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Showing 20 results for Insulin Resistance

Hossein Hadinedoushan, Robert Normann,
Volume 3, Issue 2 (7-2005)

Background: Polycystic ovary syndrome (PCOS) is related to obesity and to major metabolic alterations including both insulin resistance and beta-cell dysfunction. Ghrelin was identified as the endogenous ligand for the growth hormone secretagogue (GHS) receptor. The actions of ghrelin are carried out through interaction with specific receptor, named GHS-R. Objective: In a case-control study, we compared the expression of ghrelin and GHS-Rs mRNA by Quantitative Real-time PCR method in studied groups in order to determine the role of ghrelin and GHS-Rs in pathogenesis of PCOS. Materials & Methods: Follicular fluid samples were obtained at oocyte collection from 22 patients undergoing IVF-ET as control and 11 patients were diagnosed as having PCOS. Total RNA was extracted from isolated follicular fluid cells and 2�g RNA was diluted and reverses transcribed using random primers and Superscript II. Specific primers for the ghrelin, GHS-R1a and GHS-R1b were designed. Samples were run in triplicate on an ABI Geneamp 5700 sequence detection system. They were subjected to 40 cycles of amplification under condition 92�C- 20s and 62�C-1min using 3�l diluted cDNA (1:7), 10�l 2X SYBR green, 3�l diluted cDNA. ?-actin mRNA was assayed and then normalized to total RNA measurements for each sample. Results: Age, weight and resulting pregnancies did not vary between PCOS and non-PCOS patients, whereas the BMI and serum testosterone level of PCOS were significantly higher than non-PCOS patients. Quantitative real-time RT-PCR showed that mRNA for ghrelin and GHS-R 1b were detectable in follicular fluid cells from all patients. We failed to find mRNA for GHS-R 1a in any of follicular fluid cells. There were no significant difference in ghrelin and GHS-R1b mRNA expression levels between PCOS and non-PCOS groups. Conclusion: Our findings indicate that ghrelin and ghrelin receptors may not be considered risk factors for pathogenesis of PCOS.
Javad Mohiti-Ardekani, Nasim Tarof, Abbas Aflatonian,
Volume 7, Issue 3 (7-2009)

Background: Leptin is an adipokine that circulates in a free form and bound to a soluble leptin receptor. Patients with polycystic ovary syndrome have increased insulin resistance and high incidence of obesity.
Objective: This study was carried out to evaluate levels of leptin and free leptin in women with polycystic ovarian syndrome (PCOS) and note any relationships with insulin resistance and adiposity.
Materials and Methods: We assessed the correlation of metabolic parameters with the levels of free leptin and it’s bound form in 27 PCOS women (aged 26±5.6 years) and 27 healthy women with normal menstrual cycle as controls (aged 25 ±4 years).Total leptin and insulin levels were measured using ELISA. Free leptin form was purified by Gel filtration chromatography and their collected fractions were measured by a sensitive ELISA-Kit. Insulin resistance was calculated by homeostasis model assessment (HOMA).
Results: In PCOS patients and control group a correlation between leptin and body mass index (BMI) was found. A significant difference was found between leptin and free leptin levels in PCOS subjects and controls (p<0.05). Significant correlations were found between free and total leptin with insulin resistant in PCOS subjects (r=0.78 p=0.00, r=0.84 p=0.003) and control groups respectively (r=0.86 p=0.00, r=0.69 p=0.00).
Conclusion: Total and free leptin forms are correlated significantly with BMI in patients with PCOS and in controls. Total and free leptin forms showed significant correlations with insulin resistance but no significant difference was seen in the two groups investigated.
Nasrin Ghasemi, Mohammad Reza Mortazavizadeh, Aboolfazl Khorasani Gerdekoohi,
Volume 8, Issue 3 (7-2010)

