Role of ghrelin and adiponectin in pathogenesis of polycystic ovary syndrome, effect of metformin

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Abstract

Aim

This study was aimed to determine the role played by ghrelin and adiponectin in the pathogenesis of polycystic ovary syndrome (PCOS) and to study the effect of metformin, which has insulin-sensitizing properties on PCOS and on ghrelin and adiponectin, to relate metabolic changes with reproductive changes.

Patients and methods

This study included 10 lean women (BMI<27 kg/m2) as controls, and another 10 age-matched obese women (BMI>30 kg/m2) and 20 age-matched obese female (BMI>30 kg/m2) patients with PCOS divided into two subgroups under placebo or metformin 850 mg three times daily for 6 months. The biochemical and hormonal parameters assessed were fasting plasma glucose and insulin, homeostasis model assessment-insulin resistance (HOMA-IR), luteinizing hormone, follicle stimulating hormone, sex hormone-binding globulin, androstenedione, ghrelin, and adiponectin.

Results

Both fasting glucose and insulin were increased significantly in obese women and obese female PCOS patients than the lean controls; also, HOMA-IR was significantly increased but decreased significantly after metformin treatment. Luteinizing hormone, follicle stimulating hormone, and androstenedione were significantly increased in obese women and obese female PCOS patients than the lean controls, whereas sex hormone-binding globulin, ghrelin, and adiponectin decreased significantly in obese women and obese female PCOS patients than the lean controls and increased significantly after metformin treatment. There was a significant positive correlation between ghrelin and adiponectin in both obese women and obese female PCOS patients before treatment, but a significant negative correlation between ghrelin, BMI, HOMA-IR, and androstenedione; also, there was a significant negative correlation between adiponectin, BMI, and HOMA-IR.

Conclusion

Our study suggested that in obese women and obese female PCOS patients, ghrelin and adiponectin were decreased, which suggests metabolic disorders, and reverted to normal after correction of insulin resistance by metformin. Other studies are suggested to determine the effect of a hypocaloric diet and physical exercise.

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