Assessment of the Relationship Between Serum High Molecular Weight Adiponectin Hormone Levels and Insulin Resistance in Patients with Polycystic Ovary Syndrome

Abstract

The purpose of this study was to assess the rate of insulin resistance (IR) and the relationship between IR and high-molecular weight adiponectin (HMWA) in patients with polycystic ovary syndrome (PCOS). A cross sectional study involving 43 women with PCOS and 39 normal women was carried out over a period of nine months. Fasting glucose and insulin levels, lipid parameters and androgen levels were measured in all serum samples. HMWA was determined by enzyme-linked immunosorbent assay and IR was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR) index. The IR was more prevalent in the PCOS group than in the controls (p=0.002). Dehydroepiandrosterone sulfate, sex hormone binding globulin, free androgen index, total testosterone, insulin, and HOMA-IR levels were significantly higher in the PCOS group as compared to the control group (all p<0.05). Moreover, HMWA was significantly lower and negatively correlated with the clinical and biochemical hyperandrogenism in the PCOS group. HMWA and HOMA-IR were also associated with triglyceride, body mass index, and fat mass in this group. ROC curve analyses demonstrated that the AUC, indicative of the HMWA value for discriminating PCOS with IR, was 0.725, with a confidence interval of 0.615–0.835 (p=0.001). The serum HMWA levels are lower in patients with PCOS, which suggest that HMWA might be involved in the pathogenesis of PCOS. We also conclude that HMWA might be a strong determinant of IR in PCOS patients.

The Complex Roles of Adipokines in Polycystic Ovary Syndrome and Endometriosis

“…Since HMW adiponectin is particularly considered to be the best marker for IR, several studies have examined HMW levels in women with PCOS. In a recent study, HMW adiponectin was observed to be significantly lower and negatively correlated with hyperandrogenism in the PCOS group, corroborated by a study reporting an inverse correlation between HMW adiponectin and the free androgen index (FAI) [ 160 , 161 ]. A study including 122 women with PCOS and 89 control individuals particularly reported HMW adiponectin and the HMW/total adiponectin ratio (HMWR) to be reduced in PCOS.…”

Polycystic ovary syndrome: new insights on the puzzle of adiposity, chronic low-grade inflammation and metabolic disturbances

“…The disagreement among studies may be related to distinct factors, such as ethnicity or to differences in the methods of adiponectin determination. Recently, the measurement of high molecular weight-active adiponectin forms instead of total adiponectin has shown to increase the accuracy of assessments of the relationship between adiponectin and insulin resistance in PCOS (7,8). Interestingly, the results of the Cardoso et al study also reinforce the notion that higher/dysfunctional fat mass in PCOS may release inflammatory mediators, such as TNF and IL6, contributing to pathophysiological mechanisms related to the development of metabolic and reproductive dysfunctions of the syndrome (2,9).…”