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous complex genetic disorder characterized by hyperandrogenemia hyperinsulinemia insulin resistance and chronic anovulation. It is the most common endocrine disorder in women of reproductive age with an enigmatic pathophysiologic and molecular basis. Obesity hyperandrogenism and infertility occur frequently in PCOS which mostly have a genetic predisposition and are features known to be associated with the development of breast cancer risk.
Objective: In present study frequency of PCOS in patients with premenopausal breast cancer was compared with the frequency in women without breast cancer.
Materials and Methods: This is a case-control study which compared PCOS frequency in 166 patients with premenopausal breast cancer and 166 healthy controls with normal mammography in last 6 months.
Results: Eleven patients (6.62%) in case group and 16 patients (9.63%) in control group had polycystic ovary syndrome according to their questionnaire. The difference was not significant (p=0.645).
Conclusion: There was no relationship between frequency of polycystic ovary syndrome and breast cancer in this study. This might be due to the age of patients with breast cancer in this study which was mostly over 40. It could be significant if the patients were chosen in lower age for showing more effect of genetic than environment. The adjustment or matching of other risk factors could help to find the better results.
Tayebe Hemati, Nasrin Moghadami-Tabrizi, Fateme Davari-Tanha, Bahram Salmanian, Pouya Javadian,
Volume 9, Issue 3 (7-2011)

Background: Polycystic ovarian syndrome (PCOS) is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome.
Objective: This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients.
Materials and Methods: This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normo ovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) plasma levels in the blood sample of the 3rd day of their menstrual cycle. Insulin resistance was determined with the fasting glucose (mmol/L) to insulin (mIU/L) ratio and HOMA-IR (Homeostasis model assessment-Insulin resistance). Independent-samples T-test and linear regression test were utilized to analyze the obtained data.
Results: Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant (IR) (LogHOMA-IR?0.57) and non insulin resistant (NIR) patients. The IR group had significantly higher homocysteine (p-value=0.02), fasting insulin and glucose levels (p-value<0.001) rather than NIR group.
Conclusion: PCOS patients have a leaning toward hyperhomocysteinaemia and insulin resistance. Insulin resistant patients are found to have higher homocysteine level.
Ashraf Moini, Fatemeh Javanmard, Bita Eslami, Najmeh Aletaha,
Volume 10, Issue 2 (7-2012)

Background: Polycystic ovarian syndrome (PCOS) is a condition associated with chronic anovulation, insulin resistance and androgen excess. Women with this syndrome are at increased risk of metabolic syndrome.
Objective: The aim of the present study was to determine the prevalence of metabolic syndrome (MBS) in women with PCOS referred to Arash Hospital in different ages and body mass index (BMI).
Materials and Methods: A cross-sectional study was conducted in Gynecologic Clinic at Arash Hospital affiliated with Tehran University. A total of 282 women with PCOS ages between 15-40 years were included. The prevalence of Metabolic Syndrome and its components in this population were the main outcomes. Height, weight, waist circumference, blood pressure and laboratory tests (FBS, TSH, HDL-C, serum prolactin, triglycerides and total cholesterol) were measured in this population.
Results: The prevalence of MBS in PCOS women was 22.7% (64 cases). The rate of central obesity, FBS more than 110 mg/dl, triglycerides more than 150 mg/dl, high-density lipoprotein cholesterol levels (HDL-C) less than 50 mg/dl, and blood pressure ?130/85 mmHg in PCOS women was 31% (87), 3.2% (9), 33% (93), 68.8% (194), and 10.6% (30), respectively. The risk of MBS was increased in older and the obese women (BMI ?30 kg/m2). Conclusion: The present sample showed women with PCOS have a high prevalence of MBS and its individual components, particularly decreased HDL-C.
Diana Chanukvadze, Jenara Kristesashvili, Nana Kvashilava,
Volume 10, Issue 4 (8-2012)

