[Serum levels of ghrelin and leptin in women with polycystic ovary syndrome].
OBJECTIVE
To compare ghrelin and leptin levels in women with PCOS and healthy subjects and to evaluate the relationship between them and the heterogeneity of clinical and biochemical manifestations of women with polycystic ovary syndrome (PCOS).


METHODS
45 women with PCOS and 20 controls were included in the study. Serum levels of ghrelin, leptin, testosterone, immune-reactive insulin (IRI), sex hormone-binding globulin, dehydroepiandrosterone sulfate, cortisol, LH and FSH were measured. Free androgen index (FAI) and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Body mass index (BMI) and waist-to-hip ratio (WHR) were assessed.


RESULTS
Serum ghrelin levels in PCOS patients were lower (21.78 +/- 2.12 ng/ml vs. 34.67 +/- 3.57 ng/ml; p = 0.04) and leptin levels were higher (15,03 +/- 2,9 ng/ml vs. 6,16 +/- 0,60 ng/ml p = 0,048) than the control group. In group with PCOS negative correlation exists between ghrelin and testosterone (r = -0.315; p < 0.05) and between ghrelin and leptin levels (r = -0.306; p < 0.05). The latter correlation disappeared after partial correlation analysis controlling for BMI, WHR and HOMA-IR. In PCOS patients there were strong positive correlation between leptin and IRI (r = 0.592, p < 0.01) and HOMA-IR (r = 0.637, p< 0.01). In PCOS patients with more pronounced insulin resistance the correlation between leptin levels and HOMA-IR is independent of BMI, WHR and waist circumference.


CONCLUSIONS
Our study confirms the strong association that exists between serum leptin levels and clinical and hormonal indices of IR. The ghrelin level in women with PCOS reflects the metabolic and hormonal changes which are characteristics of the syndrome. The inverse correlation between ghrelin and leptin in these women is mediated through metabolic factors.
Pekhlivanov
B
B
Mitkov
M
M
Orbtsova
M
M
Terzieva
D
D