Correlation of serum lipoprotein ratios with insulin resistance in infertile women with polycystic ovarian syndrome: a case control study

Background: Dyslipidemia and insulin resistance [IR], occurring in most infertile women with polycystic ovarian syndrome [PCOS], increase the risk of cardiovascular disease [CVD] and type 2 diabetes. This study aimed to assess the relationships between lipopro-tein ratios and IR in PCOS women

Materials and Methods: Thirty six infertile women with PCOS selected based on Andro-gen Excess Society [AES] criteria and 29 healthy women matched for age were recruited to this case-control study. After physical measurements, fasting serum glucose [Glu], insulin and lipid profile levels [triglycerides [TGs], total cholesterol [TC], low-density lipoprotein-cholesterol [LDL-C] and high-density lipoprotein-cholesterol [HDL-C]] were measured, while lipoprotein ratios [TC/HDL-C, LDL-C/HDL-C, TG/HDL-C] were calculated. IR was also calculated using homeostasis model assessment [HOMA]-IR. The optimal cutoffs of lipoprotein ratios in relation to HOMA-IR were calculated based on the Receiver Operating Characteristics [ROC] curve analysis using the area under curve [AUC]

Results: Waist circumference [WC], insulin levels, HOMA-IR, TG levels, and all lipoprotein ratios were significantly higher, while HDL-C was lower in PCOS group as compared to healthy controls. All lipoprotein ratios, TG levels, and WC are significantly correlated with insulin levels and HOMA-IR. Among lipoprotein ratios, the highest AUC of the ROC belonged to TG/HDL-C ratio with sensitivity of 63.6% and specificity of 84.4% [TG/HDL-O3.19] as a marker of IR in infertile PCOS women

Conclusion: Lipoprotein ratios, particularly TG/HDL-C, are directly correlated with insulin levels and can be used as a marker of IR [HOMA-IR] in infertile PCOS patients

Influence of omega-3 fatty acid eicosapentaenoic acid on IGF-1 and COX-2 gene expression in granulosa cells of PCOS women

The omega-3 [omega-3] fatty acid eicosapentaenoic acid [EPA] is currently used in the clinic as a nutritional supplement to improve infertility, particularly in women with polycystic ovarian syndrome [PCOS]. The present study was designed to investigate the effect of EPA on insulin-like growth factor 1 [IGF-1] and cyclooxygenase 2 [COX-2] gene expression in primary cultured granulosa cells from patients undergoing in vitro fertilization [IVF], and also to compare this effect with those in granulosa cells of PCOS patients. In this experimental study, human granulosa cells were isolated from follicular fluid of normal and PCOS women undergoing IVF by hyaluronidase digestions, followed by Percoll gradient centrifugation. Cells were cultured in vitro, exposed to a range of concentrations of the EPA [25-100 micro M] for 24 hr, and investigated with respect to COX-2 and IGF-1 gene expression by real time-PCR. In both groups, all doses of the EPA significantly induced IGF-1 mRNA gene expression compared to the untreated control. High doses of EPA in the presence of recombinant [r] FSH produced a stimulatory effect on IGF-1 and a suppressive effect [p=0.01] on the COX-2 gene expression, which were more pronounced in granulosa cells from PCOS patients. EPA affect diversely the gene expression of IGF-1 and COX-2 in granulosa cells, which were more pronounced in PCOS compared to control. These findings represent the possible underlying molecular mechanisms for the positive impact of the omega-3 fatty acids on reproduction, especially in patients with PCOS

Metabolic syndrome and its characteristics among reproductive-aged women with polycystic ovary syndrome: a cross-sectional study in northwest Iran

Metabolic syndrome [MetS] is a clustering of factors known to increase the risk for cardiovascular disease [CVD] and diabetes mellitus. Polycystic ovary syndrome [PCOS], the most common endocrine disorder among reproductive-aged women, is also closely linked to MetS. Limited information is available pertaining to the prevalence of MetS in Iranian PCOS women; therefore this study assesses the frequency of MetS and its components among PCOS women from Tabriz, Iran. In this cross-sectional study, we evaluated a total of 200 women with PCOS who referred to the only specialty and subspecialty gynecological center in Northwestern Iran. PCOS was diagnosed according to Rotterdam criteria. This study defined clinical and biochemical parameters for MetS by the National Cholesterol Education Program Adult Treatment Panel III [NCEP ATP III] criteria. Statistical analyses were performed with descriptive-analytical methods using SPSS software version 16. MetS was identified in 39.5% of PCOS women. The frequencies of individual components of MetS among studied subjects were: high-density lipoprotein cholesterol level [HDL-C]<50 mg/ dL [99.5%], waist circumference[WC] >/=88cm [65%], triglycerides [TG] >/=150 mg/dL[98%], and blood pressure>/=130/85 mmHg[34%].There were no fasting glucose concentrations>/=110 mg/dL. The frequency of MetS increased with body mass index [BMI]as follows: normal [5.4%], overweight [41.5%] and obese [85.7%] women [p<0.0001]. The PCOS women in this study had a high frequency of MetS and its individual components, particularly decreased HDL-C and increased triglyceride levels. These data can useful for lifestyle modification programs