Background: Polycystic ovary syndrome (PCOS) is the most common cause of hyperandrogenism in women. Non-classic congenital adrenal hyperplasia (NCAH) is very close to PCOS. The diagnosis of hyperandrogenism is not based on the finding of decreased or increased levels of a single hormone. Objective: In our paper, we are going to test correlation between clinical signs and biochemical markers of hyperandrogenism.
Materials and Methods: In this prospective study, we calculated free testosterone (cFT), bioavailable testosterone (cBT), free androgen index (FAI), free estrogen index (FEI), total testosterone (TT), sex-hormone binding globulin (SHBG), estradiol (E2), dehydroepiandrosterone-sulfat (DHEA-S), 17α -hydroxyprogesterone (17α -OHP), prolactin (P), C-peptid and homeostasis model assessment for insulin resistance (Homa-IR) were measured in two groups of young untreated women with PCOS and NCAH.
Results: In our research, we did not find any significant differences between PCOS and NCAH groups by age, hormonal and calculated parameters of androgens. Waist to hip ratio (WHP) and body mass index (BMI) values were higher in the group of patients with PCOS than NCAH group. But in all patients we found positive correlation between hirsutism score and FAI, cFT, cBT, as well as we found negative correlation between hirsutism score and SHBG. We also tested hormonal and calculated parameters of androgens between PCOS patients by upper body and lower body obesity, but we did not find any significant differences. There was not any difference by the hirsutism score in these groups either.
Conclusion: In our research we found that the calculated values of cFT, cBT and FAI are helpful for determinate hirsutism score in all hirsute patients, despite of ovarian or adrenal hyperandrogenemia.
Shokoufeh Bonakdaran, Zahra Mazloom Khorasani, Behrooz Davachi, Javad Mazloom Khorasani,
Volume 10, Issue 5 (10-2012)

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of reproductive age. Insulin resistance is a frequent metabolic disturbance in PCOS. Vitamin D deficiency is a common problem. Accumulating evidence suggests that vitamin D has a role on insulin sensitivity so may contribute to reduction of hyperandrogenemia.
Objective: The aim was to determine the effects of vitamin D treatment in metabolic components and ovulation evidence in PCOS.
Materials and Methods: Fifty one untreated PCOS patients were randomly divided into three groups and treated with calcitriol, metformin, or placebo. Before and 3 months after treatment, ovulation evidence was assessed by ovarian trans abdominal sonography. Plasma fasting glucose, insulin, homeostasis model assessment insulin resistance (HOMA-IR), 25-hydroxyvitamin D, parathyroid hormone and androgen levels were measured before and after treatment. A 75gr glucose test was performed before and after treatment and two set of results was compared.
Results: Three patients did not continue this study. Only 11 patient (22.9%) had sufficient vitamin D levels (>30 ng/ml). Metformin caused a significant decrease in weight (p=0.027), insulin level (p=0.043), and insulin resistance (p=0.048). Systolic blood pressure and PTH significantly improved after calcitriol (p=0.029, p=0.009 respectively). An improvement in ovulation was detected after calcitriol and seven patients, without evidence of ovulation before treatment, illustrated ovulation after 3 months. Difference with calcitriol in ovulation was significant versus other two methods (p=0.02). Conclusion: Calcitriol treatment in PCOS may be prior to metformin in ovulation induction.
Laleh Eslamian, Soheila Akbari, Vajihe Marsoosi, Ashraf Jamal,
Volume 11, Issue 4 (6-2013)

Background: Fetal growth in diabetic pregnancies is a complex process and probably abnormalities in other metabolic pathways such as protein and lipid, as well as carbohydrate are responsible for delivering of macrosomic newborn.
Objective: The purpose of this study was to investigate the association between fetal growth and different maternal metabolic parameters in women with gestational diabetes mellitus (GDM) in comparison to control group.
Materials and Methods: This was a prospective cohort study conducted between March 2011 and May 2012, on 112 pregnant women with GDM and 159 healthy pregnant women. In order to determine of lipids or lipoproteins changes during pregnancy and to investigate any possible effects on fetal growth, lipid components, glucose and insulin levels were obtained in maternal serum three times in third trimester.
Results: Maternal serum glucose, total cholesterol (TC), low and high density lipoprotein (LDL-c, HDL-c) levels did not show any significant difference between two groups. While insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride (TG) values were detected to be significantly higher in the GDM cases especially after 32 weeks of gestation (p<0.001). After adjustment for confounding variables, maternal hypertriglyceridemia remained as a significant risk factor for delivering large for gestational age (LGA) newborns (p=0.04); and according to spearman test the increase of TG level was correlated with increase of insulin resistance and HOMA-IR (p<0.001, CI: 0.312).
Conclusion: Due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight, it is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels.
Zhongyu Qu, Yanhui Zhu, Jingjing Jiang, Yuhua Shi, Zijiang Chen,
Volume 11, Issue 9 (12-2013)

