The plasma nitric oxide and homocysteine levels and their association with insulin resistance in South Indian women with polycystic ovary syndrome

Kandasamy S.; Inmozhi Sivagamasundari R.; Bupathy A.; Sethupathy S.

doi:10.18203/2320-6012.ijrms20163774

Authors

Kandasamy S. Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education & Research, Puducherry, India
Inmozhi Sivagamasundari R. Division of Biochemistry, Rajamuthaiah Medical College and Hospital, Annamalai University, Tamilnadu, India
Bupathy A. Department of Obstetrics and gynaecology, Indira Gandhi Medical College & Research Institute, Puducherry, India
Sethupathy S. Division of Biochemistry, Rajamuthaiah Medical College and Hospital, Annamalai University, Tamilnadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20163774

Keywords:

Endothelial dysfunction, Homocysteine, Insulin resistance, Nitric oxide, Polycystic ovary syndrome

Abstract

Background: Women with polycystic ovary syndrome (PCOS) exhibit features of the metabolic syndrome apart from low-grade chronic inflammation and endothelial dysfunction and may be at increased risk for cardiovascular disease (CVD). The Nitric oxide (NO) and Homocysteine (Hcy) are important plasma markers of endothelial dysfunction, an early marker of atherosclerosis. There are no Indian studies on NO and Hcy levels in women with PCOS and their association with Insulin Resistance (IR). Therefore the present study is to estimate plasma levels of NO and Hcy in south Indian women with PCOS and association with insulin resistance.

Methods: 104 women with PCOS and 95 healthy age matched control subject were enrolled in the study. Standard physical methods and Chemiluminescent Immunoassay technique were employed for estimation of Anthropometric parameter and plasma sex hormones respectively. Fasting insulin, glucose, NO and Hcy were measured by standard methods. Insulin resistance was evaluated by using Homeostasis Model Assessment for Insulin Resistance (HOMA- IR)

Results: Women with PCOS had significantly higher insulin resistance (P<0.01), Hcy (p<0.05) and lower NO levels (P<0.05), IR was positively correlated with Hcy (r= 0.610, p<0.01) and negatively correlated with NO (r= -0.285; p<0.01)

Conclusions: Our data revealed that South Indian women with PCOS had elevated IR and homocyeteine and lowered NO levels.

Metrics

Metrics Loading ...

References

Lee H, Oh JY, Chung H, Cho WY. The prevalence and risk factors for glucose intolerance in young Korean women with polycystic ovary syndrome. Endocrine. 2009;36(2):236-2.

Norman RJ, Dewailly D, Legro R S, Hickey TE. Polycystic ovary syndrome. Lancet. 2007;370:685-97.

Wild RA, Carmina E, Diamant-Kandarakis E. Assessment of cardiovascular risk and prevention of cardiovascular diseases in women with PCOS; A consensus statement by the Androgen Excess and PCOS (AE-PCOS). Society J Clin Endocrinol Metab. 2010;95:2038-49.

Vanhoutte Pan. Endothelial dysfunction: The first step towards coronary arteriosclerosis. Circ J. 2009;73:595-601.

Verma S, Buchanan MR, Anderson TJ. Endothelial function testing as a marker of vascular diseases. Circulation. 2003;108:2054-9.

Victoria S, Greg Atkinson, Daniel J. Endothelial function measured using flow-mediated dilation in PCOS: A meta-analysis as the observational studies. Clinical endocrinology. 2012;77:1-9.

Marri M, Manuel LR, Insenser M. Circulating markers of oxidative stress and polyester ovary syndrome-a systemic review and meta-analysis 2013;19:268-88.

Karabulut AB, Cakmak M, Kiran RT, Sahin I. Oxidative stress, metabolic profile and polyestic ovary syndrome. Med Sci. 2013;1(1):27-34.

Atiq M. The polycystic ovary syndrome status- a risk factor for future cardiovascular disease. Recent advance in cardiovascular risk factor. 2012; 9:151-200.

Tyagi M, Sedoris KC, Steed M, Ovechkin AV, Moshal KS. Mechanisms of homocysteine-induced oxidative stress. Am J Heart Circ Physiol. 2005;289:2649-56.

Lalitha S, Jaweed SA. Homocysteine, C-reactive protein and traditional cardiovascular risk markers in polycystic ovary syndrome. Int J current Rev. 2013;5:63.

