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Levels of Some Proinflammatory Cytokines in Obese Women with Polycystic Ovary Syndrome after Metformin Therapy

Background: Polycystic ovary syndrome is a heterogeneous disorder and its etiology appears to be complex and multifactorial; characterized by hyperandrogenism, chronic anovulation and infertility. It’s associated with evidence of low-grade chronic inflammation, as indicated by the presence of elevated levels of high sensitive C- reactive protein levels, interleukin-6 and tumor necrosis factor-α. The source of excess circulating tumor necrosis factor-α in obese Polycystic ovary syndrome patient is likely to be the adipose tissues while in lean women increased visceral adiposity has been proposed as a source of excess tumor necrosis factor-α.Objectives: to evaluate the levels of high sensitive C- reactive protein, tumor necrosis factor-α and interleukin-6 in patients with polycystic ovary syndrome before and after treatment with metformin; with emphasis on their relationship with the improvement in ovulation rate and body mass index in Iraqi women.Methods: 69 Iraqi females with PCOS, with mean age of 25.8±4.4 years, body mass index 31.14±2.23 kg/m2 and insulin resistant equal to 3.15±0.25. Additionally, 30 healthy fertile women BMI= 26.87±3.1 kg/m2 and mean age 23.4±2.8 years), the patients were treated with metformin 1500 mg/day for 3 months. Blood samples were obtained in the morning subsequent to an overnight fasting at baseline and at the end of the 12 weeks period of treatment, the samples were analyzed for plasma glucose level estimated by enzymatic colorimetric kit, while serum insulin , TNF-α, IL-6 , hs-CRP, Progesterone and sex hormone binding globulin . Results: BMI values were significantly increased at baseline value in patients (P<0.05) compared with healthy controls, then significantly decreased (12.9%) after treatment compared with baseline values, HOMA-IR index were significantly elevated in patients group at baseline compared with control, and significantly decreased by 17.4% after treatment. Regarding the influence of metformin on inflammatory markers, the present study demonstrated significant elevation of baseline levels (P<0.05) of TNF-α, hs-CRP and IL-6 compared with controls, and the baseline levels significantly decreased after treatment by 16%, 38% and 37% respectively. Meanwhile, sex hormone binding globulin levels were significantly decreased in PCOS patients compared with healthy controls, and significantly increased after treatment by 16.6%, also progesterone levels decline at baseline compared with control group, and it was increased significantly after treatment by 24%.Conclusions: The study detects an increased level of inflammatory cytokines, SHBG and decrease level of progesterone in Iraqi females with PCOS, and metformin therapy improves serum levels of the inflammatory cytokines associated with increased ovulation rate.

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Publication Date
Tue Dec 17 2013
Journal Name
Al-kindy College Medical Journal
Publication Date
Fri Jun 01 2012
Journal Name
Almustansiriyah Journal Of Pharmaceutical Sciences (ajps)
Levels of Some Pro-inflammatory Cytokines in Pregnant Women with Polycystic Ovary Syndrome

The objective of this study is to determine levels of some pro-inflammatory cytokines (IL-12 and SIL-2R) in pregnant women with polycystic ovary syndrome (PCOS) and also to determine incidence of spontaneous abortion during first trimester in pregnant women with PCOS compared with non-PCOS pregnant women. This Study was performed on (93) women, consisted of: 1- (63) pregnant women during the first trimester, which included:A- (33)PCOS pregnant women and subdivided into the following groups: (20) successful pregnant PCOS, (7) blighted Ovum PCOS and (6) missed abortion PCOS. B- (30) non-PCOS pregnant women, which included: (27) successful pregnant control and (3) non-PCOS pregnant women were withdrawn from this study because of their abortion

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Effect of Metformin Therapy on Reducing Leptin Resistance and Enhancing Ovulation in Women with Polycystic Ovary Syndrome

Background: The relation between insulin resistance ,leptin levels and other hormones in women with polycystic ovary syndrome(PCOS) is still controversial.Metformin therapy is proved effective in reducing insulin resistance and also in some studies it was seen to be effective in reducing leptin levels.
Al- Kindy Col Med J 2012 ; Vol .8 No. (2) p: 65
Objective: to study the effect of metformin on reducing leptin levels and enhancing ovulation in PCOS women.
Methods:metformin 500mg 3 times daily for 3 months was was given to 36 women
with proved PCOS, in addition to that, other parameters were included.
Results:28 women out of 36(77.78%) showed an evidence of ovulation ovulation after 3 months of metformin therapy(p<0.01)

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Publication Date
Wed Nov 28 2018
Journal Name
Iraqi Journal Of Science
Serum level evaluation of interleukin-18 in obese women with polycystic ovary syndrome