Background: Polycystic ovary syndrome (PCOS) is highly associated with non-alcoholic fatty liver disease (NAFLD). There are extensive ethnic differences in the clinical manifestations, pathological changes, and ovarian changes in women with PCOS.
Objective: To investigate the prevalence and clinical characteristics of NAFLD in Chinese women with PCOS.
Materials and Methods: Non-pregnant women with PCOS (N= 602) and matched controls without PCOS (N=588) were recruited. Basal endocrine, oral glucose tolerance test, insulin release level, lipid level, blood pressure, and body mass index (BMI) were measured. Liver biochemical and B-hepatitis and C-hepatitis indices were determined.
Results: NAFLD was significantly more prevalent in women with PCOS than controls (32.9% vs. 18.5%) and included 113 (57.1%) mild, 75 (37.8%) moderate and 10 (5.1%) severe cases. Luteinizing hormone was significantly lower in PCOS women with NAFLD than without NAFLD. In the PCOS group, NAFLD prevalence and severity increased with BMI. The liver index was significantly higher (p<0.001), and the quantitative insulin sensitivity check index and high density lipoprotein cholesterol were significantly lower (p<0.001) in the PCOS group than controls. Insulin resistance, abdominal obesity, diabetes mellitus, abnormal glucose tolerance, liver dysfunction, dyslipidemia, hypertension, and metabolic syndrome were significantly more prevalent in the NAFLD group than controls.
Conclusion: Chinese women with PCOS have a high prevalence of mostly mild and moderate NAFLD, not significantly associated with hyperandrogenism that increased significantly with BMI. Insulin resistance and metabolic abnormalities are important factors associated with NAFLD. Chinese women with BMI ≥24 kg/mP2P should be screened for NAFLD.
Anahita Enzevaei, Saghar Salehpour, Maryam Tohidi, Nasrin Saharkhiz,
Volume 12, Issue 7 (8-2014)

Background: Polycystic ovary syndrome (PCOS) is the most common hyperandrogenic disorder among women and is often defined as hyperandrogenic syndrome. These patients are at risk for oligo/amenorrhea, chronic anovulation, infertility, obesity, spontaneous abortion, insulin resistance, hyperinsulinemia and metabolic syndrome. Thyroid disorders especially hypothyroidism is more common in these people. In PCOS patients, subclinical hypothyroidism may aggravate insulin resistance.
Objective: The goal was to find any relationship between subclinical hypothyroidism and insulin resistance in PCOS patients.
Materials and Methods: In this prospective cross sectional study we included all PCOS patients coming to infertility clinic of Taleghani Hospital in 2010-2012 who had the criteria of Rotterdam for PCOS. Then the clinical examination was done for them and height, weight, body mass index and lab data were measured including thyroid hormone and biochemical profile. The data were analyzed by SPSS software version 20.
Results: Among 75 PCOS patients, 19 (25.5%) had subclinical hypothyroidism and 56 patients (74.4%) were euthyroid. The prevalence of insulin resistance was 22.7% and 77.3% of patients had no insulin resistance were normal.
Conclusion: We could find no relationship between insulin resistance and subclinical hypothyroidism in PCOS patients.
Manal T Mutib, Farqad B Hamdan, Anam R Al-Salihi,
Volume 12, Issue 7 (8-2014)

