الفهرس 
FOLLICULOGENESISOnly 14 pages are availabe for public view
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Abstract
P
olycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-aged women associated with anovulation, infertility and hyperandrogenism (Lim et al., 2013).
Women with PCOS have increased risk of metabolic syndrome (Hudecova et al., 2011), type 2 diabetes (Moran et al., 2010), and cardiovascular diseases including coronary heart disease and stroke (de Groot et al., 2011).
A large proportion of women with PCOS are overweight, obese or centrally obese. Excess body weight worsens certain features of PCOS including hyperandrogenism (Liou et al., 2009), menstrual disturbances (Liou et al., 2009), infertility (Brassard et al., 2008), insulin resistance (Kaya et al., 2009) and dyslipidaemia (Lim et al., 2013).
Ghrelin is a recently discovered peptide hormone produced by oxyntic cells in the gastric mucosa (Kojima et al., 1999) with important effects on energy balance, food intake and weight regulation (Otto et al., 2005). Ghrelin is a strong secretagogue of growth hormone (Ghigo et al., 2005). Low ghrelin levels were found in conditions of positive energy balance such as obesity (Tschop et al., 2001) and, accordingly, studies have reported low ghrelin levels to be associated with insulin resistance and diabetes (Poykko et al., 2003).
These biological functions of ghrelin lead to speculation about its possible role in the pathogenesis of PCOS (Pagotto et al., 2002). A significant correlation between androgen levels and ghrelin was found in some studies (Panidis et al., 2005), thus further supporting the relationship between android characteristics in PCOS and metabolic (Diamanti-Kandarakis et al., 2007) and cardiovascular risk factors (Rizzo et al., 2007).
The aim of this study is to compare ghrelin levels in women with polycystic ovary syndrome and healthy subjects and to evaluate the relationships between circulating ghrelin and the clinical and biochemical manifestations in women with polycystic ovary syndrome.
This study is a case control study which was conducted at Ain Shams University Maternity Hospital during the period between March and November 2014. The study included forty two patients with polycystic ovarian syndrome and forty two healthy subjects who were recruited from the outpatient clinic.
Blood sample were withdrawn after an overnight fast and before any therapy in the 2nd day of menstrual period and the following values were determined: Ghrelin, blood glucose, immune-reactive insulin (IRI), follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
The difference in the mean of age between the study and control group was statistically non significant (p>0.05), also, all the anthropometric measurements including: weight, height, BMI and waist/ hip ratio showed a non significant difference between both groups (p>0.05).
The mean of serum level FSH was comparable between study and control group (p>0.05), while significantly higher serum LH (9.52 versus 5.42 IU/L) and LH/FSH ratio (1.86 versus 1) were found in the PCOS group versus control group respectively (p<0.001).
The mean ± SD of serum ghrelin level was 860.56±100.08 pg/ml among the study group compared to 1246.67±105.94 pg/ml and this difference was statistically highly significant (p<0.001).
In the current study, results showed that the mean of blood glucose did not differ significantly between both groups, while serum immune-reactive insulin (IRI) and consequently the mean of homeostasis model assessment–insulin resistance (HOMA-IR) were significantly higher in the PCOS group as compared to controls (p<0.001).
In the present study bivariate correlation showed that serum ghrelin level was significantly indirectly proportional with blood glucose (p=0.003) and HOMA-IR (p=0.02) among the study group while other variables showed a non significant correlation. Serum ghrelin level was also significantly indirectly proportional with blood glucose (p=0.01) and HOMA-IR (p=0.03) among the control group and other variables also showed a non significant correlation with serum ghrelin level. This suggests a link between insulin sensitivity and ghrelin concentrations.