Polycystic ovary syndrome (PCOS), a multifaceted condition, often has salient features like insulin resistance (IR). Abnormal alternation in insulin synthesis and function usually alters PCOS expressivity by deviating molecular and biochemical activity underlying this pathophysiology. This review intends to unveil the molecular basis of the genetic polymorphism of IR and its correlation with PCOS. It also highlights the existing methods of IR estimation. Searching of different articles using keywords including PCOS, IR, and polymorphism in various databases was performed to illustrate the review article. POCS, and IR are complex and multifactorial conditions in terms of the contributing factors, their interactions, and expressivity. Further studies on diversified genotype responses to environmental and ethnic variances are required for precise understanding. Insulin resistance (IR) and polycystic ovary syndrome (PCOS) are intricately interacted conditions that abnormally alter functions from genetic to organ system level. Complex gene-environment interactions make it difficult to understand the etiology and manifestation, and so diagnosis and management approaches of the heterogeneous pathophysiology are not foolproof. Further studies on genetic susceptibility related to ethnic distribution are essential for the implementation of personalized treatment of IR and PCOS. 

An insight of association of insulin resistance with polycystic ovary syndrome

Context: Polycystic ovarian syndrome (PCOS) is a polygenic and multifactorial endocrinopathy. Vitamin D deficiency (VDD) is found to be interlinked with insulin resistance (IR), dyslipidemia, and obesity in PCOS. Aims: To find out the correlation of VDD with IR and dyslipidemia in PCOS population of West Bengal (WB). Settings and Design: The study was conducted in and around Kolkata, WB with PCOS patients and their age-matched controls. Materials and Methods: Nutritional status, vitamin D profile, obesity indices, and IR index of both PCOS and control groups were studied. Statistical Analysis Used: The statistical analysis was performed to estimate the difference and correlation of quantitative variables by using Statistical Package for the Social Sciences (SPSS, version 20, IBM). Results: Dietary fat and carbohydrate intake was significantly higher in PCOS individuals relative to recommended dietary allowance (RDA) and the control group. Deficiency of serum 25-OH vitamin D (VDD) is evident in both the control and PCOS groups. However, the prevalence of IR among PCOS patients is significantly higher (64%) than in control (4%), and it is significantly correlated with VDD (P < 0.01). homeostatic model assessment for insulin resistance is found to be a comorbidity of dyslipidemia in PCOS patients. Conclusions: VDD, IR, and obesity potentially aggravate the phenotypic manifestations of PCOS. VDD in the control individuals of young age might be an alarming forecast for the development of PCOS in future life. 

Vitamin D and pathophysiology of polycystic ovary syndrome: A case–control study

Background: Polycystic ovary syndrome (PCOS) is a complex endocrinopathy of women in their reproductive age with diversity in clinical manifestations. The phenotypic expressions and altered anthropometric indices are the key indicators of the abnormal transformations in metabolic, endocrine, and reproductive functionality of PCOS. Stress-induced activation of the Sympathetic-Adrenal-Medullary (SAM)-system and Hypothalamic-Pituitary-Adrenal (HPA)-axis results in series of neuroendocrine adaptations where over-activation of SAM/HPA response negatively affects the Hypothalamic-Pituitary-Gonadal (HPG) axis that highlight the possibility of the adverse impact of stress response system on reproductive and metabolic functions. Psychological distress and anxiety induced by the COVID-19 pandemic may aggravate the expressivity of PCOS and associated complexities. Objective: The present study aimed to find out some phenotypic features (hirsutism, acne, Acanthosis Nigricans (AN) and alopecia) in association with deviated anthropometric and derived indices, and stress biomarkers (Salivary α-amylase (SAA) and cortisol of SAM and HPA-axis respectively) among PCOS patients. Statistical analysis: SPSS (IBM, version 20) and Microsoft Office Excel 2010 were implied, and the quantitative variables were described as mean±SD (P < 0.01 and P < 0.05). Results: Significant alternations in the anthropometric indices were observed for PCOS patients that may lead to health risk. Alteration in body composition was strongly correlated with stress biomarkers in the case of both the experimental and control group. Central obesity was found to be a significant indicator of altered body composition in response to stress. Conclusion: Stress is a key modulator in the alternation of phenotypic manifestation as well as body composition of PCOS patients which could be the plausible reason for further deterioration of this multifaceted disorder due to the COVID-19 pandemic.

/pdf/evaluation-of-association-of-anthropometric-indices-with-vsowfbfmw1.pdf

Nilansu Das

Papers

Evaluation of association of anthropometric indices with stress response in pcos population

Report of a hitherto unreported sequence present and expressed in a cancer cell line