Cover
Vol. 4 No. 2 (2014)

Published: December 31, 2014

Pages: 32-39

Research Article

Correlation between Homocysteine and Insulin Resistance in women with Polycystic Ovarian Syndrome Referring to AL-Yarmook Teaching Hospital

Dhilal Q. Mohammed 1 Hawaa AL-Dhahir 2 Sabah M. Husein 3
1Dept. of Physiology-College of Medicine-Iraqi University-Baghdad,IRAQ
2Dept. of Physiology-College of Medicine University of Baghdad - Baghdad,IRAQ
3Dept. of physiology-Al-Kindy College of Medicine-University of Baghdad-Baghdad,IRAQ
History
  • Received: September 1, 2014
  • Available Online: December 1, 2014

Abstract

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders among females in reproductive age. Women with PCOS have several cardiovascular disease risk factors. Hyperinsulinemia and insulin resistance (IR) which is a known key factor in the development of type 2 diabetes (T2DM) may associate PCOS. Homocysteine, a sulfur-containing amino acid, is toxic to vascular endothelium, leads to early atherosclerosis. PCOS said to be associated with high plasma homocysteine. Objective: To determine the correlation between insulin resistance and homocysteine in PCOS patients. Methods: Patients diagnosed as PCO according to Androgen Excess and PCOS Society/2009 criteria were grouped into two groups: those with BMI less than 30kg/m2 and those with BMI 30kg/m2 and more. Blood was drawn for biochemical and hormonal assay. Information tabulated, means and percentages used, and the results were analyzed. Results: Homocysteine levels were significantly higher (P value < 0.05) in PCOS group (12.28±1.89 µmol/l) as compared to control (9.51±1.92 µmol/l).HOMA-IR was significantly higher (P value < 0.05) in PCOS (4.15±2.54) as compared to control (1.69±0.54) .There was no correlation between IR and homocysteine within PCOS group. Conclusions: Polycystic ovarian patients have higher levels of homocysteine and IR compared to control but there is no correlation between IR and homocysteine within PCOS group.

