Academic journal article Journal of Health Population and Nutrition

Association of Insulin Resistance with Lipid Profile, Metabolic Syndrome, and Hormonal Aberrations in Overweight or Obese Women with Polycystic Ovary Syndrome

Academic journal article Journal of Health Population and Nutrition

Association of Insulin Resistance with Lipid Profile, Metabolic Syndrome, and Hormonal Aberrations in Overweight or Obese Women with Polycystic Ovary Syndrome

Article excerpt

INTRODUCTION

Polycystic ovary syndrome (PCOS) is often characterized by the manifestation of oligo/anovulation, clinical or biochemical hyperandrogenism and/or polycystic ovaries. PCOS affects 5% to 10% women of reproductive age (1). It is addressed that PCOS is a heterogeneous gynaecological syndrome associated with a wide range of endocrine and metabolic abnormalities, including hyperinsulinaemia, hyperglycaemia, glucose intolerance, dyslipidaemia, and obesity, which are regarded as the hallmark components of metabolic syndrome (MetS) (2).

Insulin resistance (IR) is considered the common cause of other aberrations in this disorder which affects the long-term health of PCOS patients (3). For instance, IR is considered to play a role in defected lipid profile. It is estimated that 70% of women with PCOS have at least one abnormal li- pid constituent (4). Obese women with PCOS are more prone to dyslipidaemia, particularly elevated triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) (5,6). Some studies are suggestive of significantly lower levels of HDL-C in PCOS women compared to weight-matched controls (7). However, in other investigations, no difference was observed in lipid profile between PCOS women and control participants (8,9).

It is estimated that approximately one-third of PCOS women also have MetS (10). In fact, PCOS is considered one of the ovarian manifestations of MetS (11). A study (10) showed that metabolic syndrome and its components are common in PCOS, especially among women with the highest BMIs and insulin levels. While obesity is regarded one of the putative factors leading to MetS, IR seems to contribute mainly to the link between PCOS and MetS (12). In addition, accumulating evidence indicates that women with MetS also exhibit hyperandrogenism (13), a well-established contributor to PCOS aetiology (14). Androgen in excess appears to affect independently, which further exacerbates the cardiometabolic aberrations in PCOS women (15). However, another study (6) showed that no correlation exist between lipid profile and gonadotrophic hormones or testosterone among PCOS patients. On the other hand, it was also suggested that metabolic disturbances were seemingly more pertinent to adiposity/insulin metabolism than to circulating androgen levels (16).

IR might also negatively correlate with dehydroepiandrosterone sulphate (DHEAS) concentration in PCOS patients (17). It is reported that obese women with PCOS have lower DHEAS levels compared to non-obese PCOS patients (18). Several studies have shown an inverse association between serum DHEAS and cholesterol levels (19,20), resulting in the high incidence of ischaemic heart disease (21,22).

The present study primarily focuses on the associations of IR with endocrinometabolic parameters among Iranian PCOS women. So far, most of the studies have discussed these interactions among PCOS patients with various body mass indices (BMIs) (6,23,24) whereas the present article discusses just on overweight or obese PCOS patients. The potential interrelationships of IR, obesity, endocrine disturbances, and MetS have been rarely studied altogether in the setting of PCOS. Therefore, this report was aimed to better clarify the mutual effects of these pathogenic abnormalities in overweight or obese PCOS patients subdivided into insulinresistant (IR) and insulin-sensitive (IS) groups.

MATERIALS AND METHODS

Patient population

This cross-sectional study was conducted from January 2011 to August 2012 in Gynecology and Endocrinology Outpatient Clinics of Tabriz University of Medical Sciences. Sixty-three overweight or obese patients diagnosed with PCOS were recruited in this study. The research protocol was approved by the Ethics Committee of Tabriz University of Medical Sciences (ethical code=906). Written informed consent was obtained from all participants.

The diagnosis of PCOS was confirmed according to the revised Rotterdam criteria (25), in which the presence of any two out of the three following criteria was required: (i) oligo- and/or anovulation (<8 menstrual periods per year) (26); (ii) clinical and/ or biochemical signs of hyperandrogenism, including hirsutism (Ferriman-Gallwey score >8); and (iii) polycystic ovaries on sonography (i. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.