Leptin in non PCOS and PCOS women: a comparative study
Keywords:
Leptin, PCOS, InsulinAbstract
Background: Leptin, a hormone secreted by adipose tissues, controls body weight through regulation of appetite and thermogenesis. The present study was aimed to observe role of leptin in healthy and polycystic ovary syndrome (PCOS) women.
Methods: Correlation between serum leptin and anthropometric, endocrine and metabolic profile was studied in 30 apparently healthy women (control group) and 38 PCOS women (PCOS group). Each group was stratified based on body mass Index (BMI), as normal weight (BMI<23) and overweight/obese (BMI>23).
Results Leptin level was high in 30% control group and in 65.79% PCOS group. Mean leptin (ng/ml) in PCOS group was higher compared to control group (18±1.9 v/s 12±1.7, p<0.05). Mean leptin levels were higher in overweight/obese subgroup as compared to normal weight subgroup in both Control (p<0.05) and PCOS groups (p=<0.05). In control group, leptin showed positive correlation with waist circumference (WC) (r=-0.49, p<0.01) and negative correlation with Cholesterol: HDL ratio (p<0.05). In PCOS group, leptin showed positive correlation with BMI (r=0.377,p<0.05) and Triglyceride (r=0.34,<0.05) and negative correlation with Fasting Blood Glucose( FBG)(r=-0.33,p<0.05). In normal weight subgroup among control group (n=25), leptin showed positive correlation with LDL (r=0.49, p<0.05). In control overweight/obese subgroup (n=5), leptin showed positive correlation with Follicle Stimulating Hormone (FSH) (r=+1.0, p<0.05) and inverse correlation with testosterone(r=-1.0,p<0.05). In normal weight subgroup among PCOS group, leptin had a positive correlation with LDL: HDL ratio (r=0.488, p<0.05).
Conclusions: Hyperleptinemia is common in obesity. Leptin controls glycemic status in patients with IR. Correlation of leptin with FSH and testosterone is influenced by obesity and PCOS. Leptin regulation of lipid homeostasis is influenced by obesity or PCOS.
References
Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38(9):1165-74.
Kalra A, Nair S, Rai L. Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome. Indian J Med Sci. 2006;60(11):447-53.
Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994;372(6505):425-32.
Caro JF, Sinha MK, Kolaczynski JW, Zhang PL, Considine RV. Leptin: the tale of an obesity gene. Diabetes. 1996;45:1455–62.
Rotterdam group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Hum Reprod 2004;19(1):41-7.
Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS , Chadha D et al. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. JAPI. 2009;57:163-170.
Brzechffa PR, Jakimiuk AJ, Agarwal SK, Weitsman SR, Buyalos RP, MagoffinDA. Serum immunoreactive leptin concentrations in women withpolycystic ovary syndrome. J Clin Endocrinol Metab. 1996;81:4166–9.
Laughlin GA, Morales AJ, Yen SSC. Serum leptin levels in women with polycystic ovary syndrome: the role of insulin resistance/hyperinsulinemia. J Clin Endocrinol Metab. 1997;82:1692–6.
Mendonça HC, Montenegro RM Jr, Foss MC, Silva de Sá MF, Ferriani RA. Positive correlation of serum leptin with estradiol levels in patients with polycystic ovary syndrome. Braz J Med Biol Res. 2004;May;37(5):729-36.
Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med. 1996;334(5):292-5.
Paz-Filho G, Mastronardi C, Wong M-L and Licinio J. Leptin therapy, insulin sensitivity and glucose homeostasis. IJEm 2012;6:S549-55.
Askari H, Tykodi G, Liu J, Dagogo-Jack S. Fasting plasma leptin level is a surrogate measure of insulin sensitivity. J Clin Endocrinol Metab. 2010;95(8):3836-43.
Yu WH, Walczewska A, Karanth S, McCann SM. Nitric oxide mediates leptin-induced luteinizing hormone-releasing hormone (LHRH) and LHRH and leptin-induced LH release from the pituitary gland. Endocrinology. 1997;138(11):5055-8.
Barash IA, Cheung CC, Weigle DS, et al. Leptin is a metabolic signal to the reproductive system. Endocrinology. 1996;137:3144 –7.
Spritzer PM, Poy M, Wiltgen D, Mylius LS, Capp E. Leptin concentrations in hirsute women with polycystic ovary syndrome or idiopathic hirsutism: influence on LH and relationship with hormonal, metabolic, and anthropometric measurements. Hum Reprod. 2001;16(7):1340-6.
Pehlivanov B, Mitkov M. Serum leptin levels correlate with clinical and biochemical indices of insulin resistance in women with polycystic ovary syndrome. Eur J Contracept Reprod Health Care. 2009;14(2):153-9.
Segal KR, Landt M, Klein S. Relationship between insulin sensitivity and plasma leptin concentration in lean and obese men. Diabetes. 1996;45(7):988-91.
Zimmet P, Hodge A, Nicolson M, Staten M, de Courten M, Moore J, et al. Serum leptin concentration, obesity, and insulin resistance in Western Samoans: cross sectional study. BMJ 1996;313:965-9.
Sørensen TI, Echwald S, Holm JC. Leptin in obesity. BMJ. 1996;313:953-4.
Taylor RW, Keil D, Gold EJ, Williams SM, Goulding A. Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristic curves. Am J Clin Nutr. 1998;67(1):44-9.
Mantzoros CS, Dunaif A, Flier JS. Leptin concentrations in the polycystic ovary syndrome. J Clin Endocrinol Metab. 1997Jun;82(6):1687-91.
Tuominen JA, Ebeling P, Heiman ML, Stephens T, Koivisto VA. Leptin and thermogenesis in humans. Acta Physiol Scand. 1997May;160(1):83-7.
Haluzík M, Fiedler J, Nedvídková J, Ceska R. Serum leptin concentrations in patients with combined hyperlipidemia: relationship to serum lipids and lipoproteins. Physiol Res. 1999;48:363-8.