Relationship of Serum Leptin and Ghrelin between Insulin Resistance and Anthropometric Indices in Women with Polycystic Ovary Syndrome

Document Type : Original Article

Authors

1 Associate Professor of Nutrition, Nutrition Research Center, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

2 M.Sc. of Nutrition, Student Research Committee, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Professor of Nutrition, Nutrition Research Center, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

4 Associate Professor of Obstetrics & Gynecology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

5 M.Sc. of Epidemiology, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

6 B.Sc. of Nutrition, Faculty of Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is one of the prevalent diseases in women. Insulin resistance is a predominant clinical feature in this syndrome. Leptin and ghrelin have significant effects on PCOS. Studies in this field are limited with conflicting results, so this study was designed to evaluate serum leptin and ghrelin and their relationship with insulin resistance and anthropometric indices in women with PCOS.
Methods: This case-control study conducted with simple method sampling on 30 PCOS women and 30 healthy controls in Alzahra hospital of Tabriz in 2010. Weight, height, waist and hip circumferences, level of blood glucose, serum leptin and ghrelin were measured by standard methods. Body mass index (BMI), waist to hip ratio (WHR) and insulin resistance were calculated. Mean of leptin, ghrelin and their relationship between insulin resistance, BMI and WHR were determined by SPSS software version 11.5.
Results: Mean of serum leptin level and insulin resistance in PCOS patients were respectively 21.68±4.52 (ng/ml) and 3.47±0.54 IU and in control group were respectively 17.96±3.00 (ng/ml) and 1.81±0.31 IU (P=0.001). Ghrelin level in PCOS patients and control groups were respectively 210.33±10.98 (ng/ml) and 216.00±14.76 picomole/liter (P=0.08). There was a positive correlation between serum leptin level and BMI, WHR and insulin resistance in PCOS patients (r=0.84, r=0.55, r=0.67, respectively, P<0.05). In controls, serum leptin level was correlated with BMI and insulin resistance (r=0.93, r=0.77, respectively, P<0.05). No significant relationship was found between serum ghrelin and insulin resistance and anthropometric indices in patients and controls.
Conclusion: Serum leptin level is higher in PCOS patients but the difference of serum ghrelin level in two groups was not significant. In women with PCOS serum leptin is an effective factor in insulin resistance, while ghrelin is not. In these patients, serum leptin is influenced by anthropometric indices, while serum ghrelin is not.

