HOMOCYSTEINE LEVEL IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME WITH AND WITHOUT INSULIN RESISTANCE

Area of Science:

• Endocrinology
• Reproductive Medicine
• Metabolic Disorders

Background:

• Polycystic Ovary Syndrome (PCOS) is traditionally associated with hyperinsulinemia and hyperandrogenism.
• Emerging research highlights the role of hyperhomocysteinemia (HHcy), potentially linked to insulin resistance, in PCOS pathogenesis.
• HHcy is increasingly recognized as a characteristic feature of PCOS.

Purpose of the Study:

• To investigate and compare homocysteine (Hcy) levels in patients diagnosed with PCOS, differentiating between those with and without insulin resistance.
• To assess the correlation between Hcy levels, insulin resistance, and Body Mass Index (BMI) in PCOS patients.

Main Methods:

• A study involving 59 female patients with PCOS, aged 13-35 years.
• Patients were categorized into two groups: Group I (38 with PCOS and insulin resistance) and Group II (21 with PCOS without insulin resistance).
• PCOS patients were further classified into subgroups based on Hcy levels: low (≤ 6.09 μmol/l), moderate (6.10-9.33 μmol/l), and high (>9.34 μmol/l).

Main Results:

• Patients with PCOS and insulin resistance exhibited significantly higher Hcy levels, HOMA-IR, and BMI compared to those without insulin resistance.
• The prevalence of elevated and high-normal Hcy levels (high Hcy subgroup) was markedly greater in the PCOS with insulin resistance group (84.2%) versus the PCOS without insulin resistance group (52%).
• A significant elevation in Hcy levels was observed in PCOS patients with insulin resistance.

Conclusions:

• Homocysteine levels are significantly elevated in patients with PCOS, especially in the presence of insulin resistance.
• Controlling and correcting Hcy levels, in conjunction with managing insulin resistance, is recommended for improving reproductive outcomes in PCOS management.
• HHcy represents a significant, potentially modifiable factor in PCOS management.