STATUS OF INSULIN LEVELS IN POLY CYSTIC OVARIAN SYNDROME PATIENTS
Type of manuscript : Research article
Running title : insulin levels in PCOS patients
Saveetha Dental College , saveetha university
Mrs. A.Jothi Priya
Department of Physiology
Saveetha Dental College,
162, Poonamallee High Road
Tamil Nadu , India
Email ID- [email protected]
Email: [email protected]
Telephone no. : 9500047276
Author name. : Shivani.N
Guide name. : Mrs.Jothi Priya
Year of study. : BDS-I 2017-18
Total Word count. : 2,119words.
Introduction:To check the levels of insulin in Poly cystic ovarian syndrome patients and compare them with normal patients. Women with Poly cystic ovarian disorder have high odds of insulin protection with an expanded danger of metabolic ailments. It is watched that obese PCOS ladies are more prone to high insulin levels. Hence, the aim of my study is to analyse the status of insulin in PCOS patients.
Materials and methods:
Patients were selected from those attending the out patient department of Saveetha Dental College, and hospitals and divided into two groups as follows
In women with PCOD, high insulin levels can cause the ovaries to secrete more androgen hormones as testosterone.Having insulin resistance can increases the risk of developing diabetes.Individuals with the age group of 20-30 years PCOS Patients.
Individuals with other systemic illness like cardio vascular disease, Renal failure, Stroke, endocrine illness.Individuals with acute illness like fever.Immunocompromised individuals.
Informed consent was obtained from the patient before sample collection. 5ml of fasting venous blood was collected and distributed in plain collection tubes and centrifuged in 3000rpm for serum. Then serum was separated and analysed to estimate the Fasting blood sugar by GOD-POD method by using ERBA CHEM 5 plus analyser. Insulin was analysed by ROBONIK ELISA READER. Insulin resistance was calculated by HOMO-IR calculation.
All the data were analysed by using SPSS package. Paired sample t test analysis was done to find out significant differences between the two groups. All the tests were considered significant at p < 0.05 level. CONCLUSION: Patients who visited Saveetha dental college were selected and were categorised into two groups. Group 1- PCOD patients group 2- normal females. The insulin levels of the patients were compared and the levels were noted. It was seen that the insulin levels of the PCOD patients was higher than those in the normal patients. INTRODUCTION: Insulin is our stockpiling hormone. The blood glucose level increments after eating. cerebrum, liver, heart, eye and pancreas cells may get harmed if blood glucose levels increments persistently . Insulin is utilized by our body to store overabundance glucose in our muscle and liver cells for later utilize. Polycystic ovarian disorder (PCOS) happens in around 10% of ladies amid their regenerative age, in this way being one of the commonest endocrine issue in ladies 1The disorder is characterized, in the wake of barring different clutters which may be available in a comparative form, by event of either two of the accompanying three highlights: I) anovulation, ii)clinical or potentially biochemical indications of hyperandrogenism,and iii) polycystic ovaries 2 Women with Poly cystic ovarian disorder have high odds of insulin protection with an expanded danger of metabolic ailments. It is watched that hefty PCOS ladies are for the most part insulin-safe separated from their adiposity 3,4 In lean PCOS ladies, the level isn't clear and it's motivation stays obscure. In spite of the fact that there have been no particular populace based investigations, a 5– 10% pervasiveness of this issue in ladies of conceptive age is most likely a sensible moderate gauge. This is construct as a furthest farthest point in light of investigations of the predominance of polycystic ovaries, which found that 20% of self-chose typical ladies had polycystic ovary morphology on ovarian ultrasound.A significant number of these ladies experience the ill effects of endocrine variations from the norm 5 Generally, insulin protection and the hyperinsulinemia influences around 65– 70% of ladies with PCOS 4, with around 70– 80% of corpulent ladies (BMI >30) and 20– 25% of lean ladies (BMI<25) displaying these attributes. Insulin protection is free of stoutness and it is connected particularly to PCOS, with variations from the norm of cell systems of insulin activity and insulin receptor work having been archived 6,7. Around 70% of PCOS ladies are insulin safe 8,9In PCOS females with ordinary glucose levels at first, the rate of change to strange glucose