Adipokines and ghrelin dysfunction - Any co-relation with etiogenesis of PCOS?

Is it primarily insulin resistance?? Is it primarily high adrenal/ ovarian Androgens?? May not be .The disrupted secretion of adipose tissue derived hormones and the gut hormone ghrelin precede the signs of metabolic syndrome observed in PCOS:Who irritates abd fat to alter the secretion of adiponectin and final clinically expressed as PCO. There are four persons who ignites fire (irritates fat) to results in “ Adipokines and ghrelin dysfunction” What we new about PCO? However some of these metabolic perturbations occur even in lean women with PCOS and therefore are rightfully recognized as intrinsic to PCOS. Although many of these findings can be largely explained by the increased prevalence of abdominal obesity even in normal weight PCOS patients some data suggest that disrupted secretion of adipose tissue derived hormones and the gut hormone ghrelin precede the signs of metabolic syndrome observed in PCOS patients Whether adipokines and ghrelin dysfunction is a consequence of the interaction among obesity visceral fat distribution hyperandrogenemia and hyperinsulinemia or is an intrinsic feature of PCOS is yet to be determined. It is now strongly speculated that altered adipose tissue secretion Adipokines and ghrelin dysfunction is secondary to A) obesity or B) hypoandrogenism and C) hyperinsulinemia or D) intrinsic to PCOS(genetic effect-the culprit gene –Candidate gene )

: The Leptin :Leptin hormone & its correlation with PCO -Researchers have observed that significantly increased serum leptin levels in PCOS patients compared to control subjects even when stratified by BMI suggesting that the elevated serum leptin level in PCOS patients is not only a result of increased body mass but is also due to specific factors related to CPSO. Reports however now pouring in that there is no association of serum leptin levels with TT or FT (T=testosterone) serum levels in women with PCOS , In contrast when these associations were controlled for BMI and WHR a significant negative association between serum leptin and TT levels was observed . TT was retained as a significant negative predictor of the serum leptin level when it was included as an independent variable. the serum leptin level is nearly equally affected by obesity and the diagnosis of PCOS per se and that among all examined

adipokines in our study leptin is perhaps the least specific for the diagnosis of PCOS. Correlation of Leptin with HOMA IR value :- HOMA IR value was not independently associated with serum leptin levels researchers failed to detect this association in normal weight PCO . But it is speculated that overweight PCOS patients may have some correlation of Leptin . As such it is concluded that the more pronounced role of IR will be associated with a higher BMI on serum leptin levels would have been identified. The serum leptin level is nearly equally affected by obesity and the diagnosis of PCOS per se and that among all examined adipokines in our study leptin is perhaps the least specific for the diagnosis of PCO. serum leptin level as an objective variable and adjusted for various confounding factors as explanatory variables a PCOS diagnosis had the greatest predictive value for serum leptin levels followed by BMI It is therefore obvious that ABC of Adiponectin

Many studies have demonstrated hypoadiponcetinemia in PCSO patients irrespective of obesity however these studies highlighted the importance of abdominal fat distribution we failed to establish a link between serum levels of Adiponectin and WHR contrary to the results of other studies. The lack of association between WHR and Adiponectin in our population may be partly explained by the higher proportion of normal weight PCOS patients included in our study as well as possible differences in body fat distribution among Croatian women compared to women of other European countries.

We found no association between serum Adiponectin levels and serum concentrations of TT or FR in PCOS patients which is consistent with the work of several other authors . We observed a significant negative association between DHEAS and Adiponectin levels in our PCOS group but this was lost after controlling for BMI and WHR .

Several reports have described association of Adiponectin levels with indication of IR which were further supported by a meta analysis published in 2009. We were unable to demonstrate any association between serum Adiponectin levels and IR measured by the HOMA IR in our population similar to studies by Sarray et al and O connor et al ) and also diff meta analysis published by Li et al These conflicting results are likely attributable to the differences in genetic predisposition for obesity and IR in distinct populations.

We demonstrated that a PCOS diagnosis severed as the strongest independent predictor of serum Adiponectin levels in stepwise multiple regression models the serum leptin level is nearly equally affected by obesity and the diagnosis of PCOS per se and that among all examined k adipokines in our study leptin is perhaps the least specific for the diagnosis of PCOS.