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Abstract

CORRELATIONS BETWEEN SERUM OSTEOCALCIN, LEPTIN & INSULIN SENSITIVITY INDEX IN OBESE & NON-OBESE PCOS WOMEN

Shatha H. Ali and Ali M.A. Al-Nuaimi*

ABSTRACT

Both lean and obese patients with PCOS have been found to be at risk for insulin resistance and type 2 diabetes mellitus. The exciting evidence, of particular interest is whether osteocalcin level in the circulation is associated with glucose metabolism in humans. Additionally, an adipocyte -secreted hormone affecting energy metabolism, was also a major determinant of bone remodeling, namely leptin indirectly inhibits bone accrual through a central pathway comprising hypothalamus and central nervous system. This newly identified feedback loop between bone and energy metabolism is mediated by osteocalcin (OC). The present study is aimed to evaluate the correlations between serum leptin and osteocalcin levels in relation to glucose homeostasis with hormonal changes (LH, FSH, Prolactin, Testosterone) in obese and nonobese women with poly cystic ovary syndrome (PCOS). Methods: This study included fifty women with poly cystic ovaries syndrome (PCOS) and thirty four apparently healthy control women with regular menstruation (28±2days). The diagnosis of PCOS was based on the revised Rotterdam Criteria. Both of PCOS patients and controls were divided into sub-groups according to their BMI into: twenty-five obese (BMI ≥30) with (Mean ±SEM BMI = 35.934±0.746) and another twenty five non-obese poly cystic ovaries syndrome women (Mean ±SEM BMI =25.074±0.456). Whereas, the controls were divided as: seventeen obese (Mean ±SEM BMI= 37.140±1.470) and seventeen non-obese (Mean ±SEM BMI= 25.022±0.683) healthy control women with regular menstruation and age range (20-40 years) and BMI matching that of the patients groups. Venous blood samples were collected at 9:00 am after an overnight fasting between the 3rd and 5th days of a spontaneous bleeding episode of the PCOS group and of a menstrual cycle of the controls for analysis. Results: Although, serum osteocalcin levels were not significantly different from their corresponding controls, in both obese and non-obese PCOS patients, levels were significantly elevated in non-obese patients as compared to obese patients (p= 0.006). serum leptin levels were significantly elevated in obese PCOS patients as compared to their corresponding control group, non-obese control and non-obese PCOS patients respectively(18.338±0.538, 17.266±0.718 and 17.173±0.549 ng/ml, p <0.05). Furthermore, serum insulin levels were elevated significantly in obese patients as compared to non-obese patients and non-obese controls (p < 0.0001, 0.0001, respectively). Even so, there were no significant different in serum insulin levels between controls groups. The leptin / BMI ratio was significantly lowered in obese PCOS patients as compared to their control group, non-obese control and non-obese PCOS patients respectively(p <0.05). The insulin /osteocalcin ratio was not significantly different from their corresponding controls, in both non-obese and obese PCOS patients. The Estimation of Insulin Sensitivity Index (Quantitative Insulin Sensitivity Check Index – QUICKI) values showed a highly significantly difference in obese PCOS women as compare to obese controls (p < 0.0001), but there was no significant difference between non-obese PCOS women and their control (0.329±0.003, 0.335±0.003, respectively).Significant correlations among the studied parameter indicate that QUIKI values with Leptin/BMI ratio to be negatively correlated (r= -0.398, p=0.049). While QUIKI values was positively correlated with Leptin/insulin ratio (r= 0.764, p<0.000) in Non-Obese PCOS Women. Furthermore, data analysis indicates that in Obese PCOS Women QUICKI values were positively correlated to Leptin/Insulin ratio (r = 0.758, p <0.0000). Therefore, further studies of osteocalcin are required to elucidate it‟s role in metabolism can provide the fundamental basis of therapeutic strategies for metabolic disorders associated with PCOS among other disorders linked to insulin resistance.

Keywords: PCOS, Osteocalcin, Leptin, OUICKI.


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