Background: Polycystic ovarian syndrome (PCOS) is a complex, heterogeneous disorder of uncertain etiology with strong genetic background. Insulin resistance is present in the majority of PCOS cases with linkage and association between single nucleotide polymorphisms of insulin receptor (INSR) gene and PCOS.
Objective: To examine whether the exon 17 of INSR gene contributes to genetic susceptibility to PCOS in Iraqi women and its effects on glucose tolerance test and lipid profile.
Materials and Methods: Sixty-five healthy Iraqi women and eighty-four infertile women with PCOS, divided into two subgroups depending on the BMI were studied. Restriction fragment length polymorphism (RFLP-PCR) analysis was performed to determine the genotypes for the His 1058 C/T polymorphism at the tyrosine kinase domain in the INSR gene. Clinical, anthropometric and biochemical parameters were also estimated.
Results: The C/T polymorphism at His 1058 in exon 17 of INSR was associated with PCOS (obese and non-obese). CC genotype frequency was higher in PCOS patients whereas TT genotype was higher in control women. Those with CC genotype had higher BMI, GTT and lipid profile than those with TT genotype.
Conclusion: An association of C/T polymorphism at His1058 of INSR with PCOS in Iraqi women was observed. Its association with indices of insulin resistance and dyslipidemia were also noticed.
Mohammad Ehsan Rahiminejad, Amirhossein Moaddab, Soghra Rabiee, Farzaneh Esna-Ashari, Shiva Borzouei, Seyyed Mohammad Hosseini,
Volume 12, Issue 12 (12-2014)

Background: Previous studies have demonstrated that clinical features of 16TPolycystic ovary syndrome16T (PCOS) are associated with a lower degree of health, self, and sex satisfaction.
Objective: Our study aimed to investigate possible associations between depression and different clinicobiochemical markers of PCOS.
Materials and Methods: In a cross-sectional analytic study, 120 PCOS women aged 18-45 yr, were enrolled. Beck Depression Inventory was used to assess depression. Also, all participants underwent biochemical studies. Individuals with 15 points and more in Beck test were referred to a psychiatrist to participate in a complementary interview for the diagnosis of depression based on Diagnostic and Statistical Manual of Mental Disorders IV (DSMIV-TR) criteria.
Results: Among the study participants, 82 women (68.3%) were non-depressed, and 38 patients (31.7%) had some degrees of depression. According to the psychiatric interview, 10 patients (8.3%) had major depression, 22 patients (18.3%) had minor depression and 6 patients (5%) had dysthymia. We failed to show any significant difference in body mass index, hirsutism, infertility, serum total testosterone, lipid profile, and the homeostasis model assessment of insulin resistance (HOMA-IR) between depressed and non-depressed subjects (p>0.05). Using Spearman correlation, we did not find a positive correlation between BDI scores and clinicobiochemical markers for all PCOS subjects (-0.139≤r≤+0.121, p>0.05).
Conclusion: In spite of high rate of depression in women with PCOS, there was no significant association between Clinicobiochemical Markers and depression.
Parvin Layegh, Zohreh Mousavi, Donya Farrokh Tehrani, Seyed Mohammad Reza Parizadeh, Mohammad Khajedaluee,
Volume 14, Issue 4 (4-2016)

Background: Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome (PCOS). Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients. 
Objective: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women.
Materials and Methods: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese (BMI ≥25) and 45 patients were non-obese (BMI <25). Presence of insulin resistance and endocrine-metabolic abnormalities were compared between two groups. Collected data were analyzed with SPSS version 16.0 and p<0.05 was considered as statistically significant. 
Results: There was no significant difference in presence of insulin resistance (HOMA-IR >2.3) between two groups (p=0.357). Waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic (p<0.001) and diastolic (p<0.001) blood pressures, fasting blood sugar (p=0.003) and insulin (p=0.011), HOMA-IR (p=0.004), total cholesterol (p=0.001) and triglyceride (p<0.001) were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone (p=0.634) and androstenedione (p=0.736) between groups whereas Dehydroepiandrotendione sulfate (DHEAS) was significantly higher in non-obese PCOS women (p=0.018). There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively.
Conclusion: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients.
Seyed Mojtaba Sohrevardi, Fahime Nosouhi, Saeed Hossein Khalilzade, Parichehr Kafaie, Mojgan Karimi-Zarchi, Iman Halvaei, Mehdi Mohsenzadeh,
Volume 14, Issue 12 (12-2016)