This study is designed to measure the level of interleukin (IL) 18 in polycystic ovary women and its association with obesity. In this study, blood samples from 50 women with PCOS and 30 healthy control women were collected from AL-Yarmouk Teaching, Baghdad Teaching hospitals During January 2018 - March 2018 for estimation of their serum level of IL18 by using enzyme-linked immunosorbent assay (ELISA) technique and evaluation serum levels of luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Testosterone, prolactin (PRL) and Estradiol (E2) by using Electrochemiluminescence immunoassay (ECLIA). The results showed that there is a highly significant increase (P < 0.001) in serum level of IL18 in PCOS women than in healthy

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
Metabolic syndrome in women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is
the most common form of chronic anovulation
associated with androgen excess; it occurs in about 5
– 10% 0f reproductive age women. Metabolic
syndrome is characterized by insulin resistance,
hypertension, obesity, abnormalities of blood clotting
and dyslipidemia.
Adult women with PCOS have an increased
prevalence of the metabolic syndrome(MBS).
Objectives: To detect the prevalence of metabolic
syndrome in women with proved PCOS, attending the
Specialized Center for Endocrinology and Diabetes, in
Baghdad.
Materials and methods : A total number of 40
women with proved PCOS were included in this study
which was conducted in the Specialized Center f

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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Metformin and Antioxidant Agents on Hirsutism in Women with Polycystic Ovary Syndrome

Forty six Iraqi women with PCOS were involved in this study . They were treated with metformin alone and with antioxidant agents (vitamin E or C).It was found that all patients who treated with metformin or with combination of metformin with antioxidant agents showed significant decrease in hirsutism score. The treatment of metformin with antioxidant agents is of great benefit in treatment of hirsutism in PCOS due to that there was no worsening effect after treatment. This may indicate that antioxidant agents may participate in alleviation of hirsutism so it can be said that oxidative stress may play an important role in developing of hirsutism in PCOS.   

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Publication Date
Thu Apr 27 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Total L-carnitine and insulin resistance in non-obese and obese Iraqi women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most frequent endocrine illnesses affecting reproductive - age women. L-carnitine has important roles in oxidative stress, energy production and glucose metabolism. It affects insulin resistance as decreased plasma carnitine level has been well reported in type II diabetes mellitus. Hence, it means L-carnitine may reduce insulin resistance which is found in PCO disease.

Objective: This study aims to measure the level of L-carnitine and insulin resistance in both obese and non- obese patients with PCOS.

Patients and Methods: Sixty women within the reproductive age with PCOS (30 obese and 30 non- obese) were recruited

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Publication Date
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Assessment of Serum Vitamin D Levels in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of
reproductive age with primary features of infertility, menstrual irregularity, and clinical or biochemical
evidence of hyperandrogenism (hirsutism, acne and high androgen level). Vitamin D has a role in the
development of metabolic and endocrine abnormalities in PCOS mediated by insulin resistance.
Objective: Measure serum 25-hydroxy vitamin D levels in women with polycystic ovary syndrome and
compare their levels with age and body mass index matched healthy controls. Also, assess the
correlation between insulin resistance and 25-hydroxy vitamin D among women with PCOS.
Subjects and Methods: Eighty eight women were involved in this st

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Determination of Serum Adiponectin Levels in Normal Weight Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age with primary manifestations of infertility, menstrual dysfunction and clinical or biochemical hyperandrogenism (hirsutism, acne and elevated androgen). Adiponectin is the most abundant adipokine. It has insulin-sensitizing, anti-atherogenic, and antiinflammatory actions.
Objective: Low adiponectin levels in women with PCOS have been largely attributed to obesity which is common among these patients. Therefore, the aim of this study was to measure adiponectin levels in normal weight women with PCOS and its contribution to development of disease.
Subjects and Methods: Fifty two (52) women were include

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Publication Date
Tue Dec 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Comparative Study of Blood Levels of Manganese, Some Macroelements and Heavy Metals in Obese and Non-Obese Polycystic Ovary Syndrome Patients

Polycystic ovary syndrome (PCOS) is a prevalent condition in women of reproductive age. It is characterized by androgen excess and chronic anovulation. Some trace elements, macroelements, and heavy metals have been linked to pathophysiological mechanisms of PCOS .

To study the alterations in the serum levels of the trace element manganese (Mn), some macroelements, magnesium(Mg) and calcium (Ca), and the heavy metals cadmium (Cd) and lead (Pb), in obese and non-obese PCOS patients; and the association of these alterations with some of the hormonal changes occurring in PCOS.

The study was carried out at Kamal Al-Samarrai Hospital (Center for Infertility treatment and in vitro Fertilization "IVF") Baghdad- Iraq. Eig

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