Evaluation of metabolic and hormonal parameters in women with PCOS living in Black Sea Region

Abstract

Polycystic ovary syndrome(PCOS) is the most common endocrinopathy which is frequently associated with metabolic syndrome. The aim of this study is to compare the clinical,biochemical and hormonal characteristics of healthy women and women with PCOS in Black Sea Region.91 healthy women(Group=1) and 109 PCOS(Group=2) patients were included in this retrospective study. This study was conducted in Samsun Women and Children’s Health Research and Training Hospital between October 2019-May 2020.The anthropometric, clinical and laboratory characteristics of the women were recorded. The Institutional Review Board of the hospital approved the study. IBM SPSS Statistics 22 programme was used for statistical analysis. . Variables were expressed as mean ± standard deviation or as a number (percentage), and statistical significance was defined as a p value of less than 0.05.In this study, no statistically significant difference was found between patients with PCOS and control subjects in age,height ,BMI, waist circumference and waist-to-hip ratio. Weight ,BP systolic,BP diastolic and FG scores, were significantly higher in patients with PCOS compared to control subjects.In this study,no statistically significant difference was found between patients with PCOS and control subjects in FSH, estradiol prolactin ,TSH,fT3,fT4 and DHEASO4 levels.But,LH, cortisol, total and free testesterone and 17-OH progesteron levels were significantly higher in patients with PCOS compared to control subjects.Also in this study, vitamin B12 and the 25-OH-D levels were significantly lower in patients with PCOS compared to control subjects.HbA1C,fasting blood glucose levels,fasting insulin levels and HOMA-IR were significantly higher in patients with PCOS compared to control subjects . Total-C , LDL-C and TG levels were significantly higher in women with PCOS compared to control subjects.Also HDL-C levels were significantly lower in women with PCOS compared to control subjects.As a result, the risk of metabolic syndrome is increased in PCOS patients because of high androgen levels,obesity and insulin resistance.

Keywords

• polycystic ovarian syndrome
• metabolic syndrome
• hormone profile
• lipid profile

References

1. Abbot DH, Dumesic DA, Frank S. Developmental origin of polycystic ovary syndrome-a hypothesis. J Endocrinol 2002;174:1.
2. Ashwell M, Chinn S, Stalley S, Garrow JS 1982 Female fat distribution a simple classification based on two circumference measurements. International Journal of Obesity 6, 143–152.
3. Camargo CA, Jr. Vitamin D and cardiovascular disease: time for large randomized trials. J Am Coll Cardiol. 2011;58(14):1442-4.
4. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989:38:1165-74.
5. Fonseca V, Guba SC, Fink LM.Hyperhomocysteinaemia and the endocrine system: implications for atherosclerosis and thrombosis. Endocrine Reviews,1999;20, 738–759.
6. Fulghesu A, Magnini R, Portoghese E, et al. Obesity-related lipid profile and altered insulin incretion in adolescents with polycystic ovary syndrome. J Adolesc Health 2010; 46: 474– 81.
7. Hassan NE, El-Orabi HA, Eid YM, Mohammed NR. Effect of 25-hydroxyvitamin D on metabolic parameters and insulin resistance in patients with polycystic ovarian syndrome. Middle East Fertil Soc J 2012; 17: 176–180.
8. Hoffman LK, Ehrmann DA. Cardiometabolic features of polycystic ovary syndrome. Nat Clin Pract Endocrinol Metab 2008;4(4):215-22.

9. Kaya C, Dinçer CS, Satiroğlu H. Obesity and Insulin Resistance Associated With Lower Plasma Vitamin B12 in PCOS Reprod Biomed Online 2009 Nov;19(5):721-6
10. Ketel IJ, Serne EH, Ijzerman RG, Korsen TJM, Twisk JW, Hompes PGA et al. Insulin-induced capillary recruitment is impaired in both lean and obese women with PCOS. Hum Reprod 2011; 26(11):3130– 3137.
11. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999;84(1):165-9.
12. Li HW, Brereton RE, Anderson RA, Wallace AM, Ho CK. Vitamin D deficiency is common and associated with metabolic risk factors in patients with polycystic ovary syndrome. Metabolism 2011; 60: 1475–1481.
13. Manousopoulou A, Al-Daghri NM, Garbis SD, Chrousos GP. Vitamin D and cardiovascular risk among adults with obesity: a systematic review and meta-analysis. Eur J Clin Invest. 2015;45(10):1113-26.
14. Mathieu P, Pibarot P, Larose E et al: Visceral obesity and the heart. Int J Biochem Cell Biol, 2008; 40: 821–36.
15. Matthews DR, Hosker JP, Rudenski AS et al. 1985 Homeostasis model assessment: insulin resistance and (cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412–419.
16. McCarty MF 2000 Increased homocysteine associated with smoking, chronic inflammation, and ageing may reflect acute phase induction of pyridoxal phosphatase activity. Medical Hypotheses 2000; 55, 289–293.
17. Moini A, Shirzad N, Ahmadzadeh M, Hosseini R, Hosseini L, Sadatmahalleh SJ. Comparison of 25-hydroxyvitamin D and calcium levels between polycystic ovarian syndrome and normal women. Int J Fertil Steril 2015;9:1–8.
18. Poretsky L, Piper B. Insulin resistance, hypersecretion of LH, and a dual-defect hypothesis for the pathogenesis of polycystic ovary syndrome. Obstet Gynecol. 1994;84:613-21.
19. Rossi B, Sukalich S, Droz J, et al. Prevalence of metabolic syndrome and related characteristics in obese adolescents with and without polycystic ovary syndrome. J Clin Endocrinol Metab 2008; 93: 4780–6. 46.
20. Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25.
21. Schacter M, Raziel A, Friedler S et al. Insulin resistance in patients with polycystic ovary syndrome is associated with elevated plasma homocysteine. Human Reproduction 2003 ,8, 721–727.
22. Sung CC, Liao MT, Lu KC, Wu CC. Role of vitamin D in insulin resistance. J Biomed Biotechnol. 2012;2012:634195.
23. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935;29:181-91.
24. Takiishi T, Gysemans C, Bouillon R, Mathieu C. Vitamin D and diabetes. Rheum Dis Clin North Am. 2012;38(1):179-206.
25. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106(25):3143–3421.
26. Thompson RL, Spedding S, Buckley JD. Vitmain D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol 2012;77:343–50.
27. Van der Schueren BJ, Verstuyf A, Mathieu C. Straight from D-Heart: vitamin D status and cardiovascular disease. Curr Opin Lipidol. 2012;23(1):17-23.