Background: Insulin resistance and hyperinsulinemia may play a role in pathogenesis of PCOS. One of the common therapeutic methods is using insulin-sensitizing drugs such as metformin and thiazolidinediones.
Objective: The purpose was to determine the effect of metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS.
Materials and Methods: Eighty four women randomly received one of the following for 3 months: metformin (n=28) (500 mg three times a day), pioglitazone (30 mg daily) (n=28) and combination of both metformin and pioglitazone (n=28) (30 mg/day pioglitazone plus 500 mg metformin three times a day). Hormonal profile, fasting serum insulin, body weight, body mass index, menstrual status and waist to hip ratio were evaluated before and after treatment.
Results: Metformin and pioglitazone and combination therapy induced favorable changes in fasting serum insulin, HOMA-IR index, QUICKI, fasting glucose to insulin ratio in women with PCOS. Body weight, BMI, and waist to hip ratio increased significantly after treatment with pioglitazone but the data were similar after administration of metformin or combination therapy. Total testosterone level decreased significantly only after treatment with metformin. After 3 months in patients who received pioglitazone or combination therapy, menstrual cycles became regular in 71.4% and 73.9% respectively. While menstrual improvement happened only in 36.4% of the patients treated with metformin.
Conclusion: These findings suggest that insulin-sensitizing drugs induce beneficial effect in insulin resistance and menstrual cyclicity but only metformin ameliorated hyperandrogenemia in women with PCOS. Treatment with combination of metformin and pioglitazone did not show more benefit than monotherapy with each drug alone.Keywords:
Maryam Rahsepar, Soleiman Mahjoub, Sedigheh Esmaeilzadeh, Maryam Kanafchian, Maryam Ghasemi,
Volume 15, Issue 6 (7-2017)

Background: There is little evidence about antioxidant properties of vitamin D. Recent studies suggest that oxidative stress may play a major role in the pathophysiology of polycystic ovary syndrome (PCOS), but the association of vitamin D with oxidative stress is still not known in PCOS.
Objective: The goal of the present study was to evaluate the correlation between serum 25-hydroxy vitamin D and oxidative stress markers in PCOS group compared to control group.
Materials and Methods: 60 PCOS women (20-40 yr old) and 90 healthy women as control group were participated in this case-control study. Fasting serum level of 25-hydroxy vitamin D 25(OH) D, glucose, insulin, calcium, malondialdehyde (MDA), protein carbonyl (PC), also homeostasis model assessment for insulin resistance (HOMA-IR) and fasting glucose to insulin ratio (FGIR) were measured.
Results: It was found that the mean of serum 25(OH)D was lower in the PCOS group (10.76±4.17) than in the control group (12.07±6.26) but this difference was not statistically significant (p=0.125). Fasting insulin, HOMA-IR and MDA were significantly higher in the PCOS patients as compared to the controls, whereas PC level did not differ for the two groups (p=0.156). No significant correlations were found between 25(OH) D levels and oxidative stress markers (MDA and PC).
Conclusion: The findings indicated no significant differences in the serum 25(OH) D levels between the PCOS patients and the matched controls. Also, no correlation was found between the serum vitamin D levels and oxidative stress markers in both groups.
Bahia Namavar Jahromi, Mohammad Hassan Dabaghmanesh, Mohammad Ebrahim Parsanezhad, Faranak Fatehpoor,
Volume 15, Issue 7 (8-2017)

