Assessment of serum adiponectin levels in women with polycystic ovary syndrome

Background and Aim: Serum adiponectin levels were found to be altered in women with polycystic ovary syndrome (PCOS) due to the increased adiposity commonly observed in them. Accordingly, earlier studies have reported decreased adiponectin levels in PCOS women. the present study was conducted to measure serum adiponectin levels in women with PCOS and to evaluate its association with the biochemical parameters studied. Material and Methods: The present study included 50 women of reproductive age attending the department of Gynecology, tertiary care institute of India and diagnosed with polycystic ovary syndrome based on Rotterdam criteria. Fifty age-matched healthy women were recruited as controls. t. Adiponectin levels were measured along with measurement of fasting blood glucose, lipid profile using commercial kits and insulin resistance (HOMA-IR) was calculated. Results: Both the study groups were matched concerning age, however, PCOS women were obese when compared to healthy women (p<0.001). Serum total cholesterol and triglyceride levels were significantly higher (p≤0.05) and serum adiponectin concentration was significantly lower in PCOS women when compared to controls (p≤0.05). HDL cholesterol, fasting insulin and HOMA-IR were similar between cases and controls. Adiponectin did not show significant association with any of the parameters studied (Table 2). Conclusion: Serum adiponectin levels are significantly lower in women with polycystic ovary syndrome compared to healthy women. The hyperandrogenemia which is one of the characteristic features of PCOS leads to a state of adiposity which can further cause a decrease in adiponectin levels.


Introduction
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting reproductiveage women worldwide. [1]. Clinical features of PCOS namely hirsutism, acne, and alopecia originate from high circulating levels of androgens, menstrual irregularities from anovulatory cycles. [2]. and obesity is thought to originate from both the underlying IR and high androgen levels in these patients. [3]. The alarming tribulations associated with the syndrome are past the reproductive axis and these women are at a greater risk of developing the metabolic syndrome at an early age because of IR and obesity observed in 30-60% of PCOS patients. [4,7]. The adipose tissue not only stores a large quantity of fat as an energy source [8]. but also expresses a variety of genes of secretory proteins. [9,13]. The human apM1 gene has been recently discovered, and it is exclusively expressed in white adipose tissue. [14]. The product of this gene is called adiponectin, a 244-amino acid protein with high structural homology to collagen VIII, X, complement C1q, and TNF. [15,16]. Adiponectin expression is increased by peroxisome proliferatoractivated receptor agonists. [17,18]. Although the physiological role of adiponectin still has to be clarified, recent findings have indicated that it may be a kind of matrix protein with potential antiatherogenic and anti-inflammatory effects. [19][20][21][22]. Because adiponectin is a fat cell product, secreted into the circulating blood, it might be responsible for the metabolic and neuroendocrine derangements characteristic of obesity and obesityrelated disease, such as PCOS. Serum adiponectin levels were found to be altered in women with PCOS due to the increased adiposity commonly observed in them. Accordingly, earlier studies have reported decreased adiponectin levels in PCOS women.
Further, the altered adiponectin levels are proposed to contribute to the endocrine and metabolic disturbances observed in PCOS women. In this background, the present study was conducted to measure serum adiponectin levels in women with PCOS and to evaluate its association with the biochemical parameters studied.

Material and Methods
The present study included 50 women of reproductive age attending the department of  level and level of significance were set at 95% and 5% respectively.

Discussion
It has been established that adiponectin is almost exclusively produced in adipose tissue. [23.
Adiponectin is probably one of the most important adipocytokines of adipose tissue. [24]. It is highly expressed and actively secreted by adipocytes.
Polycystic ovary syndrome is commonly associated with metabolic disturbances such as glucose intolerance and dyslipidemia in addition to hormonal changes.
Obesity is not only observed in about 50% of women with PCOS, but is also involved in the development of metabolic complications. The altered adiponectin levels in the setting of increased adiposity in PCOS women are one of the important factors contributing to complications. PCOS women had significantly lower serum adiponectin levels when compared to healthy women [ Table 1]. Similar findings were reported in earlier studies. [28,29].
This relationship between PCOS and low adiponectin also changed a little across different age groups.
Furthermore, family histories of PCOS and IR were also significantly associated with lower adiponectin levels. We found low levels of adiponectin in lean young women with PCOS. Several studies have demonstrated reduced levels of serum adiponectin in women with PCOS. [30,35]. Also, few of them have shown an association of low adiponectin levels in PCOS women irrespective of the weight and/or BMI of patients. [31][32][33].
In the present study, PCOS women were overweight and had significantly higher BMI than controls [