瘦素、神经肽Y与多囊卵巢综合征关系的研究

目的 :探讨瘦素和神经肽Y(NPY)在多囊卵巢综合征 (PCOS)发病中的作用。方法 :测定 15 3例PCOS患者和6 7例对照组患者的身高体重指数 (BMI)、脂肪百分率、腰围 /臀围比值 (WHR)、E2 、P、T、PRL、LH、FSH、口服葡萄糖耐量试验 (OGTT)、血糖、胰岛素、C肽、瘦素和NPY ,应用Pearson相关分析法分析瘦素或NPY与各指标之间的相互关系 ,对与BMI、脂肪百分率、瘦素和NPY呈显著相关的各指标进一步进行Partial相关分析。结果 :PCOS患者的血清瘦素水平为17.9± 1.8ng/L ,NPY血清水平为 2 97.7± 9.8μg/L ,均明显高于对照组的血清瘦素 (10 .6± 2 .1ng/L)和NPY水平 (15 3.5±13.4 μg/L) (P <0 .0 1,P <0 .0 5 )。Pearson相关分析发现 ,BMI、WHR、脂肪百分率、OGTT、空腹血糖、胰岛素、C -肽值、OGTT胰岛素曲线下面积等与瘦素或NPY在PCOS组和对照组都呈显著正相关 ,PCOS组的相关系数高于对照组。两组的平均年龄、FSH、E2 、LH、LH/FSH、T、PRL、OGTT血糖、C -肽曲线下面积均与瘦素或NPY无显著相关关系。BMI、脂肪百分率及OGTT胰岛素曲线下面积均与PCOS组的血清瘦素和NPY明显高于对照组的现象有关。结论 :高NPY和瘦素水平与PCOS患者的肥胖和胰岛素抵抗密切相关 ,可能参与了PCOS的发生、发展     

达英-35对非肥胖、非胰岛素抵抗多囊卵巢综合征胰岛素敏感性的影响

目的探讨达英-35[diane-35,每片含醋酸环丙孕酮(CAP)2 mg和乙炔雌二醇(EE)35 μg]对非肥胖、非胰岛素抵抗(IR)多囊卵巢综合征(PCOS)胰岛素敏感性的影响.方法选取32例非肥胖、非IR的PCOS患者作为研究对象,达英-35治疗3个月,治疗前后测定体重指数(BMI)、腰臀比(WHR)、血清促卵泡生成素(FSH)、促黄体生成素(LH)、睾酮(T)、瘦素(Leptin)和性激素结合球蛋白(SHBG),并进行口服糖耐量试验(OGTT)和胰岛素释放试验,计算游离雄激素指数(FAI)、葡萄糖和胰岛素曲线下面积、空腹血糖/胰岛素之比(GIR)、OGTT各时点的胰岛素/血糖比以及卵巢体积.结果①治疗前后BMI、WHR和FSH无改变,LH、LH/FSH值、FAI和卵巢体积明显下降(P＜0.01),T也较治疗前降低(P＜0.05),SHBG则明显升高(P＜0.01),血Leptin升高(P＜0.05).②治疗前后空腹血糖均在正常范围,葡萄糖曲线下面积(AUC葡萄糖)无改变,治疗后胰岛素曲线下面积(AUC胰岛素)、OGTT各时相的胰岛素/血糖比和胰岛素水平均升高(P＜0.01),GIR则从11.24±2.15 mg·L/dl·mU明显下降为3.77±0.60 mg·L/dl·mU (P＜0.01).结论达英-35在明显改善非肥胖、非IR PCOS高雄激素血症的同时有胰岛素抵抗的迹象,其原因可能与周围组织胰岛素敏感性下降有关.     

