الفهرس 
POLYCYSTIC OVARIAN SYNDROMEOnly 14 pages are availabe for public view
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Abstract
T
he polycystic ovary syndrome is a disorder that is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphologic features. As defined by the diagnostic criteria of the National Institutes of Health (i.e., hyperandrogenism plus ovulatory dysfunction), “classic” polycystic ovary syndrome affects 6 to 10% of women of reproductive age, but the prevalence may be twice as high under the broader Rotterdam criteria.
This complex polygenic disorder has environmental influences (e.g., those that contribute to obesity).
Fasting insulin level was found to be elevated even in PCOS women without evident metabolic syndrome (MS) and it was suggested that the elevated insulin contributes to the elevated androgen production by the ovaries and other complications. Several studies indicated that as much as 60-95% of PCOS women show insulin resistance (IR), which becomes aggravated if accompanied by increased abdominal fat. The higher BMI in the PCOS group was also observed by many studies as polycystic ovary syndrome (PCOS) is closely associated with obesity but the prevalence of obesity varies between published studies according to ethnicity and geographic differences. Wang et al showed higher BMI in the PCOS group which was related to the decline in the pregnancy rate.
Upon chemerin on adipose tissue and glucose metabolism, serum chemerin has been recently studied in PCOS women. The study revealed that elevated chemerin levels can be found in obese or lean PCOS women. Chemerin can be considered as an important determinant of insulin resistance in PCOS. However, the association between chemerin levels and obesity is lacking in Egyptian PCOS women.
The present study was aiming to assess the level of chemerin level in PCOS patients and its relation to insulin resostance.
This study was conducted on 90 subjects with mean ages (28.93 +5.11) years old selected from internal medicine, endocrinology and gynecology outpatient clinics of Ain shams University Hospitals from June 2017 to June 2018 and divided into 2 groups
group 1 (45 females with PCOS) and group 2 (45 females without PCOS) as a control group.
The 2 groups were further divided into subgroups A and B according to the BMI (A:obese, B:lean).
group 1: 45 polycystic ovary syndrome patients.
group 1A) 27 obese PCO
group 1B) 18 lean PCO
group 2: 45 healthy control women
group 2A) 25 obese women
group 2B) 20 lean women
All subjects in this study were subjected to full medical history taking, thorough physical examination, anthropometric measurements, pelvic ultrasound, and assay of fasting blood glucose, fasting insulin, HOMA IR, total testosterone and chemerin.
Exclusion criteria
Diabetes mellitus, hypertension; other endocrine pathologies leading to hyperandrogenism. None of the patients had used oral contraceptives, glucocorticoids, ovulation induction agents, anti-obesity drugs or any other steroid containing drug for the last 2 months.
On comparing two studied groups:
Shows that there is statistically significant increase in PCO group versus control group regarding fasting blood sugar, fasting insulin, HOMA IR, total testosterone and chemerin levels (P-value< 0.001).
Also it shows regarding fasting insulin, HOMA IR and chemerin levels there is a statistically significant increase in obese PCO group versus lean PCO group, also it shows a statistical significant increase in lean PCO group versus obese control group and it shows a statistically significant increase in obese control group versus lean control group (P value <0.001).
As regard chemerin level there was statistically significant increase in obese control versus lean control group (p value< 0.005) and there was statistically significant increase in lean PCO group versus lean control group (p value< 0.001) and there was statistically significant increase in lean PCO group versus obese control group (p value< 0.001) and also there was statistically significant increase in obese PCO group versus lean PCO group regarding (p value< 0.001).
As regard fasting insulin and HOMA IR there was statistically significant increase in obese control versus lean control group (p value< 0.001) and there was statistically significant increase in lean PCO group versus lean control group (p value< 0.001) and also there was statistically significant increase in obese PCO group versus lean PCO group regarding (p value< 0.001).
On correlating chemerin levels with other quantitative variables:
The correlation between chemerin and other quantitative variables (age, BMI, SBP, DBP, testosterone, FBS, fasting insulin, HOMA-IR) showed that there were positive significant correlation between chemerin and BMI (P< 0.001), testosterone level (P = 0.002), FBS (P = 0.001), fasting insulin (P= 0.000), HOMA-IR (P< 0.001) in PCO group.