دور األديبونكتين واإلجهاد التأكسدي في التسبب بمتالزمة تكيس المبايض عند النساء العراقيات

Role of Adiponectin and Oxidative Status in The Pathogenesis of Polycystic Ovarian Syndrome in Iraqi Women

Polycystic ovary syndrome is one of the most common endocrine and metabolic disorders among women of reproductive age. Women suffering from PCOS present with a constellation of symptoms associated with menstrual disorder and androgen excess, which significantly impact their quality of life. They may be at increased risk of many abnormalities, including obesity, insulin resistance, type II diabetes mellitus, cardiovascular diseases (CVD), infertility, cancer, and psychological disorders.
Metabolic abnormalities, mainly insulin resistance are evident in a majority of affected individuals, especially among those women who also show obesity. Adiponectin is one of the most abundant adipokines, it plays an important role in energy metabolism and contributes to the pathogenesis of the metabolic syndrome.
Polycystic ovary syndrome is associated with oxidative stress, increased production of free radicals (Malondialdehyde) followed by decreased serum antioxidant levels (Catalase).
This study aimed to explore whether women with PCOS have any difference in adiponectin and oxidative stress levels compared to obese and non-obese control groups. Also, study the correlation between serum level of adiponectin and oxidative stress with other biochemical parameters like hormonal parameters and lipid profiles in PCOS patients.
A case-control study design conducted on 160 women age ranged between (18 – 40) years involving 80 PCOS patients subdivided according to their body mass index (BMI) into 40 obese (BMI≥30) and 40 non-obese (BMI<30) and 80 women as a control, also subdivided according to their body mass index (BMI) into 40 obese (BMI≥30) and 40 non-obese (BMI<30) at the infertility clinic of a gynecological and obstetric teaching hospital, Kerbala health directorate Iraq. Parameters concentration were measured at the College of Medicine, University of Kerbala/Iraq during the duration from Nov. 2022 to Mar. 2023. The Rotterdam criteria-2003 was used to

choose PCOS patients. Patients were interviewed and examined for weight, height, waist circumference, and hip circumference. Five milliliters of venous blood samples were collected in the early morning after an overnight fast. Fasting blood glucose and insulin, additionally to the hormonal levels of each of LH, FSH, Free testosterone, and prolactin were measured by the chemiluminescent automated immunoassay system. The lipid profile of each TC, TG, and HDL were measured by using a Spectrophotometric automatic analyzer (SMART-120). Insulin Resistance was assessed by calculating HOMA-IR using the formula (fasting glucose mg/dl × fasting insulin µU/ml)/405. The SPSS Statistics software, version 28.0 (IBM, SPSS, Chicago, Illinois, USA), was used for all statistical calculations.

The result of this study demonstrated significant elevations in LH concentrations (p<0.001), LH/FSH ratio (p<0.001) and free testosterone level (p<0.001), prolactin level (p=0.004), TC (p=0.050), TG (p<0.001), LDL(p=0.002), HOMA-IR (p<0.001)
and MDA level (p=0.01) have prevailed in the obese PCOS patient group when compared with the obese control group. While a significant decrease in FSH level (P<0.001), ADP level (P<0.001), and CAT level (P<0.001) during a comparable evaluation between obese PCOS patients and the obese control group.
The optimal diagnostic points for predicting PCOS by MDA were: (sensitivity 60 %, specificity 81.2%) at a level = 4.305 mmol/l. The present study concludes that MDA levels and HOMA-IR increased in PCOS patients while ADP and CAT levels decreased as compared with control.