الفهرس 
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Abstract
Polycystic ovarian syndrome is one of the most common endocrine disorders affecting women of reproductive age. Several studies have demonstrated that low levels of serum adiponectin are present in obesity, insulin resistance, hypertension and hyperlipidaemias.
Leptin and adiponectin increase tissue sensitivity to insulin, both stimulate the fatty acids oxidation and decreasing triglycerides.
Human obesity represents a resistance state to leptin. A direct action of insulin and leptin on POMC neurons is required to maintain normal glucose homeostasis and reproductive function for maintaining fertility.
Leptin is secreted in a pulsatile manner leptin stimulates the GnRH pulse generator and in turn LH pulses. In turn, there is attenuation of the response of LH to GnRH in obese PCOS women may be related to changes in GnRH oscillator activity caused by a leptin-resistant state circulating leptin seems to be related to the overall and central adiposity.
Adiponectin constitutes a link between intrabdominal fat mass and the metabolic and cardiovascular complications of obesity. There is growing evidence that this protein is an important regulator of insulin sensitivity. Adiponectin suppresses hepatic glucose production.
This study was conducted on the Department of Obstetrics and Gynaecology in Benha University Hospital during the period from 1/6/2011 to 1/6/2012. The study was conducted on 45 women in reproductive age (18-40 years) and included:-
1- Study group consists of 30 infertile PCOS women (BMI >25 kg/m2).
2- Control group consists of 15 fertile normal menstruating women (BMI >25 kg/m2).
The diagnosis of PCOS was based upon European Society for Human Reproduction and Embryology (ESHRE), American Society of Reproductive Medicine (ASRM); (Rotterdam, 2003).
Any 2 of the following 3 criteria:
1. Hyperandrogenic features (defined biochemically and/or clinically).
2. Ovarian dysfunction (oligo-amenorrhoea (an inter-menstrual interval > 42 days), (oligo-ovulation, or an ovulation).
3. PCOS morphology on ultrasound scans 12 follicles (2-9 mm) and /or at least one enlarged ovary < 10 ml
The aim of this study was to determine the level of serum leptin, adiponectin and their ratio in patients with polycystic ovary syndrome and to compare that with normal menstruating, ovulatory and fertile women. The study was also to evaluate a possible correlation between serum leptin, adiponectin and their ratio with the polycystic ovary syndrome and the body mass index.
The mean BMI in the PCOS group is (31.5 ± 3.5 kg/m2) and control group is (29± 2.5 kg/m2) with statistically significant difference in between that women with PCOS had significantly higher BMI compared to non PCOS control group.
The results of this study revealed that PCOS group women have significantly higher serum leptin (35.8 ± 6.7 ng/ml) than non PCOS control (17.94 ± 4.2 ng/ml). There is a highly positive significant correlation between leptin level and BMI.
The results of this study revealed that PCOS group women have significantly lower (10.56 ± 2.67 ug/ml) than non PCOS control group (13.9 ± 2.6 ug/ml). There is a highly negative significant correlation between the adiponectin level and BMI.
The mean leptin adiponectin ratio (L/A) in the non PCOS controls is 1.37± 0.4 and in the PCOS patients 3.5 ± 1.2 with sensitivity 86.7% and specificity 93.3%, Cut off point at > 2.1 indicating that the ratio was increasing with the progression of the disease. There is a highly positive correlation between ratio and BMI.