多囊卵巢综合征胰岛素抵抗与瘦素关系的探讨

目的　探讨多囊卵巢综合征 (PCOS)妇女血清瘦素 (leptin)水平与胰岛素抵抗 (IR)的关系 ,为研究PCOS的发病机制和治疗新途径提供理论依据。方法　 5 1例PCOS患者及 2 3例正常妇女均测定体重指数(BMI)、腰臀比 (WHR)、血清生殖激素及leptin水平 ,同期行口服糖耐量 (OGTT)及胰岛素 (Ins)释放试验 ,OGTT示IR者给予二甲双胍 (1 5 g/d)治疗 3个月后复测上述指标。 结果　PCOS患者血清leptin水平高于相应对照组 ,且IR组显著高于NIR组 ;PCOS患者经二甲双胍治疗后血清Ins水平显著下降 ,胰岛素敏感指数 (ISI)显著上升 ,同时leptin水平下降。相关分析表明 ,PCOS患者血清leptin与BMI、WHR及T显著正相关 ,与ISI负相关 (r=0 6 7,P <0 0 1) ,多元回归显示leptin中有BMI、ISI引入。结论　PCOS患者血清leptin水平升高与胰岛素敏感性相关 ;二甲双胍治疗PCOS患者可提高其胰岛素敏感性 ,降低血清leptin水平。     

多囊卵巢综合征血浆瘦素的改变及相关影响因素的研究

目的探讨多囊卵巢综合征(PCOS)患者血浆瘦素(leptin)水平的变化及其相关影响因素。方法用放射免疫学方法检测63例PCOS患者血浆leptin、血清泌乳素、促黄体生成素、卵泡刺激素、雌二醇、睾酮、雄烯二酮水平,同时行糖耐量及胰岛素释放实验。用相关分析探讨leptin与体重指数(BMI)、性激素、血糖、胰岛素和胰岛素敏感指数的关系。结果PCOS患者空腹胰岛素(r=0.6,P<0.01)和BMI(r=0.351,P<0.01)与血浆瘦素呈显著正相关,且空腹胰岛素对瘦素的影响更显著。结论瘦素可能与PCOS的胰岛素抵抗、高胰岛素血症密切相关。     

多囊卵巢综合征患者血清中血管生成素相关生长因子水平的评价

目的探讨多囊卵巢综合征(PCOS)患者血清中血管生成素相关生长因子(angiopoientin-related growth factor,AGF)水平变化,及AGF与PCOS患者胰岛素抵抗的关系。方法 2010年3月至2011年3月在沧州市中心医院选择67例未合并糖尿病的PCOS患者作为研究组,同期选择112例健康女性作为对照组,测定所有研究对象血清AGF质量浓度及与胰岛素抵抗相关的内分泌代谢指标。结果研究组血清AGF水平显著高于对照组(345.3±38.6)vs.(288.7±33.4)μg/L,P<0.05;PCOS胰岛素抵抗组血清AGF水平显著高于PCOS非胰岛素抵抗组(350.9±29.6)vs.(338.4±31.6)μg/L,P<0.05。AGF与BMI(r=0.23,P<0.05)、胰岛素抵抗(IR)指数(HOMA-IR)(r=0.19,P<0.05)呈正相关,与年龄、低密度脂蛋白(LDL-C)、腰臀比(WHR)、空腹血糖(FBG)、2h糖耐量试验(OGTT)、空腹胰岛素(FINS)无关。结论升高的AGF可能在PCOS患者糖脂代谢紊乱的发生发展过程中发挥作用。     

关于青春期多囊卵巢综合征胰岛素抵抗的探讨

目的　探讨青春期多囊卵巢综合征 (PCOS)胰岛素抵抗 (IR)和葡萄糖耐量减低 (IGT)的发生率。方法　选择 2 0 0 3年 2～ 9月复旦大学附属妇产科医院 2 9例 14～ 19岁的青春期PCOS患者 ,测定体重指数 (BMI)、腰臀比 (WHR)、卵巢体积、血清卵泡刺激素 (FSH)、黄体生成激素 (LH)和睾酮 (T) ,并行口服糖耐量试验 (OGTT)和胰岛素释放试验 ,根据空腹血糖 /胰岛素之比 (GIR)将其分为IR组 15例和非IR组 14例。结果　所有研究对象的空腹血糖均正常 ,两组间卵巢体积、LH/FSH比值、T水平无明显差异 (P >0 0 5 ) ,IR组BMI、WHR、曲线下葡萄糖面积 (AUC葡萄糖)和曲线下胰岛素面积 (AUC胰岛素)均高于非IR组 (P <0 0 5 ) ,而非IR组LH水平高于IR组 (P <0 0 5 ) ;IR组IGT患者占 4 0 0 % ,高于非IR组的 7 1% ,相关分析则显示GIR与BMI、WHR、空腹胰岛素水平、AUC葡萄糖 和AUC胰岛素 呈负相关。结论　肥胖和BMI正常者青春期PCOS均存在IR ,表现IR的青春期PCOS患者更易发生IGT ,要重视青春期PCOS患者IR的评估以及IGT的筛选。     

二甲双胍在多囊卵巢综合征促排卵治疗中的作用

目的　评估二甲双胍在多囊卵巢综合征 (PCOS)患者促排卵治疗中的作用。方法　以40例PCOS患者 (PCOS组 )为研究对象 ,其中 2 0例口服二甲双胍治疗 12周 ,治疗后 17例未孕者加用高纯度促卵泡激素 (FSH HP)治疗 1个周期 (A组 ) ,另 2 0例单用FSH HP治疗 1个周期 (B组 ) ;同时 ,以体重和月经周期均正常的 2 0例门诊患者为对照组。观察各组及A组患者口服二甲双胍前后血清FSH、黄体生成激素 (LH)、睾酮、瘦素、空腹血糖及空腹胰岛素水平 ;比较A、B两组促排卵治疗结果。结果　空腹胰岛素和瘦素水平 ,PCOS组显著高于对照组 (P <0 .0 5) ,PCOS肥胖者高于PCOS非肥胖者(P <0 .0 5) ,但PCOS非肥胖者与对照组相比 ,差异无显著性 (P >0 .0 5)。二甲双胍治疗后 ,LH、空腹胰岛素、睾酮及瘦素水平明显下降 (P <0 .0 5～ 0 .0 1)。PCOS组患者中有 3例服二甲双胍治疗期间妊娠 ,另外 3 7例行FSH HP促排卵治疗后有 7例妊娠 (A组 4例 ,B组 3例 ) ,总妊娠率为 19% ( 7 3 7) ;A组的排卵率 ( 88% ,15 17)和妊娠率 ( 2 4% ,4 17)虽高于B组 ( 70 % ,14 2 0 ;15% ,3 2 0 ) ,但差异无显著性 (P >0 .0 5)。结论　二甲双胍能降低胰岛素和瘦素水平 ,逆转PCOS患者性激素异常 ,使部分患者恢复排卵和妊娠 ,可增强PCOS患者对促性腺素的敏感     

体质量指数正常的多囊卵巢综合征伴胰岛素抵抗患者的临床特征及胰岛素抵抗影响因素分析

目的:观察体质量指数(BMI)正常的多囊卵巢综合征(PCOS)伴胰岛素抵抗(IR)患者的临床及生化表现,探讨其临床特征及IR的影响因素。方法:收集2015年8月至2016年6月就诊于黑龙江中医药大学附属第一医院妇科门诊的BMI正常(18.5 kg/m~2≤BMI≤23.9 kg/m~2)的PCOS患者116例,其中PCOS伴IR患者50例,PCOS不伴IR患者66例,分析、比较两组的临床特征、性激素水平、糖脂代谢水平,采用Spearman或Pearson相关分析稳态模型胰岛素抵抗指数(HOMA-IR)的影响因素。结果:1PCOS伴IR组患者腰臀比、多毛评分明显高于PCOS不伴IR组患者,差异有统计学意义(P0.05);2PCOS伴IR组患者空腹葡萄糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)显著高于PCOS不伴IR组患者,差异有统计学意义(P0.05),PCOS伴IR组患者高密度脂蛋白(HDL)显著低于PCOS不伴IR组患者,差异有统计学意义(P0.05);3对BMI正常的PCOS患者进行相关分析,HOMA-IR与年龄、BMI、卵泡刺激素(FSH)、黄体生成激素(LH)、LH/FSH、睾酮(T)、硫酸脱氢表雄酮(DHEAS)、雄烯二酮(AND)无关(P0.05);与腰臀比(r=0.386)、FPG(r=0.459)、FINS(r=0.981)、TC(r=0.360)、TG(r=0.343)和LDL(r=0.467)呈正相关(P0.01),与性激素结合球蛋白(SHBG)(r=-0.220,P0.05)、HDL(r=-0.288,P0.01)呈负相关。结论:BMI正常的PCOS伴IR患者腰臀比、多毛评分及糖、脂代谢指标较无IR的PCOS患者均有改变。BMI正常的PCOS患者的IR与腰臀比、FPG、FINS、TC、TG、LDL及SHBG、HDL相关。     

瘦素与妊娠期糖尿病胰岛素抵抗的关系

目的　探讨瘦素与妊娠期糖尿病 (GDM)胰岛素抵抗 (IR)关系及在GDM发病机制中的作用。方法　应用放射免疫法测量 32例GDM妇女、 30例正常糖耐量妊娠妇女 (NGT)的空腹瘦素、C肽水平及空腹胰岛素和 75g葡萄糖耐量试验 (OGTT)后 2h的胰岛素水平。应用稳态模型胰岛素抵抗指数 (HOMA -IR)及胰岛分泌功能指数 (HBCI) ,比较两组HOMA -IR及HBCI的差异 ,分析两组空腹瘦素与IR之间的关系。结果　①GDM组HOMA -IR (2 3± 0 3)高于NGT组 (1 4± 0 4 ) ,差异有显著性 (P <0 0 1) ;两组间HBCI比较差异无显著性 (P >0 0 5 )。②GDM组血清瘦素水平 (2 4 7± 2 2 )ng ml高于NGT组 (2 0 3± 1 5 )ng ml,两组之间比较差异有显著性 (P <0 0 5 )。相关分析表明 ,在GDM组瘦素与HOMA -IR呈正相关 (rLeptin =0 5 4 8,P <0 0 0 1) ,在NGT组二者之间无相关性 (rNGT =0 2 2 1P >0 0 5 )。结论　妊娠期IR程度增加 ,可能是GDM主要的发病机制之一。瘦素与GDM胰岛素抵抗有关 ,可能参与GDM的发病     

多囊卵巢综合征代谢特征分析

目的探讨多囊卵巢综合征(PCOS)胰岛素抵抗与非胰岛素抵抗患者临床及代谢特征。方法回顾性分析2012年1月至2014年12月就诊于广东省妇幼保健院妇科门诊的218例PCOS患者,按HOMA稳态模型(HOMA-IR)分为两组,PCOS胰岛素抵抗(PCOS-IR)组和PCOS非胰岛素抵抗(PCOS-NIR)组,比较两组临床及生化指标。结果 PCOSIR组体重指数、腰围、腰臀比均高于PCOS-NIR组,差异有统计学意义(P0.01)。PCOS-IR组总胆固醇、三酰甘油、低密度脂蛋白、空腹血糖、3 h血糖、尿酸水平明显高于PCOS-NIR组,血脂异常(72.62%)、空腹糖耐量受损(4.8%)、糖耐量异常(32.1%)、糖尿病(8.3%)、高尿酸血症(83.1%)的发生率均高于PCOS-NIR组,差异均有统计学意义(P0.05)。两组高密度脂蛋白、1 h血糖、2 h血糖,差异无统计学意义(P0.05)。结论 PCOS-IR组患者存在更为严重的血糖、血脂及尿酸的代谢紊乱。葡萄糖耐量试验在筛查PCOS患者糖耐量异常及诊断糖尿病中具有重要的意义。尽早改善患者胰岛素抵抗,干预血糖、血脂、尿酸代谢紊乱,可能对延缓并发症发生有一定的作用。     

Metformin therapy increases insulin-like growth factor binding protein-1 in hyperinsulinemic women with polycystic ovary syndrome

OBJECTIVES: Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism, insulin resistance, compensatory hyperinsulinemia, and increased levels of free insulin-like growth factor-I (IGF-I), presumably due to a decline in IGF binding protein 1 (IGFBP-1). This study was designed to evaluate effects of metformin therapy on serum levels of IGFBP-1 and IGF-I. STUDY DESIGN: Twenty-seven obese, hyperandrogenic PCOS women with elevated fasting insulin were treated for 12 weeks with metformin (500 mg p.o., t.i.d.). Serum levels of insulin, testosterone, sex hormone binding globulin (SHBG), IGF-I, and IGFBP-1 were measured before and after treatment. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed at baseline and at the end of therapy. RESULTS: Metformin therapy significantly increased IGFBP-1 concentration by 38% (P = 0.05) but had no demonstrable effect on the total IGF-I levels. Fasting insulin levels declined by 38% (P = 0.0001) while the glucose/insulin ratio increased by 72% (P = 0.0001) and quantitative insulin sensitivity check index (QUICKI) increased by 8% (P = 0.0001). Metformin treatment also significantly decreased testosterone (by 37%, P = 0.0001) and increased SHBG concentration (by 16%, P = 0.04). Multiple linear regression analysis revealed that baseline IGFBP-1 levels correlated inversely and independently with two baseline parameters: WHR (P = 0.003) and free testosterone index (P = 0.04). CONCLUSIONS: The present study shows that metformin therapy not only restores normal levels of insulin and testosterone, but also decreases the pool of free-bioactive IGF-I by increasing the levels of circulating IGFBP-1. We provide further arguments in favor of metformin therapy in hyperinsulinemic women with PCOS.     

Serum Leptin Elevation in Obese Women with PCOS: A Continuing Controversy

PURPOSE: To evaluate leptin levels in a sample of obese women with PCOS and compare the results with obese and non-obese control, to be ultimately correlated with BMI, and insulin sensitivity. METHODS: Leptin and insulin assays by immuno-radiometric method, glucose assay by enzymatic colorimetric method. RESULTS: Leptin levels were significantly different between obese and non-obese subjects, and were significantly different between insulin resistant and non-insulin resistant obese PCOS, but were not significantly different between obese non-insulin resistant PCOS, and obese controls. CONCLUSIONS: Body mass index and insulin resistance are the two main factors governing serum leptin levels.     

Metformin decreases circulating acylation-stimulating protein levels in polycystic ovary syndrome.

AIM: There are no studies that examine the circulating acylation-stimulating protein (ASP) levels in patients with polycystic ovary syndrome (PCOS). The present study was designed to determine the ASP levels in PCOS and to evaluate the effect of metformin on plasma fasting ASP concentrations. METHODS: Twenty women with PCOS and 20 healthy controls matched for age and body mass index (BMI) were included in the study. We determined ASP and other biochemical parameters before and after treatment. RESULTS: Baseline levels of plasma ASP, complement 3 (C3), waist-to-hip ratio (WHR), homeostasis model assessment-insulin resistance index (HOMA-IR), fasting insulin, triglycerides (TG) and very-low-density lipoprotein cholesterol (VLDL-C) were significantly higher in patients than in controls. After 3 months of metformin treatment, BMI, WHR, ASP, C3, fasting glucose, fasting insulin, HOMA-IR, total cholesterol, TG, VLDL-C and free testosterone decreased significantly, whereas apolipoprotein A-I and high-density lipoprotein cholesterol increased significantly. CONCLUSIONS: The major novel information of the present study is that ASP and C3 values are markedly increased in non-obese patients with PCOS, with a decrease evidenced with metformin treatment.     

Serum leptin levels correlate with clinical and biochemical indices of insulin resistance in women with polycystic ovary syndrome

Objectives To compare serum leptin levels in women with polycystic ovary syndrome (PCOS) and healthy subjects, and to evaluate the relationship between leptin concentration and insulin resistance.

Methods Forty-five women with PCOS and 20 controls were included in the study. Serum levels of leptin, testosterone, immune-reactive insulin (IRI), sex hormone-binding globulin, dehydroepiandrosterone sulfate, cortisol, LH and FSH were measured. Free androgen index (FAI) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed.