Keywords

References

  1. Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007 Aug 25;370(9588):685-97.
  2. Stein IF and Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935;29 (2):181-91.
  3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004 Jan;81(1):19-25.
  4. Dasgupta S, Reddy BM. Persent status of understanding on the genetic etiology of polycystic ovary syndrome. J Postgrad Med 2008 Apr-Jun;54(2): 115-25.
  5. Halaas JL, Gajiwala KS, Maffei M, Cohen SL, Chait BT, Rabinowitz D, et al. Weight-reducing effects of the plasma protein encoded by the obese gene. Science 1995 Jul 28;269(5223):543–6.
  6. Wabitsch M, Blum WF, Muche R, Braun M, Hube F, Rascher W, et al. Contribution of androgens to the gender difference in leptin production in obese children and adolescents. J Clin Invest 1997 Aug 15;100(4): 808–13.
  7. Nakazato M, Murakami N, Date Y, Kojima M, Matsuo H, Kangawa K, et al. A role for ghrelin in the central regulation of feeding. Nature 2001 Jan 11;409(6817):194–8.
  8. Garcı´MC, Lo´pez M, Alvarez CV, Casanueva F, Tena-Sempere M, Dieguez C. Role of ghrelin in reproduction. Reproduction 2007 Mar;133(3):531–40.
  9. Volante M, Allia E, Gugliotta P, Funaro A, Broglio F, Deghenghi R, et al. Expression of ghrelin and of the GH secretagogue receptor by pancreatic islet cells and related endocrine tumors. J Clin Endocrinol Metab 2002 Mar; 87(3):1300–8.
  10. Atamer A, Demir B, Bayhan G, Atamer Y, Ilhan N, Akkuz Z. Serum levels of leptin and homocysteine in women with polycystic ovary syndrome and its relationship to endocrine, clinical and metabolic parameters. J Int Med Res 2008 Jan-Feb;36(1):96–105.
  11. Pehlivanov B, Mitkov M. Serum leptin levels correlate with clinical and biochemical indices of insulin resistance in women with polycystic ovary syndrome. Eur J Contracept Reprod Health Care 2009 Apr;14(2):153-9.
  12. Pekhlivanov B, Mitkov M, Orbtsova M, Terzieva D. [Serum levels of ghrelin and leptin in women with polycystic ovary syndrome]. [Article in Bulgarian]. Akush Ginekol (Sofiia) 2008;47(3):15-9.
  13. Daghestani MH, Daghestani MH, El-Mazny A. Circulating ghrelin levels and the polycystic ovary syndrome: correlation with the clinical, hormonal and metabolic features. Eur J Obstet Gynecol Reprod Biol 2011 Mar;155(1):65-8.
  14. Ozgen IT, Aydin M, Guven A, Aliyazicıoglu Y. Characteristics of polycystic ovarian syndrome and relationship with ghrelin in adolescents. J Pediatr Adolesc Gynecol 2010 Oct;23(5):285-9.
  15. Panidis D, Asteriadis C, Georgopoulos NA, Katsikis I, Zournatzi V, Karkanaki A, et al. Decreased active, total and altered active to total ghrelin ratio in normal weight women with the more severe form of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2010 Apr;149(2):170-4.
  16. Sepilian VP, Crochet JR, Nagamani M. Serum soluble leptin receptor levels and free leptin index in women with polycystic ovary syndrome: relationship to insulin resistance and androgens. Fertil Steril 2006 May;85(5): 1441-7.
  17. Mitkov M, Pehlivanov B, Orbetzova M. Serum ghrelin level in women with polycystic ovary syndrome and its relationship with endocrine and metabolic parameters. Gynecol Endocrinol 2008 Nov;24(11):625-30.
  18. Calvar CE, Intebi AD, Bengolea SV, Hermes R, Spinedi E. [Leptin in patients with polycystic ovary syndrome. Direct correlation with insulin resistance]. [Article in Spanish]. Medicina (B Aires) 2003;63(6):704-10.
  19. Erel CT, Senturk LM, Kaleli S, Gezer A, Baysal B, Tasan E. Is serum leptin level regulated by thyroid functions, lipid metabolism and insulin resistance in polycystic ovary syndrome? Gynecol Endocrinol 2003 Jun;17(3):223-9.
  20. Glintborg D, Andersen M, Hagen C, Frystyk J, Hulstrom V, Flyvbjerg A, et al. Evaluation of metabolic risk markers in polycystic ovary syndrome (PCOS). Adiponectin, ghrelin, leptin and body composition in hirsute PCOS patients and controls. Eur J of Endocrinol 2006 Aug;155(2): 337–45.
  21. Orio F Jr, Lucidi P, Palomba S, Tauchmanova L, Cascella T, Russo T, et al. Circulating ghrelin concentrations in the polycyctic ovary syndrome. J Clin Endocrinol Metabol 2003 Feb;88(2):942–5.
  22. Waśko R, Komarowska H, Warenik-Szymankiewicz A, Sowiński J. Elevated ghrelin plasma levels in patients with polycystic ovary syndrome. Horm Metab Res 2004 Mar;36(3):170-3.
  23. Kilic-Okman T, Guldiken S, Kucuk M. Relationship between homocysteine and insulin resistance in women with polycystic ovary syndrome. Endocr J 2004 Oct;51(5):505-8.
  24. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistanceand b cell function from fasting plasma glucose and insulin in man. Diabetologia 1985 Jul;28(7):412-9.
  25. Mahmoudi T, Gourabi H, Ashrafi M, Yazdi RS, Ezabadi Z. Calcitropic hormones, insulin resistance, and the polycystic ovary syndrome. Fertil Steril 2010 Mar;93(4): 1208-14.
  26. DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril 2005 May;83(5):1454-60.
  27. Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med 2006 Jul;12(7):324-32. Review.
  28. Teede HJ, Hutchison S, Zoungas S, Meyer C. Insulin resistance, the metabolic syndrome, diabetes, and cardiovascular disease risk in women with PCOS. Endocrine 2006 Aug;30 (1):45–53.
  29. Bideci A, Amurdan MO, Yesilkaya E, Demirel F, Cinaz P. Serum ghrelin, leptin and resistin levels in adolescent girls with polycystic ovary syndrome. J Obstet Gynaecol Res 2008 Aug;34(4):578-84.
  30. Takeuchiu T, Tsutsumi O. Basal leptin concentrations in women with normal and dysfunctional ovarian conditions. Int J Gynecol Obstet 2000 May;69(2):127-33.
  31. Mantzoros CS, Dunaif A, Flier JS. Leptin concentrations in the polycystic ovary syndrome. J Clin Endocrinol Metab 1997 Jun;82(6):1687–91.
  32. Fernandez-Fernandez R, Tena-Sempere M, Aguilar E, Pinilla L. Ghrelin effects on gonadotropin secretion in male and female rats. Neurosci Lett 2004 May;362(2):103–7.
  33. Kelesidis T, Kelesidis I, Chou S, Mantzoros CS. Narrative review: the role of leptin in human physiology: emerging clinical applications. Ann Intern Med 2010 Jun 19;152(2):93-100.
  34. Kopelman PG. Hormones and obesity. Baillieres Clin Endocrinol Metab 1994 Jun;8(3):549-75. Review.
  35. Barber TH, Casanueva1 FF, Karpe F, Lage1 M, Franks S, McCarthy MI, et al. Ghrelin levels are suppressed and show a blunted response to oral glucose in women with polycystic ovary syndrome. Eur J Endocrinol 2008 Apr;158(4):511–6.
  36. Shiiya T, Nakazato M, Mizuta M, Date, Y, Mondal MS, Tanaka M, et al. Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J Clin Endocrinol Metab 2002 Jan;87(1):240–4.
  37. Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, et al. Plasma ghrelin levels after dietinduced weight loss or gastric bypass surgery. N Engl J Med 2002 May 23;346(21):1623–30.
  38. Date Y, Nakazato M, Hashiguchi S, Dezaki K, Mondal MS, Hosoda H, et al. Ghrelin is present in pancreatic alphacells of humans and rats and stimulates insulin secretion. Diabet 2002 Jan;51(1): 124–9.
  39. Egido EM, Rodriguez-Gallardo J, Silvestre RA, Marco J. Inhibitory effect of ghrelin on insulin and pancreatic somatostatin secretion. Eur J Endocrinol 2002 Feb;146(2):241–4.

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