STATUS OF INSULIN IN POLY CYSTIC OVARIAN SYNDROME
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: 2017 words
TOPIC: TO ANALYSE THE LEVELS OF INSULIN IN POLY CYSTIC OVARIAN SYNDROME PATIENTS
Introduction:To check the levels of insulin in Poly cystic ovarian syndrome patients and compare them with normal 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. This can result in body hair, acne, and irregular or fewer periods. 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. This is because PCOD patients are resistant to insulin which makes it secrete more androgen hormones. INTRODUCTION: Insulin is our storage hormone. The blood glucose level increases upon eating. brain, liver, heart, eye and pancreas cells may get damaged if blood glucose levels increases continuously . Insulin is used by our body to store excess glucose in our muscle and liver cells for later use. Polycystic ovarian syndrome (PCOS) occurs in about 10% of women during their reproductive age, thus being one of the commonest endocrine disorders in women 1The syndrome is defined, after excluding other disorders which might be present in a similar fashion, by occurrence of either two of the following three features: i) anovulation, ii)clinical and/or biochemical signs of hyperandrogenism,and iii) polycystic ovaries 2 Women with Poly cystic ovarian syndrome have high chances of insulin resistance with an increased risk of metabolic diseases. It is observed that obese PCOS women are mostly insulin-resistant apart from their adiposity 3,4 In lean PCOS women, the level is not clear and it's cause remains unknown. Although there have been no specific population based studies, a 5–10% prevalence of this disorder in women of reproductive age is probably a reasonable conservative estimate. This is based as an upper limit on studies of the prevalence of polycystic ovaries, which found that 20% of self-selected normal women had polycystic ovary morphology on ovarian ultrasound . Many of these women suffer from endocrine abnormalities 5 Overall, insulin resistance and the hyperinsulinemia affects about 65–70% of women with PCOS 4, with about 70–80% of obese women (BMI >30) and 20–25% of lean women (BMI<25) exhibiting these characteristics. Insulin resistance is independent of obesity and it is related specifically to PCOS, with abnormalities of cellular mechanisms of insulin action and insulin receptor function having been documented 6,7. About 70% of PCOS women are insulin resistant 8,9In PCOS females with normal glucose levels initially, the rate of conversion to abnormal glucose metabolism can be 25% over just three years10 and insulin abnormalities are highly possible in adolescents with PCOS.11,12 Thus, in this research, my aim is to analyse the levels of insulin in poly cystic ovarian syndrome patients and compare it with the normal 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 <1 ? Optimal >1.9 ? Early Insulin Resistance
>2.9 ? Significant Insulin Resistance
PCOS is a heterogeneous syndrome. In the phenotypic spectrum, we can find obese, invariably insulin-resistant women, and at the other extreme, lean PCOS patients with marked with hyperandrogenemia but without insulin resistance. Nevertheless, until now, there have been few studies 13,14 conducted on larger groups of PCOS women to evaluate whether insulin resistance is invariably connected with PCOS and, consequently, whether the majority of lean PCOS women is thus insulin resistant or whether insulin resistance is only related to body weight. Few studies found decreased insulin sensitivity only in association with abdominal obesity or in lean PCOS women if they were also hyperinsulinemic. Insulin resistance is a major risk factor for diabetes mellitus type 2. It is closely associated with syndrome X and is probably one of its central features PCOS women show a pattern of cardiovascular risk factors putting them at a greater risk of cardiovascular events 15
Because no specific sole is known for the cause of PCOS, it is multifactorial. 16
In PCOS, some of the physiological events within the ovarian cycle and folliculogenesis are changed. 17
Infertility associated with PCOS has been attributed to numerous factors, including oligo?an ovulation, dysfunctional gonadotrophin secretion, elevated systemic and/or local ovarian androgen levels, and dysfunction of any or several ovarian growth factors and their binding proteins. Recently, studies have focused on systemic and local effects of IR and its secondary effects—systemic, metabolic and ovarian.
PCOD patients face many health issues like metabolic diseases. There is a clear view that PCOD patients have increased chances of diabetes type 2. 18,19,20
Patients who visited Saveetha dental college were selected and were categorised into two groups. Group 1- normal females in the age group 20-30years and group 2- PCOD patients. The insulin levels of the patients were compared and the levels were noted. It was seen that the Levels of the insulin in PCOD patients was higher than those in the normal patients. This is because PCOD patients are resistant to insulin which makes it secrete more androgen hormones. It was seen that normal patient’s insulin level was 3.63±2.02 whereas in patients with PCOD, the insulin level was 12.34±5.09. The amount of insulin resistance offered by the patient is also Calculated. The insulin resistance in normal patients was 0.83±0.43 and those with PCOD had 3.05±1.37. From the results, it is clear that the insulin levels of PCOD patients is higher than the insulin levels of the normal patients. Also, the insulin resistance is high for patients with PCOD.
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