Adiponectin as a Serum Marker of Adipose Tissue Dysfunction in Women with Polycystic Ovary Syndrome: Correlation with Indicators of Metabolic Disturbances

Abstract

Adipose tissue is a major store of energy for the human body. Polycystic ovary syndrome (PCOS) patients are more prone to abnormal production of some regulatory proteins secreted from the adipose tissue. This study aims to investigate serum levels of adiponectin and their correlation with metabolic and endocrine indices in PCOS. Patients and methods. This study was conducted on 61 women with PCOS and 17 healthy women whose age and body mass index (BMI) were matched. Adiponectin serum levels were assessed and correlated with parameters of metabolic and hormonal disturbances. Results. In PCOS women, serum levels of insulin, HOMA-IR, testosterone, LH, and LH/FSH were significantly higher, while SHBG was lower than in healthy women. Lower adiponectin was observed in both PCOS groups compared to the control group. Serum levels of adiponectin correlated inversely with BMI (r=-0.56; p<0.001),WC(r =-0.452;p<0.001), insulin levels (r=-0.409; p<0.001), HOMA-IR (r=-0.368; p<0.001), and free androgen index (FAI) (r=-0.53; p<0.001). A positive correlation was found between adiponectin and LH (r= 0.35; p<0.001), LH/FSH ratio (r= 0.33; p<0.001) and SHGB (r= 0.51; p<0.001). Serum adiponectin levels are decreased in women with PCOS compared to the control group. The decrease in adiponectin concentration indicates its potential role in metabolic disorders in the pathogenesis of PCOS, as well as in the development and progression of insulin resistance in PCOS patients.

Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s

“…Additionally, within granulosa cells derived from normal ovaries, insulin enhances FSH-induced aromatase activity and collaborates with LH to promote the expression of sterol-regulatory genes encoding the LDL receptor, stAR protein, 3-hydroxysteroid-dehydrogenase (3-HSD) and cytochrome P450 side-chain cleavage (P450scc) [ 75 ]. These results imply that insulin might influence follicle growth by, at least in part, elevating the protein-level expression of its receptor substrates [ 76 ]. Moreover, insulin boosts LH receptor expression within granulosa cells obtained from developing human follicles [ 77 ].…”

“…However, these cells maintain normal steroidogenic output when exposed to physiological insulin doses. Furthermore, follicles retrieved from polycystic ovaries show abnormal patterns of expression of IRS-1 and -2 compared to healthy ones [ 76 ]. In particular, theca and granulosa cells exhibited elevated IRS-2 staining intensity while concurrently displaying decreased IRS-1 staining only in granulosa cells.…”

“…These findings suggest that IR could specifically impact carbohydrate metabolism by selectively reducing IRS-1 in granulosa cells, leading to a compensatory rise in IRS-2 expression. Additionally, given the recognized antiapoptotic role of IRS-2, its increased presence in small antral follicles could indicate a potential association with cyst accumulation in polycystic ovaries [ 76 ].…”

Serum adiponectin in Indian women with polycystic ovary syndrome

“…Another recent study has reported that hypoadiponectinaemia is present in both obese and lean women with PCOS with variable degrees of insulin resistance. On the other hand, other recent studies who have also observed decreased total adiponectin and HMW adiponectin levels in PCOS women suggested that the lowered adiponectin levels occur independent of BMI and insulin resistance and that the posttranscriptional/translational modifications contribute to the low levels of HMW adiponectin in PCOS [ 22 ]. Examination of adipose tissue in women with PCOS has shown that the expression of messenger RNA (mRNA) for adiponectin is significantly lower in women with PCOS compared with weight-matched women without PCOS.…”

Abdominal Obesity in Women with Polycystic Ovary Syndrome and Its Relationship with Diet, Physical Activity and Insulin Resistance: A Pilot Study

“…Notably, apart from energy storage function, the adipose tissue is also a very crucial and active endocrine organ that secretes a variety of adipokines influencing the regulation of metabolism related to the sensitivity of tissues to insulin and reproductive function [ 11 ]. There is substantial evidence confirming that women with PCOS, regardless of obesity, are characterized by significantly lower concentrations of adiponectin compared to healthy women [ 8 , 12 , 13 , 14 , 15 , 16 , 17 ]. Leptin and resistin are other adipokines whose concentrations are abnormal in PCOS women.…”