Adipokines and Inflammatory markers in patients with Polycystic Ovary Syndrome (PCOS) and age and Body Mass Index (BMI) matched controls

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 678-689-Adipocyte Biology
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-688
Sachin Mittal*1, Premlata Varthakavi1, Ravi Verma1, Manoj Dharam Chadha2, Tejal Lathia2, Ameya Joshi2, Pratibha Pawal3, Jayashree Dholye3 and Sachin Rahate2
1T.N. Medical College & B.Y.L. Nair Hospital, Mumbai, India, 2T. N. Medical College & B.Y.L. Nair hospital, Mumbai, Mumbai, India, 3T. N. Medical College & B.Y.L. Nair hospital, Mumbai, Mumbai
Introduction: PCOS affects 7-10% of reproductive age females & is associated with obesity, Insulin resistance (IR), an increased risk of Type 2 Diabetes Mellitus and cardiovascular disease. Adipocyte dysfunction impacts insulin sensitivity and is associated with atherosclerosis through autocrine & paracrine mechanism. Obesity per se, causes adipocyte dysfunction.

Hypothesis: Women with PCOS have abnormal adipokines and proinflammatory markers, independent of age & obesity.

Objective: 1. To determine the levels of Total & High Molecular Weight Adiponectin (HMW-A), Leptin,  Interleukin-18 (IL-18), High sensitivity C-Reactive Protein (hsCRP), Tumor Necrosis Factor α (TNFα), Lipids & lipoprotein fractions in PCOS & to compare these with age & BMI matched, normally cycling women.

2. To assess the influence of obesity, IR and hyperandrogenism on these parameters.

Setting: Tertiary Care Municipal Charitable Teaching Hospital in Mumbai, India

Methods:50 consecutive patients of PCOS (Rotterdam criteria) & 50 age & BMI matched controls, between18-35 years participated.  All subjects underwent 75 gm. Oral Glucose Tolerance Test. Indices of IR, Free Androgen Index (FAI), Visceral Adiposity Index (VAI) carotid intima medial thickness (CIMT) & Body composition (DXA) were done. A single person did anthropometry.

Result: There was no significant difference in age, BMI, Waist Circumference, total body fat, truncal fat  & HOMA-IR between the two groups. Cases had higher Waist Hip Ratio [(WHR), 0.88 ± 0.05 vs 0.85 ± 0.03, p=0.007], FAI (1.23 ± 0.62 vs 0.65 ± 0.45, p=0.004), CIMT (0.51±0.08 vs 0.45±0.09 cm, p=0.001), VAI (5.5 ± 3.3 vs 4.7 ± 3.2, p=0.027). The Total-A (0.76 ± 0.6 vs 0.98 ± 0.46 ng/ml, p=0.006) & HMW-A (0.38 ± 0.29 vs 0.61 ± 0.34 ng/ml, p=0.000) were lower, IL-18 (204 ±71.45 vs 174.39 ± 39.56 pg/ml, p=0.04) & hsCRP(3.06 ± 2.36 vs 2.08 ± 2.02 mg/l, p=0.002) higher, while Leptin & TNFα were not significantly different in cases, when compared with controls. Cases had higher LDL (96.6±24.6 vs 86.5±21.4 mg/dl, p=0.04), Triglycerides (137.7 ± 109.2 vs 113.5 ± 71 mg/dl, p=0.04), lower HDL (33.6 ± 8.8 vs 38.5 ± 8.4 mg/dl, p=0.002) and Apolipoprotein A1/B ratio (1.34 ± 0.42 vs 1.63 ± 0.39, p<0.00), while there was no difference in Total Cholesterol & Lp-a. HOMA-IR(r=-0.445, p=0.00), FAI (r=-0.475, p=0.00), WHR (r=-0.442, p=0.00) & CIMT(r=-0.380, p=0.00) correlated inversely with Total & HMW-A & positively with IL-18 and hsCRP. BMI correlated the most with IL-18 (r=0.399, p=0.00). Multiple linear regression analysis for predictors of Total & HMW-A showed Age, BMI, FAI to be significant predictors, with a trend towards WHR.

Conclusion: Total and HMW-A are lower, while, hsCRP & IL-18 are higher in PCOS. The significant difference in the levels of Total and HMW-A levels, despite non-significant difference in HOMA-IR levels suggests possible influence of other variables like androgens and WHR on these parameters

Nothing to Disclose: SM, PV, RV, MDC, TL, AJ, PP, JD, SR

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: (Institute research committee)Nair Golden jubilee research foundation, T.N. Medical College, Mumbai Department Development Fund of Hospital