دراسة العلاقة بين إندوثيلين -1 وفيسفاتين مع مقاومة الأنسولين لدى النساء المصابات بمتلازمة تكيس المبايض.

Study The Association Between Indothelin-1 And Visfatin with Insulin Resistance in Women with Poly Cystic Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS), is a common heterogeneous endocrine disorder that affects women of growing age particularly at the early to the late reproductive stage (15–35 years) .
Endothelin-1 (ET-1) is an indicator of endothelial injury dysfunction and is elevated in women with androgen excess polycystic ovary syndrome (PCOS).(
Visfatin is an adipocytokine known as a pre-B cell colony-enhancing factor, 52kDalton protein expressed in a variety of tissues including adiposities, lymphocytes, bone marrow, liver, and muscle. Visfatin binds to insulin receptors and exhibits insulin-mimetic actions; therefore, it stimulates glucose uptake in adipocytes and muscle cells and suppresses glucose release from hepatocytes. It is now believed that visfatin action can be endocrine, paracrine, and autocrine as well. These autocrine effects of visfatin may play an important role in regulating insulin sensitivity in the liver
Aim of this study :
The aim was to evaluate serum ET-1 & visfatin levels
among women with PCOS and control to detect maybe these markers pre-indicators for PCOS . And is there a relationship between age and BMI.
Methods: This study is a case-control study involving (120 women) aged of them between (20-40)years and a BMI(of 20-35)kg/m². 60 PCOS patients. and 60 non-PCOS women as a control in child-bearing age at the Reproductive Fertility consultant of a gynecological and obstetric teaching hospital, BABILON. health directorate Iraq and College of Medicine, the University of Kerbela Iraq. The Rotterdam criteria-2003 was presumed to Patients with any 2 of the next 3 items that can be recognized in diagnosis: oligomenorrhea or amenorrhea, increase androgen levels. The controller group has regular menstruation, with normal ovaries as they were detected by the gynecologist.PCOS cases were classified into three subgroups (A, B, C) according to infertility(normal which no infertility, primary infertility was 40, and secondary infertility was 20) .5ml of blood was drawn from women and put in a gel tube to measure serum ET-1 and Serum visfatin level (ng/ml) were assessed by ELISA, measure hormones(LH, FSH, F.testo) in second day of the cycle(CD2) by minividas, measure lipid profile (total cholesterol TC, high-density lipoprotein HDL, low-density lipoprotein LDL, very low-density lipoprotein VLDL and triglyceride TG) by colorimetric assay using a spectrophotometer, measure insulin by ELISA assay. and fasting blood sugar by maglumi device.
Results: The mean levels of biomarkers among infertility groups in women with PCOS showed that parameters significantly differed among the groups (p values <0.05). level of LH; Testosterone; TG; Insulin; W\H and LH/FSH ratio were shown to have a positively significant increase with secondary infertility cases. While FSH; HDL and fasting blood sugar decreased significantly in the same group. Endothelin-1 and visfatin were shown as diagnostic points for predicting PCOS cases compared to the control group. ET-1 increases in primary infertility than secondary, and positive relation between ET-1, visfatin and LH, F.testo, TG, FBS, IR,w/h . and negative relation with HDL. And there is a high positive relation between ET-1 and visfatin. The efficiency of the predicting value was assessed using the receiver operating characteristic (ROC) curve.
Conclusion: according to the observed data concluded that:
– Endothelin-1& Visfatin may be pre-indicator diagnostic markers for PCOs because increase in patient than control.
-Endothelin was increasing with age
-Visfatin was associated with abdominal obesity and insulin resistance as well as obesity, but not with metabolic syndrome and pre-diabetes Mellitus.