digestion can be 25% over only three years10 and insulin variations from the norm are exceedingly conceivable in young people with PCOS.11,12 In this way, in this examination, my point is to break down the levels of insulin in poly cystic ovarian disorder patients and contrast it and the typical patients. Materials and Methods Patients were selected from those attending the out patient department of Saveetha Dental College, and hospitals and divided into two groups as follows Inclusion Criteria Individuals with the age group of twenty to thirty years PCOS Patients Exclusion Criteria Individuals with other systemic illness like cardio vascular disease, Renal failure, Stroke, endocrine illness. Individuals with acute illness like fever. Immunocompromised individuals Sample collection Informed consent was obtained from the patient before sample collection. 5ml of fasting venous blood was collected and distributed in plain collection tubes and centrifuged in 3000rpm for serum. Then serum was separated and analysed to estimate the Fasting blood sugar by GOD-POD method by using ERBA CHEM 5 plus analyser. Insulin was analysed by ROBONIK ELISA READER. Insulin resistance was calculated by HOMO-IR calculation. RESULTS AND DISCUSSIONS: All the data were analysed by using SPSS package. Paired sample t test analysis was done to find out significant differences between the two groups. All the tests were considered significant at p < 0.05 level. PARAMETERS CONTROL PCOS p value FBS 93±8.29 99.1±14.66 0.1 Insulin 3.63±2.02 12.34±5.09 0.0001 Insulin Resistance 0.83±0.43 3.05±1.37 0.0001 INSULIN = mIU/L, Glucose – mg/dl = Homo –IR Fig.1 Fig.2 <1 ? Optimal >1.9 ? Early Insulin Resistance
>2.9 ? Significant Insulin Resistance
PCOS is a heterogeneous disorder. In the phenotypic range, we can discover fat, perpetually insulin-safe ladies, and at the other extraordinary, lean PCOS patients with set apart with hyperandrogenemia however without insulin protection. All things considered, up to this point, there have been few examinations 13,14 led on bigger gatherings of PCOS ladies to assess whether insulin protection is constantly associated with PCOS and, subsequently, regardless of whether the greater part of slender PCOS ladies is in this way insulin safe or whether insulin protection is just identified with body weight. Barely any examinations discovered diminished insulin affectability just in relationship with stomach corpulence or in lean PCOS ladies on the off chance that they were likewise hyperinsulinemic. Insulin protection is a noteworthy hazard factor for diabetes mellitus type 2.15,16 It is nearly connected with disorder X and is most likely one of its focal highlights PCOS ladies demonstrate an example of cardiovascular hazard factors putting them at a more serious danger of cardiovascular events(Fig.1 and Fig.2) 17,18,19
Since no particular sole is known for the reason for PCOS, it is multifactorial. 20
In PCOS, a portion of the physiological occasions inside the ovarian cycle and folliculogenesis are changed. 21
Barrenness related with PCOS has been ascribed to various variables, including oligo?an ovulation, broken gonadotrophin emission, hoisted foundational and additionally nearby ovarian androgen levels, and brokenness of any or a few ovarian development factors and their coupling proteins. As of late, thinks about have concentrated on fundamental and neighborhood impacts of IR and its optional impacts—foundational, metabolic and ovarian. 22,23
PCOD patients confront numerous medical problems like metabolic infections. There is an unmistakable view that PCOD patients have expanded odds of diabetes write 2. 24,25
Patients who went by Saveetha dental school were chosen and were ordered into two gatherings. Gathering 1-typical females in the age bunch 20-30years and assemble 2-PCOD patients. The insulin levels of the patients were looked at and the levels were noted. It was seen that the Levels of the insulin in PCOD patients was higher than those in the typical patients. This is on the grounds that PCOD patients are impervious to insulin which influences it to discharge more androgen hormones. It was seen that ordinary patient’s insulin level was 3.63±2.02 though in patients with PCOD, the insulin level was 12.34±5.09. The measure of insulin protection offered by the patient is additionally Calculated. The insulin protection in typical patients was 0.83±0.43 and those with PCOD had 3.05±1.37. From the outcomes, plainly the insulin levels of PCOD patients is higher than the insulin levels of the typical patients. Likewise, the insulin protection is high for patients with PCOD.