Keywords

References

  1. Haugaard LK, Vestergaard H, Skouby Haugaard LK, Vestergaard H, Skouby SO. Polycystic ovary syndrome and comorbidity. UgeskrLaegeer. 2010;18:172(3):199-202.
  2. Mak W, Dokras A. Polycystic ovarian syndrome and the risk of cardiovascular disease and thrombosis. SeminThrombHemost. 2009; 35(7):613-620.
  3. Salehpour S, Saad N, Ashrafi M, Emami H. The effect of metformin therapy on menstrual function in PCOS. Med J Iran Hosp.2002; 15(1):20-22
  4. Pehlivanov B, OrbetzovaM. Characteristics of different phenotype of polycystic ovary syndrome in a Bulgarian population. Gynecol. Endocrinol.2007; 23(10):604- 609.
  5. Amiri I., Rabiee S., Goodarzi M.T., Etemadi K. and Z.Hematpour: Assessment of Correlation between Homocysteine Concentration inFollicular Fluid and Oocyte and Embryo Quality in Polycystic Ovary Syndrome Patients Undergoing Assisted Reproductive Technology. Sci J Hamadan Univ Med Sci 2013; 19 (4):11-19(IVSL).
  6. The Rotterdam ESHRE/ASRM sponsored PCOS consensus work shop group revised (2003). Consensus on diagnostic criteria and long term health risk related to polycystic ovary syndrome. Fertil Steril. 2004; 81: 19-25.
  7. Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at long –term follow- up: a retrospective cohort study. Clin Endocrinol (Oxf). 2000; 52(5): 595-600.
  8. McCarty MF. Increased homocysteine associated with smoking, chronic inflammation, and aging may reflect acute- phase induction of pyridoxal phosphatase activity. Med Hypotheses 2000; 55: 289-293.
  9. Tsilchoroziddou T, Overton C, Conway GS. The pathophysiology of polycystic ovary syndrome. Clin Endocrinol 2004;60:1-7.
  10. Dei Bianco A, Maruti G, Fulgieri AM. Recurrent spontaneous miscarriage and hyperhomocysteinemia. Minerva Ginecol. 2004; 56:379-383.
  11. Salehpour S., Manzor-al-ajdad O., Samani EW., Abadi A. "Evaluation of homocysteine levels in patients with polycystic ovary syndrome". International journal of Fertility and Sterility, 2011; 4, (4): 168-171.(IVSL)
  12. Tarkun I, Cetinarslan B, Canturk Z, Turemen E. The plasma homocysteine concentrations and relationship with insulin resistance in young women with polycystic ovary syndrome. Turkish journal of Endocrinology and Metabolism, 2005; 1:23.
  13. Matthews DR, Hosker JP, Rudeniski AS, Nylor BA, Teacher DF, Turner RC. Homeostatic Model Assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentration. Diabetologia. 1985 Jul; 28 (7): 412-419.
  14. Moll S,Homocysteine.Retrieved December 15,2004,at http:// www. fvleiden. org/ask/77.html.
  15. Azziz R:polycystic ovary syndrome,insulin resistance, and molecular defects of insulin signaling.J Clin Endocrinol Metab 2002.87:4085-4087.
  16. Giallauria F,Orio F,Palomba S,Lombardi G,Colao A,Vigorito C:Cardiovascular risk in women with polycystic ovary syndrome. J Cardiovasc Med (Hagerstown) 2008,9:987-992.
  17. Wang ET,Calderon M R,Wellons MI, Daviglus ML,Merkin SS,Schreiner PJ. et al.:Polycystic ovary syndrome and risk for long-term diabetes and dyslipidemia.Obstet, 2011;117: 6-13.
  18. Cho LW, Tayagopal V, Klipatrick ES, Holding S, AtkinSL.The LH/FSH ratio has little use in diagnosis of polycystic ovary syndrome. Ann Clinbiochem may,2006: 43: 217-219.
  19. Saxena KF, Parcash A, Nigam A, Mishra A. Polycystic ovary syndrome: is obesity a sine qua non? A clinical, hormonal, and metabolic assessment in relation to body mass index. J Endocr Metab. 2012; 16: 996-999.
  20. Temel I., Çelik Ö., Hasçalik Ş., Çelik N., Şahin İ. AND Aydin S.: Serum nonesterified fatty acids, ghrelin, and homocysteine levels in women with polycystic ovary syndrome. Turk J Med Sci,2010; 40 (2): 221-228.
  21. Escobar-Morreale HF, Asuncion M, Calvo RM, Sancho J, San Millan JL. Receiver operating characteristic analysis of the performance of basal serum hormone profiles for the diagnosis of the polycystic ovary syndrome in epidemiological studies. Eur J Endocrinol 2001;145(5):619- 624.
  22. Barth JH, Field HP, Yasmin E, Balen AH. Defining hyperandrogenism in polycystic ovary syndrome: measurement of testosterone and androstenedione by liquid chromatographytandem mass spectrometry and analysis by receiver operator characteristic plots. Eur J Endocrinol. 2010; 162(3):611- 615.
  23. Yilmaz N, Pektas M, Tonguc E, Kilic S, Gulerman C, Gungor T, et al. The correlation of plasma homocysteine with insulin resistance in polycystic ovary syndrome. J Obstet Gynaecol Res. 2008; 34(3): 384-391.
  24. Kleinwechter H, Schafer-Graf U. Hyperglycemia and adverse pregnancy outcome study. Der Diabetologe 2012; 8(8): 652- 656. (abstract)
  25. Yildiz BO, Gedik O. Assessment of glucose intolerance and insulin sensitivity in polycystic ovary syndrome. Reprod Biomed Online 2004;8:649-656.
  26. Barcellos CR, Rocha MP, Hayashida SA, Nery M, Marcondes JA. Prevalence of abnormalities of glucose metabolism in patients with polycystic ovary syndrome. Arq Bras Endocrinol Metabol 2007;51:601-605. (IVSL).
  27. Gagnon C, Baillargeon JP. Suitability of recommended limits for fasting glucose tests in women with polycystic ovary syndrome. CMAJ 2007;176:933- 938.
  28. Rekha S, Patel ML, Pooja G, et al: Correlation between elevated homocysteine levels and insulin resistance in infertile women with or without polycystic ovary syndrome in North Indian population.2013; 5(3):113-123.
  29. Li X, Shao R. PCOS and obesity: insulin resistance might be a common etiology for the development of type 1 endometrial carcinoma. Am J Cancer Res, 2014;4(1): 73-79.
  30. Sills ES, Genton MG, Perloe M, Schattman GL, Bralley JA, Tucker MJ. Plasma homocysteine, fasting insulin, and androgen patterns among women with polycystic ovaries and infertility. J Obstet Gynaecol Res, 2001; 27: 163-168.
  31. Legro RS, Kunselman AR, Dunaif A:Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. Am J Med. 200; 111: 607-613.
  32. Loverro G., Lorusso F.,Mei L., Depalo R, Cormio G., Selvaggi L. et al.: The plasma homocysteine levels are increased in polycystic ovary syndrome. Gynecologic and Obstetric J., 2002;53(3): 157- 162.
  33. Guzelmeric K, Alkan N, Pirimoglu M, Unal O, Turan C. Chronic inflammation and elevated homocysteine levels are associated with increased body mass index in women with polycystic ovary syndrome. Gynecol Endocrinol. 2007; 23(9): 505-510.
  34. Mancini F, Cianciosi A, Reggiani GM, Facchinetti F, Battaglia C, de Aloysio D. Endothelial function and its relationship to leptin, homocysteine, and insulin resistance in lean and over weightamenorrheic women and PCOS patients: a pilot study. Fertil Steril. 2009;91(6): 2537- 2544.
  35. Kilic-Okman T, Guldiken S, Kucuk M. Relationship between homocysteine and insulin resistance in women with polycystic ovary syndrome. Endocr J 2004;51:505-515.
  36. Schachter M, Raziel A, Friedler S, Strassburger D, Bern O, Ronel R. Insulin resistance in patients with polycystic ovary syndrome is associated with elevated homocysteine. Hum Reprod 2003;18(4): 721-727.
  37. Meigs JB, Jacques PF, Sehlhub J, Singer DE, Natham DM, Rafi N, et al. Framingham Offspring study. Fasting plasma homocysteine levels in the insulin resistance syndrome: the Framingham Offspring study. Diabetes Care 2001; 24:1403- 1410
  38. Hemati T, Moghadami-Tabrizi N, Davari-Tanha F, Salmanian B, Javadian P. High plasma homocysteine and insulin resistance in patients with polycystic ovary syndrome. Reproductive Medicine 2011; 9(3): 223-228.