HOMOCYSTEINE LEVEL IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME WITH AND WITHOUT INSULIN RESISTANCE.

Until recent period, hyperinsulinemia and hyperandrogenism were thought to be involved in the pathogenesis of polycystic ovary syndrome (PCOS), however, in recent years several studies reported that hyperhomocysteinemia, which may be associated with insulin resistance, plays important role in the pathogenesis of PCOS. Therefore, hyperhomocysteinemia (HHcy) can be considered as one of the newly identified characteristics of PCOS. The aim of the study was to evaluate homocysteine (Hcy) levels in patients with PCOS with and without insulin resistance. The study was conducted in 59 patients with PCOS aged 13-35 (mean age 24.5±3.5). Patients were divided into 2 groups: Group I - 38 patients with PCOS and insulin resistance, Group II - 21 patients with PCOS without insulin resistance. PCOS patients as well were divided into 3 subgroups according to homocysteine values: low - ≤ 6.09 μmol/l, moderate - 6.10-9.33 μmol/l, high >9.34 μmol/l). In patients with PCOS and insulin resistance were established a significant increase in homocysteine levels, HOMA-IR and BMI indicators compared to those patients with PCOS without insulin resistance. In the group of patients with PCOS with insulin resistance homocysteine level with increased and high normal level of homocysteine (high Hcy subgroup, >9.34 μmol/l) were significantly more common (84.2%) compared to patients without insulin resistance (52%). