The evaluation of the association of insulin resistance with inflamatory and local endothelial factors in women with polycystic ovary syndrome

VIII-SUMMARYOBJECT: Polycystic ovary syndrome (PCOS) is one of the most causes of chronicanovulatuar dysfunction which results in infertility in women. Approximately, 5-10 % of the reproductive age women are affected by this disorder. Thisendocrinopathic condition, in reproductive age women was first described fiftyyears ago. What causes the disorder has not been classified yet. The aim of thisstudy is to determine whether there is a relation between the inflammatuarmarkers, local endothelial factors and already known insulin resistance in womenwho have PCOS; if yes, to determine the most effected parameter and the factorsthat may be foreseen about the long-term risks of the disease.MATERIAL-METHOD: 41 women who have PCOS (patient group) and 31healthy women (control group) were included in the study. Hormone profile andserum levels of fasting blood glucose, insulin, high sensitive C reactive protein(hs-CRP), fibrinogene, C3, interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α),vasculary endothelial growth factor (VEGF), nitric oxide (NO) and adiponectinwere measured in the 2-5th days of the menstrual cycle from all cases. Statisticalanalysis was done with Independent Sample T-test and Pearson correlationanalysis.RESULTS: Fasting insulin levels and HOMA-IR value were statisticallysignificantly higher in the PCOS group. We determine insulin resistance in 9patients ( %22 ) in PCOS group and in 2 patients ( % 6 ) in the control groupwhen we compare insulin resistance according to HOMA-IR between the groupsas the cut-off value was 2,7. Fibrinogene, hs-CRP, C3 and VEGF levels werestatistically significantly higher in the PCOS group (p< 0.0001, p=0.008, p=0.001,p=0.04, respectively). No statistically significant difference was found betweenthe two groups in the NO and adiponectin levels ( p> 0.05). But the results werehigher in the PCOS group although not statistically significant. No correlation wasfound between HOMA-IR level and adiponectin, NO, VEGF and inflammatuarmarkers in the PCOS group (p>0.05). There was a strong correlation in thepositive direction between the body mass index (BMI) and hs-CRP and a weakcorrelation in the negative direction between BMI and adiponectin in the PCOS45group. While waist/hip ratios are positively correlated with LDL cholesterol andhs-CRP levels; NO, VEGF levels were weakly positive correlated with TNF-α inthe PCOS group.CONCLUSION: Because of the cardiovasculary risk factors such as insulinresistance, obesity, dyslipidaemia and hyperandrogenism are seen frequently inPCOS, this situation certainly supports that cardiovasculary risk is higher. Also,the determination of high levels of inflammatuar markers lead us to the increaseof high cardiovasculary risk in these patients. In this point, however we cansuppose that inflammatuar process begins in the earlier times, but, there is nodefinite data available yet about the trigger of the beginning of the atherosclerosisor the beginning point of the inflammation event in PCOS. Further studies areneeded to clarify the relations between the cardiovasculary risk and insulinresistance and inflammatuar markers and local endothelial factors in PCOS.46