Results Serum leptin levels in PCOS patients were higher than in the control group independently of BMI, WHR and waist circumference. In PCOS patients there was a strong positive correlation between leptin and IRI (r = 0.592, p < 0.01) on the one hand, and leptin and HOMA-IR, on the other (r = 0.637, p < 0.01). In PCOS patients with more pronounced insulin resistance (IR) the correlation between leptin levels and HOMA-IR is independent of BMI, WHR and waist circumference. We did not find any correlation between leptin and other hormonal indices in PCOS patients.

Conclusions Our study confirms the existence of a significant positive correlation between serum leptin levels and clinical and hormonal indices of IR. The hyperleptinaemia is probably due to leptin resistance and may be characteristic of the syndrome. The lack of correlation with other hormonal parameters is probably due to the heterogeneity of the PCOS group.     

Altered leptin,adiponectin, resistin and ghrelin secretion may represent an intrinsic polycystic ovary syndrome abnormality

Abstract

The aim of the study was to investigate whether altered adipose tissue secretion of various adipokines is secondary to obesity, hyperandrogenism, and hyperinsulinemia or intrinsic to polycystic ovary syndrome (PCOS). This cross-sectional study included 151 women diagnosed with PCOS by the Rotterdam criteria and 95 healthy women matched by age, body mass index (BMI), and waist-to-hip ratio (WHR). Clinical, biochemical, and hormonal characteristics were assessed. Serum concentrations of ghrelin and adiponectin were found to be significantly lower and concentrations of leptin and resistin significantly higher in women with PCOS than in healthy women matched by age, BMI, and WHR. A PCOS diagnosis made the largest contribution to predicting serum levels of leptin, adiponectin, resistin, and ghrelin in all stepwise multiple regression models, which included PCOS diagnosis, BMI, WHR, luteinizing hormone, total testosterone, free testosterone and homeostatic model assessment of insulin resistance as independent predictors. Leptin, adiponectin, ghrelin and resistin levels may serve as independent biomarkers for the diagnosis of PCOS.     

Are serum chemerin levels different between obese and non-obese polycystic ovary syndrome women?

The objective of this study is to measure serum chemerin levels in women with polycystic ovary syndrome (PCOS) and assess their relationship with clinical, metabolic, and hormonal parameters. One hundred eighteen PCOS women and 114 healthy women were recruited in this study. Their blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), fasting insulin (FIN), fasting plasma glucose (FPG), blood serum sex hormone, and blood lipid were measured. Serum chemerin, leptin, and adiponectin were measured by ELISA. Serum chemerin was significantly higher in the obese PCOS group (47.62?±?11.27?ng/mL) compared with non-obese PCOS (37.10?±?9.55?ng/mL) and the obese (33.71?±?6.17?ng/mL) and non-obese (25.78?±?6.93?ng/mL) control groups (p?p?相似文献   

Evidence for competing effects of body mass,hyperinsulinemia, insulin resistance,and androgens on leptin levels among lean,overweight, and obese women with polycystic ovary syndrome

OBJECTIVE: To evaluate the relationships between leptin, body composition, insulin resistance, androgens, and reproductive indices among women with polycystic ovary syndrome (PCOS).DESIGN: Matched case-control study.SETTING: Academic reproductive endocrine practice; school of public health.PATIENT(S): Forty-six Caucasian women with PCOS and 46 population-based controls matched by age and body mass index (BMI).INTERVENTION(S): None.MAIN OUTCOME MEASURE(S): Leptin, insulin, androgenic hormones, body composition parameters; reproductive parameters.RESULT(S): Overall, leptin levels among women with PCOS did not differ significantly from those of control women (20.4 +/- 14.9 vs. 21.9 +/- 14.3 ng/mL). However, within the lowest BMI tertile, women with PCOS had significantly lower leptin levels (9.6 vs. 18.3 ng/mL), comparable insulin, and higher testosterone concentrations than controls of similar body mass. Within the overweight and obese subgroups, both insulin and testosterone levels were increased among women with PCOS; leptin levels, although higher among obese cases, were not statistically different than those in controls.CONCLUSION(S): Below a certain BMI, hyperandrogenic women with PCOS have lower leptin levels than controls. Conversely, overweight and obese PCOS subjects appear to produce insufficient leptin for a given fat mass, relative to the degree of hyperinsulinemia, potentially because of the competing effects of adipocyte insulin resistance and androgens on leptin.     