Background: Endocrine abnormalities related to polycystic ovary Syndrome (PCOS) are important problems.
Objective: To compare serum leptin levels between infertile women with and without PCOS. To rank sensitivity of six indirect methods for detection of insulin resistance (IR) and to evaluate the association between leptin and IR in PCOS group.
Materials and methods: This Case-controlled study performed on 189 infertile women referred to Shiraz Mother and Child Hospital during 2012-2015. Ninety-nine PCOS cases according to Rotterdam criteria were compared to 90 cases without PCOS. Serum leptin, body mass index (BMI), several hormones, and their correlation coefficients with leptin were compared. IR in PCOS women was measured by indirect methods, including fasting blood sugar (FBS), fasting insulin (FI), glucose/insulin, homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and MacAuley index. Association between IR and leptin was evaluated. Independent sample t-test and Pearson’s test were used.
Results: Infertile women with PCOS had higher BMI (26.47±3.62 vs. 24.82±5.18 kg/m2) and serum leptin levels (41.79±187.89 vs. 19.38±12.57 ng/mL). Leptin showed significant association with weight and BMI in both groups (p<0.001) and to age in non-PCOS group. HOMA-IR showed the highest rate of IR followed by FI and QUICKI methods. The mean leptin levels had positive association with IR assessed by HOMA-IR (p<0.001), QUICKI (p<0.001), FI (p=.002), and FBS (p=0.02).
Conclusion: BMI and IR have positive association with serum leptin in PCOS infertile women. HOMA-IR followed by FI and QUICKI is the most sensitive test for detection of IR.
Marzieh Zohrabi, Elham Rahmani, Niloofar Motamed, Samad Akbarzadeh,
Volume 15, Issue 10 (12-2017)

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disease and associated with insulin resistance. CXC Ligand 5 (CXCL5) is a new cytokine which is secreted from white adipose tissue during obesity and by blocking insulin signaling pathway inhibits the activity of insulin and promotes insulin resistance.
Objective: The aim of this study was to assess serum level of CXCL5 in PCOS women with normal body mass index.
Materials and Methods: In this case-control study, 30 PCOS women with normal body mass index as the case group and 30 non-PCOS women as the controls were enrolled. Serum levels of CXCL5, insulin and other hormones factors related with PCOS were measured by ELISA method, also the biochemical parameters were measured by autoanalyzer.
Results: Significant increases in serum insulin concentration, homeostasis model assessments of insulin resistance, luteinizing hormone, luteinizing hormone/follicle-stimulating hormone, fasting blood sugar, testosterone, and prolactin were observed in the case group compared to the controls. were in the serum level of CXCL5, cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol,dehydroepiandrosterone-sulfate, creatinine, and homeostasis model assessment of beta cell function between these two groups.
Conclusion: In this study, no significant change was observed in serum concentrations of CXCL5 in PCOS women with normal BMI.
Mahnaz Ghowsi, Homayoun Khazali, Sajjad Sisakhtnezhad,
Volume 16, Issue 3 (3-2018)

Background: Studies of oxidative status in polycystic ovarian syndrome (PCOS) patients are limited with inconsistent results. The effects of resveratrol as a natural antioxidant on oxidative status in PCOS aren’t clear.
Objective: This study evaluated effects of resveratrol on oxidative stress in the liver and serum of the PCOS rats.
Materials and Methods: Fifteen female Wistar rats (3 wk old) were divided into 3 groups (n=5/each e): Control group, PCO-Control group, and PCO-Resveratrol group. For induction of polycystic ovary phenotype, testosterone enanthate 10 mg/kg was injected for 35 days subcutaneously. Then, resveratrol 10 mg/kg was injected intraperitoneally for 28 days to rats of the PCO-Resveratrol group. Ovarian sections were stained with hematoxylin/eosin. The serum glucose and insulin and the levels of malondialdehyde (MDA) and total antioxidant capacity (TAC) in serum and liver were measured.
Results: Control animals showed normal ovarian morphology and PCO-Control animals exhibited cystic follicles. There were no significant differences in liver TAC between groups. The serum MDA (p=0.034), and homeostatic model assessment insulin resistance (HOMA-IR) (p=0.014) levels in PCO-Control rats were higher than the controls. The liver MDA in PCO-Control rats was more than that of controls (p=0.001). The HOMA-IR (p=0.008) and serum MDA (p=0.006) levels in PCO-Control rats were more than those of PCO-Resveratrol rats (p=0.008). In PCO-Resveratrol group, serum TAC was higher than that of PCO-Control group (p=0.022) and liver MDA was more than controls (p=0.01).
Conclusion: Results indicated that the induction of PCOS in rats increased lipid peroxidation and insulin resistance and resveratrol improved these complications.
Zahra Kalhori, Malek Soleimani Mehranjani, Mehri Azadbakht, Mohammad Ali Shariaatzadeh,
Volume 16, Issue 4 (4-2018)

