Endocrine Abstracts

Objectives: i) To determine and compare inflammatory markers including adiponectin, visfatin and IL-18 in patients with polycystic ovarian syndrome (PCOS). ii) To find out whether adiponectin and interleukin-18 (IL-18) is associated with markers of insulin resistance, hyperandrogenism and carotid intima-media wall thickness (CIMT) as a cardiovascular risk factor.

Methods: This is a prospective controlled study involving 60 consecutive euglycemic patients with PCOS (Rotterdam criteria) aged 50 years and body mass index (BMI) matched controls were included in the study. After detailed clinical evaluation including anthropometry, besides oral glucose tolerance test, fasting venous samples were analysed for IL-18, visfatin, adiponectin, highly sensitive C reactive protein (hsCRP) and complete lipid profile. We estimated body composition (total body fat and visceral adipocity index, VAI by dual energy xray absorptiometry), CIMT (by Doppler ultrasonography), indices of insulin sensitivity (QUICKI) and resistance (homeostasis model assessment for insulin resistance, HOMA-IR) and free androgen index (FAI). Data were analyzed using online graphpad quickcalc software and P<0.05 was considered statistically significant.

Results: PCOS patients had greater FAI (1.42±0.83 vs 0.64±0.4), higher HOMA-IR (2.13±1.05 vs 1.91±1.8) and lesser QUICKI (0.156±0.025 vs 0.163±0.015) than the control groups. Patients with PCOS have significantly increased serum IL-18 and visfatin levels than that of the control group (IL-18: 213.48±76.84 vs 170.4±41.11 pg/ml, visfatin: 73.35±11.54 vs 55.56±9.27 ng/ml, P<0.05) and hsCRP (2.56±0.64 vs 1.62±0.78 mg/l, P=0.004). Similarly, the PCOS group had significantly lower level of adiponectin (0.8±0.6 vs 1.04±0.49 ng/ml, P<0.001). Correlation coefficients of IL-18 were as follows: with CIMT (0.355), FAI (0.328), HOMA-IR (0.345) and waist circumference (0.367), each with P<0.05. Similarly, the correlation coefficients of adiponectin were with CIMT (−0.312), FAI (−0.343), HOMA-IR (−0.352) and waist circumference (−0.359), each with P<0.05.

Discussion: There is alteration of adipokines and other inflammatory markers in PCOS with increase in visfatin, IL-18 and hsCRP and reduction in of adiponectin levels. Increased IL-18 and decreased adiponectin levels correlated with insulin resistance, obesity and hyperandrogenism.

Conclusion: These altered adipokine profile is associated with increased CVD risk in PCOS patients, leading to the suggestion that one of these markers like IL-18 can serve as potential therapeutic target in future for decreasing their CV risk.