Plasma homocysteine in polycystic ovary syndrome (PCOS): does it correlate with insulin resistance?

Abstract

PCOS is associated with insulin resistance and premature coronary artery disease (CAD). Hyperhomocysteinaemia is a risk factor of atheroclesrosis. Objectives: To compare plasma homocysteine in women with PCOS and matched controls and to correlate plasma homocysteine with fasting insulin concentration Method: Case control study of Sri Lankans (SL), British Asians (BA) and Caucasian (C) with and without PCOS: SL (80 vs. 45), BA (47 vs. 11) and C (40 vs. 22). Fasting homocysteine (Fluorescence Polarization Immunoassay, IMX System) was analysed and correlated with age, body mass index (BMI), central obesity and fasting insulin. Results: Mean plasma homocysteine (Hc) was significantly higher in all PCOS groups (SL 9.25 vs.8.26, p = 0.03; BA 7.73 vs. 5.29, p < 0.0001; C 8.81 vs. 6.34, P =0.007) while SL PCOS had significantly greater Hc (p = 0.0012) than other PCOS groups. Asian PCOS, women were younger than C: 26.3; 26 vs.30.1 ( P = 0.008). BMI of SL PCOS was significantly lower: 26.3; 30.59; 32.1 (p= 0.006), but with similar waist:hip ratios (WHR): 0.97, 1.04,; 0.92, NS. Fasting insulin was significantly higher in affected SL 242.9; 89.4; 48.6 pmol/I (p= 0.0003). He did not show correlation with age and BMI. Conclusions: PCOS is associated with a significant elevation of fasting plasma homocysteine when compared with matched controls. Increased homocysteine concentration in PCOS correlates with the highest fasting insulin concentration observed in affected Sri Lankans. These findings in young Sri Lankan women with PCOS bear major implications on their long-term atherosclerosis risks.