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder featured by insulin resistance and hyperandrogenism. Testosterone enanthate can induce PCOS in mice models.
Objective: We investigated the ovary stereological features along with the oxidative stress and inflammatory factors in mice following PCOS induction using testosterone enanthate.
Materials and Methods: Twelve female NMRI mice (3 wk old) were divided into 2 groups (n=6/each): Control and PCOS. PCOS was induced through daily injections of testosterone enanthate (1 mg/100g subcutaneous s.c for 5 wk). Finally, ovaries were studied stereologically. The serum levels of the follicle-stimulating hormone, luteinizing hormone, testosterone, interleukin-6, and tumor necrosis factor-α were measured using ELISA kit. Serum levels of Malondialdehyde and the antioxidant capacity were measured relatively using thiobarbituric acid and ferric reducing antioxidant power assay.
Results: The mean total volume of ovary and the mean volume of cortex (p<0.001), volume of oocyte in the preantral (p=0.011) and antral follicle (p=0.015), thickness of zona pellucida (p=0.016), the number of antral follicles (p=0.012), the serum levels of follicle-stimulating hormone (p<0.001) and the antioxidant capacity (p=0.020) reduced significantly in the PCOS group compared to the control. The number of primary (p=0.017) and preantral (p=0.006) follicles and the serum levels of testosterone (p<0.001), Luteinizing hormone (p=0.002), Malondialdehyde, Interleukin 6 and Tumor necrosis factor-α (p<0.001) showed a significant increase in the PCOS group compared to the control.
Conclusion: Testosterone enanthate induced PCOS causes stereological features in the ovary, increases the oxidative stress and inflammatory markers in mice.
Arini Firmansyah, Maisuri Tadjuddin Chalid , Retno Budiati Farid, Nusratuddin Abdullah,
Volume 16, Issue 11 (11-2018)

Background: The underlying etiology of polycystic ovarian syndrome (PCOS) is unknown and assumed to have a strong correlation with insulin resistance. Homeostasis Model Assessment of insulin resistance (HOMA-IR) is a good tool to assess insulin resistance. Low levels of serum Insulin-like Growth Factor-Binding Protein-1 (IGFBP-1) in PCOS women led to the hypothesis that hyperinsulinemia in PCOS inhibits the production of IGFBP-1, which in turn stimulates excessive androgen production.
Objective: The study is aimed to analyze the correlation between the levels of IGFBP-1 and HOMA-IR on insulin resistance in PCOS.
Materials and Methods: A cross-sectional study among 105 PCOS women, including 60 women with insulin resistance were recruited. The mean of IGFBP-1 and HOMA-IR were 6.507±4.7821 μg/l and 3.633±1.666 respectively.
Results: Low levels of IGFBP-1 were detected in all insulin resistance women. There was a correlation between HOMA-IR and overweight (p=0.045), while IGFBP-1 showed no correlation with overweight (p=0.106). In addition, no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance was detected.
Conclusion: Despite the decrease in IGFBP-1, it seems that there is no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance.

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