Author(s): Dr. Seema Mishra

Abstract:
Insulin resistance is a common feature of PCOS and is more marked in obese women, suggesting that PCOS and obesity have a synergistic effect on the magnitude of the insulin disorder. It leads to increased insulin secretion by beta-cells and compensatory hyperinsulinemia. Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and metabolic disturbances. If beta-cell compensatory response declines, relative or absolute insulin insufficiency develops which may lead to glucose intolerance and type 2 diabetes. The key characteristics in the studied group [20 women] include irregular menstruation, obesity, infertility, acne and hair growth on the face, chest, and back (hirsutism) and ovarian cysts. Also as Insulin resistance precipitates dyslipidemias, thus the PCO_s affected victims are more prone for developing CVD_s. We performed this study to determine the prevalence of glucose intolerance and parameters associated with risk for CVD_s in PCOS women. PCOS women, aged 20-48 years, were prospectively evaluated in Bilaspur city. The PCOS women were compared to 20 control women of similar age and demographical profile. Their biochemical profile including serum levels of estrogen, progesterone, Testosterone, C-peptide level, C-reactive protein, total lipid profile, BRI, waist-hip ratio, Glucosylated Hemoglobin were assessed and compared with the biochemical values in the control group. The values in the PCOs victim group in terms of Serum Insulin level, Serum Testosterone level Hb1Ac, obesity, serum Cholesterol, Triglyceride, LDL were significantly higher than the values estimated in controls, but lower in terms of serum estrogen and progesterone levels. Also the serum value of creatine Kinase was higher in the subjects, a clear indication of cardio-damaging effect of PCO_s driven dyslipidemia. We concluded that - PCOS women are at significantly increased risk for type 2 diabetes mellitus and CVD_s, suggesting that PCOS may be a more important risk factor than assumed previously for developing Insulin resistant Diabetes and CVD_s.