title: Plasma homocysteine levels in polycystic ovary syndrome and congenital adrenal hyperplasia.
abstract: The purpose of this study was to determine whether polycystic ovary syndrome (PCOS) and nonclassic 21-hydroxylase deficiency (CAH) are related to hyperhomocysteinemia, and to investigate if there is a correlation between homocysteine levels and insulin sensitivity in women with PCOS and CAH. Fifty patients with PCOS, 50 patients with CAH and 25 control women were included in the study. Blood samplings were performed in the early follicular phase for measuring hormone profile, Vitamin B(12), folate, homocysteine levels and fasting blood glucose. Ovulatory status was assessed with timed serum progesterone measurements. Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated as a measure of insulin resistance. Mean homocysteine levels were found as (8.9 + 1.9 micromol/l and 17.7 + 3.6 micromol/l) in the normal group and PCOS respectively (p<0.001), but there was no statistical significance between nonclassic 21-hydroxylase deficiency (9.0 + 2.2 micromol/l) and control group. Most of the patients in PCOS group (35 of 50) were significantly insulin resistant. However, there was no insulin resistant patient in CAH or control group. When we compare the two subgroups of PCOS women, the patients with insulin resistance had significantly higher homocysteine levels than the ones who were not insulin resistant. There were positive correlations among serum homocysteine, insulin and androgen levels in PCOS patients. There were no correlations among these parameters in CAH and control groups. Increased homocysteine levels may contribute to increased cardiovascular disease risk in patients with PCOS. The reason for hyperhomocysteinemia seems to be related to insulin resistance but not high androgen levels.
authors.affiliation: Dokuz Eylul University Endocrinology Department, Balcova, 35350 Izmir, Turkey.
authors.forename: Firat
authors.initials: F
authors.lastname: Bayraktar
authors.forename: Didem
authors.initials: D
authors.lastname: Dereli
authors.forename: A Gokhan
authors.initials: AG
authors.lastname: Ozgen
authors.forename: Candeger
authors.initials: C
authors.lastname: Yilmaz
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000097:blood* / Q000150:complications; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications; D011374:Progesterone / Q000097:blood; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000097:blood; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D001786:Blood Glucose; D006710:Homocysteine; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin; D002784:Cholesterol; D014805:Vitamin B 12; D013974:Thyroxine