Lorenz LB, Wild RA. Polycystic ovary syndrome: an evidence-based approach to evaluation and management of diabetes and cardiovascular risk for today’s clinician. Clin obstet Gynecol. 2007;50:226-46

Al-Gareeb AI, Salah W, Al-Amieer A. Effect of body weight on serum homocystein level in patient with polycystic ovary syndrome: a case control study. 2016;14(2):81-8.

Allafibadia GN, Merchant G. Polycystic ovary syndrome in the Indian subcontinent. Semin Reprod Med. 2008;26(1):22-34.

Monika LL, Beata MM, Wozniakowska E, Januaz S. Polycystic ovary syndrome; clinical implication in perimenopause. 2014;13(6):348-51.

Wills GR, Udaiwar M, Evans WE, Blundell HL. Detailed characterization of circulatory nitric oxide and free radical indices: is there evidence for abnormal cardiovascular homeostasis in young women with polycystic ovary syndrome. Basic Science. 2014;121(13):1596-603.

Mohamadin AM, Fawzia A, Abdulrahman A. Cardiovascular disease markers in women with polyestic ovary syndrome with emphasis on asymmetric dimethyl arginine and homocysteine – Ann Saudi Med. 2010;30(4):278-83.

Yuvuztaslipinar M, Kilic N, Ktar NB, Guler I. Endothelial dysfunction and insulin resistance in young women with PCOS. Jurk J Med Sci. 2014;44:787-91.

Nacul AP, Andrade CP, Schewarz P. Nitric oxide and fibrinogen in polycystic ovary syndrome: Association with insulin resistance and obesity. Eur J Obst Gynecol Repr Biology. 2007;133(2):191-6.

Kuscu N K, Uar A. Oxidative stress but not endothelial dysfunction exists in non-obese young group of patient with PCOS. Acto Obst Gynecol science. 2009;88(5):612-7.

Erdogan M, Karaderiz M, Berdeli A, Alper G. The relationship of interleukin-6, 174 GLC gene polymorphism with oxidative stress. Markers in Turkish PCOS patients. J endocrinol Invest. 2008;31(7):624-9.

Karabullet AB, Cakmak, Kiran RT, Sahin I. oxidative stress status, metabolic profile and cardiovascular risk factors in patients with polyovary cystic syndrome. Med Sci. 2012;1(1):27-34.

Sydow K, Mondom CE, John P. Insulin resistance: Potential role of the endogenous nitric oxide syntheses inhibitor ADMA. Vascular Med. 2005;10:35-43.

Levorro G, I Orusso F, Meil, Deepak R, Corminog et al. The plasma homocysteine levels are increased in polycystic ovary syndrome. Gynecol Obstruct Invest. 2002;53:157-62.

Yie Maz M, Bukan N, Ayva ZG. The effect of rosiglitazone and metformin on oxidative stress and homocysteine levels in lean patients with PCOS. Human reproduction. 2005;20:3333-40.

Wijeyaratne CN, Nirantara Kumar K, Balen AH. Plasma homocysteine in PCOS: does it correlated with insulin resistance and ethnicity? Clin Endocrinol. 2004;131:68-72.

Badawy A, State O, El Gawad SSH. Plasma homocysteine and PCOS: The missed link. Eur J Obst Gynecol Repr Bio. 2007;131:68-72.

Vibikoval J, Tallova J, Bickiova M et al. Plasma thiols and androgen levels in PCOS. Clin Chem Lab Med. 2003;41:216-21.

Battaglia C, Mancini F, Cianciosi A, Busaccth P. Vascular risk in young women with polycystic ovary and PCOS. Obst Gynecol. 2008;111:1042-50.

Maleedhu P, Vijayabhaskara M, Sharma SSB, Kodumuri PK. Status of homocysteine in polycystic ovary syndrome. J Clin Diagn Res. 2014;8(2):31-3.

Mancini F, Cianciosi A, Reggiani GM, Facchinetti F, Bttaglia C. Endothelial function and its relationship to leptin, homocysteine and insulin resistance in lean and overweight eumenorrheic women and PCOS patient. A pilot study. Fertility Sterility. 2009;9(6):2537-44.

Tyagi N, Sedoris KC, Steed M. Mechanism of homocysteine induced oxidase stress. Am J Heart Circ Phys. 2005;289:H2649-56.

Hematic T, Narsin MT, Fateme DT. High plasma homocysteine and insulin resistance in patients with PCOS. Am J Reprod Med. 2011;9(3):223-9.