The effect of hypophysectomy on inhibin production by adult rat ovaries: Changes in ovarian inhibin gene expression and serum inhibin

Our aim was to determine whether serum leptin level is regulated by thyroid hormones ,lipid metabolic products and insulin resistance status in women with polycystic ovary syndrome (PCOS). A prospective case-controlled study was carried out in Istanbul University ,Cerrahpasa School of Medicine in 25 lean PCOS (L-PCOS) women ,19 obese PCOS (O-PCOS) women and 28 normal women. The diagnosis of PCOS was established according to the clinical ,hormonal (elevated luteinizing hormone and serum androgens) and ultrasonographic findings. Fasting serum levels of thyroid stimulating hormone (TSH) ,free triiodothyronine (FT3), free thyroxine (FT4) ,fasting glucose ,insulin ,total cholesterol (TC) ,triglyceride (TG) ,high-density lipoprotein-cholesterol (HDL-C) ,low-density lipoprotein-cholesterol (LDL-C) ,very low-density lipoprotein-cholesterol (VLDL-C) and leptin were measured and compared in the three groups and the correlations between serum levels of leptin and other parameters were evaluated. Serum leptin levels were higher in the O-PCOS group ,while its level was comparable between the L-PCOS and control groups. Serum levels of FT4 were significantly lower in both L-PCOS and O-PCOS groups than the control group. Women in both L-PCOS and O-PCOS groups were found to be significantly hyperinsulinemic and insulin resistant. Serum levels of TC ,VLDL-C and TG were significantly higher in the O-PCOS group ,while serum HDL-C level was lower. There was a poor correlation between serum leptin ,and FT4 ,TC ,TG ,HDL-C and VLDL-C levels. A significant correlation was observed between serum leptin levels and both BMI and insulin resistance status in PCOS. We believe that ,although thyroid hormones and lipid metabolic products do not seem to participate in the regulation of serum leptin levels ,BMI and insulin resistance status may have a key role in women with PCOS.     

Is serum leptin level regulated by thyroid functions, lipid metabolism and insulin resistance in polycystic ovary syndrome?

Our aim was to determine whether serum leptin level is regulated by thyroid hormones, lipid metabolic products and insulin resistance status in women with polycystic ovary syndrome (PCOS). A prospective case-controlled study was carried out in Istanbul University, Cerrahpasa School of Medicine in 25 lean PCOS (L-PCOS) women, 19 obese PCOS (O-PCOS) women and 28 normal women. The diagnosis of PCOS was established according to the clinical, hormonal (elevated luteinizing hormone and serum androgens) and ultrasonographic findings. Fasting serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), fasting glucose, insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C) and leptin were measured and compared in the three groups and the correlations between serum levels of leptin and other parameters were evaluated. Serum leptin levels were higher in the O-PCOS group, while its level was comparable between the L-PCOS and control groups. Serum levels of FT4 were significantly lower in both L-PCOS and O-PCOS groups than the control group. Women in both L-PCOS and O-PCOS groups were found to be significantly hyperinsulinemic and insulin resistant. Serum levels of TC, VLDL-C and TG were significantly higher in the O-PCOS group, while serum HDL-C level was lower. There was a poor correlation between serum leptin, and FT4, TC, TG, HDL-C and VLDL-C levels. A significant correlation was observed between serum leptin levels and both BMI and insulin resistance status in PCOS. We believe that, although thyroid hormones and lipid metabolic products do not seem to participate in the regulation of serum leptin levels, BMI and insulin resistance status may have a key role in women with PCOS.