-C), total cholesterol to HDL-cholesterol (TC/HDL-C) and fasting triglyceride-glucose (TyG) indices with IR (as measured by homeostasis model assessment of IR [HOMA-IR], quantitative insulin sensitivity check index [QUICKI] and fasting glucose to insulin ratio [FGIR]), and determine a good clinical predictor for IR in Iranian PCOS woman. Methods: We evaluated 305 PCOS women. After physical evaluations, biochemical parameters were measured using commercial kits and TG/HDL-C, TC/HDL-C and TyG indices were calculated using formula. Fasting insulin level measured using ELISA technique. IR was defined as a HOMA-IR value ≥2.63, FG-IR<8.25 and QUICKI <0.33. Results: The insulin-resistance and insulin-sensitive groups, which established by HOMA-IR, FG-IR and QUICKI values, were different in terms of TG/HDL-C, TC/HDL-C and TyG indices. These indices were associated with IR after adjusting for age and BMI. The under ROC curves (AUC) of TyG, TG/HDL-C and TC/HDL-C for predicting HOMA-IR index were 0.639, 0.619 and 0.623 respectively which were significant, with a p-value 0.012, 0.033 and 0.027, respectively. The AUC of TC/HDL-C (0.614) was significant (p-value 0.04) for predicting FG-IR.Conclusion: Our findings demonstrated that the elevated TyG, TG/HDL-C and TC/HDL-C were significantly associated with IR and could be utilized as indicators of IR among PCOS women in Iran.


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