Obesity, insulin resistance, and hormonal perturbations in Iraqi women

Abstract

Background: Obesity and increased weight are related to polycystic ovarian syndrome (PCOS) progression and exacerbate insulin resistance (IR). Aims of the study: This research aimed to assess the potential impacts of BMI and IR on the functions of the pituitary-ovary and the pituitary-thyroid axis by assessing the follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), thyroid stimulating hormone (TSH), Triiodothyronine (T3), Thyroxine (T4) and prolactin serum levels in the overweight and the obese PCOS groups. Methodology: From May to December 2023, Martyr Mohammed Baqer Al-Hakim Hospital in Baghdad City, Iraq, conducted this prospective study. The individuals were divided into three BMI groups: 40 in the normal weight control group (BMI<25 kg/m 2 ), 30 in the overweight group (BMI≥25 kg/m2), and 30 in the obese PCOS group (BMI≥30 kg/m 2 ). On days two or three of menstruation, blood was drawn. Electrochemiluminescence measured basal hormones. Result: Obese PCOS patients had higher levels of LH, LH/FSH, prolactin, E2, TSH, and decreased levels of FSH, T3, and T4 compared to the normal weight group (p<0.05). Additionally, the overweight group had considerably (p<0.05) lower LH, FSH, and E2 levels than the normal weight group. LH/FSH, prolactin, T3, T4, and TSH were not significantly different (p>0.05) between groups. In the overweight group, BMI was associated with FSH (r=-0.39, P=0.03). The obese PCOS group had a comparable LH association (r=-0.52, P=0.02). Obese PCOS patients had a BMI-HOMA-IR association (r=0.42, P=0.02). Conclusion:Our research shows that BMI decreases gonadotropin release in overweight and obese PCOS patients. However, IR does not inhibit/stimulate the pituitary-ovary or pituitary-thyroid axes.