Randeva HS, Tan BK, Weickert MO, Lois K, Nestler JE, et al. (2012) Cardiometabolic Aspects of the Polycystic Ovary Syndrome. Endocr Rev. Oct 33(5): 812–41
The Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS) (2003) Human Reproduction. 19: 41–47
Dunaif A. Insulin resistance and the polycystic ovarian syndrome; mechanism and implications for pathogenesis. Endocrinol Rev. 1997; 18:774–800. doi: alopecia. Clin Endocrinol (Oxf). 1994; 10.1210/er.18.6.774. 41:231–236.
Dunaif A, Finegood DT 1996 -Cell dysfunction independent of obesity and glucose intolerance in the polycystic ovary syndrome. J Clin Endocrinol Metab 81:942–94
Dunaif A, Segal KR, Futterweit W, Dobrjansky A 1989 Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes 38:1165–1174
Holte J, Bergh T, Berne C, Berglund L, Lithell H 1994 Enhanced early insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose tolerance. J Clin Endocrinol Metab 78: 1052–1058
Rosenfield RL. Identifying children at risk for polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92:787–796
Creanga AA, Bradley HM, McCormick C, Witkop CT. Use of metformin in polycystic ovary syndrome: a meta-analysis. Ob Gyn. 2008;111:959–96
Freeman R, Pollack R, Rosenbloom E. Assessing impaired glucose tolerance and insulin resistance in Polycystic Ovarian Syndrome with a muffin test: Alternative to glucose tolerance test. Endocr Pract. 2010:1–24. PubMed
Farrell K, Antoni MH. Insulin resistance, obesity, inflammation, and depression in polycystic ovary syndrome: biobehavioral mechanisms and interventions. Fertil Steril. 2010;94:1565–1574
Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertil Steril. 2002;77:1095–1105. PubMed
Pesant MH, Baillargeon JP. Clinically useful predictors of conversion to abnormal glucose tolerance in women with polycystic ovary syndrome. Fertil Steril. 2011;95:210–215
Holte J, Bergh T, Berne C, Berglund L, Lithell H 1994 Enhanced early insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose tolerance. J Clin Endocrinol Metab 78:1052–1058
Indhavivadhana S, Wongwananuruk T, Rattanachaiyanont M, Techatraisak K, Leerasiri P, Tanmahasamut P, Popijan M. Prevalence of metabolic syndrome in reproductive-aged polycystic ovary syndrome Thai women. J Med Assoc Thai. 2010;93:653–660.
Ciampelli M, Fulghesu AM, Cucinelli F, Pavone V, Caruso A, Mancuso S, Lanzone A 1997 Heterogeneity in ? cell activity, hepatic insulin clearance and peripheral insulin sensitivity in women with polycystic ovary syndrome. Hum Reprod 12:1897–1901
Vrbikova J, Hill M, Starka L, Cibula D, Bendlova B, Vondra K, Sulcova J, Snajderova M 2001 The effects of long-term metformin treatment on adrenal and ovarian steroidogenesis in women with polycystic ovary syndrome. Eur J Endocrinol 144:619–628
T. Apridonidze, P. A. Essah, M. J. Iuorno, and J. E. Nestler, “Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome,” Journal of Clinical Endocrinology and Metabolism, vol. 90, no. 4, pp. 1929–1935, 2005.
E. Diamanti-Kandarakis, J. Papailiou, and S. Palimeri, “Hyperandrogenemia: pathophysiology and its role in ovulatory dysfunction in PCOS,” Pediatric Endocrinology Reviews, vol. 3, no. 1, pp. 198–204, 2006
L. Pellatt, S. Rice, and H. D. Mason, “Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?” Reproduction, vol. 139, no. 5, pp. 825–833, 2010
Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999;84:165–9.
Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999;22:141–6.
Adams J, Polson DW, Franks S. Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Br Med J 1986;293: 355–9.
Ruksana sheikh,Awareness of Obesity as a Risk Factor for POLY CYSTIC OVARIAN SYNDROME, J. Pharm. Sci. & Res. Vol. 7(7), 2015, 471-473
Priyanka Shenoy Awareness of Polycystic Ovarian Disease among Females of Age Group 18-30 Years .B et al /J. Pharm. Sci. & Res. Vol. 8(8), 2016, 813-816
Joshini Shanmugam, Dr. Anitha Roy, “awareness of insulin usage among diabetic patients in Chennai, international journal of science and research (IJSR) ISSN (online) : 2319-7064 Volume 6 issue 5, May 2017