Relationship between homocysteine level and morphological characteristics of ovarues in PCOS patients with and without insulin resistance

Abstract

Introduction: According to recent literature data along with hyperandrogenism and hyperinsulinemia hyperhomocysteinemia is considered as a pathogenetic factor of PCOS. Literary data in this regard are scarce and contradictory.
Aim of the study: To determine relationships between homocysteine level and ovarian morphological characteristics in PCOS patients with and without insulin resistance.
Materials and methods: 100 Georgian women with PCOS, diagnosed based on the criteria of Rotterdam Consesus 2003, were involved into the comparative prospective study. Patients underwent clinical, hormonal and instrumental investigation on the 2 – 3 rd day of menstrual cycle. Levels of FSH, LH, T, FT, HOMA - IR, Insulin, homocysteine were measured. By ultrasound examination in each ovary was counted number of antral follicules ( AFC ) of 2 – 9 mm in diameter and measured ovary volume. Based on HOMA – IR PCOS patients were devided into two groups: Group I - 60 patients with PCOS and insuli resistance, Group II - 40 patients with PCOS without insulin resistance. Statistical analyze was performed by SPSS 24.0 and past 3.0 programs.
Results: Mean BMI, insulin level and HOMA - IR in patients group I was significantly higher compared to patients group II (respectively p < 0.05, p < 0.001, p < 0.001) in PCOS patients with insulin resistance was significantly higher than in PCOS patients without insulin resistance. Ovarian morphological characteristics ( AFC, Ov / vol ) did not differ significantly between groups ( p > 0.05 ).
In PCOS patients with insulin resistance ( group I ) mean homocysteine level was significantly higher compared to PCOS patients without insulin resistance ( group II ). Plasma Hcy level in PCOS patients positevely correlated with insulin resistance and BMI. Our study results showed that in PCOS patients ovarian morphological characteristics did not correlate with homocysteine level.
Conclusion: Hcy level is significantly higher in PCOS patients with insuilin resistance comapared to PCOS patients without insulin resistance. Homocysteine level positively correlated with BMI, insulin, HOMA-IR. Homocysteine level did not correlated with ovarian volume and AFC in comparable groups. Treatment of not only hyperandrogenemia and insulin resistance, but also correction of homocysteine level in women with PCOS in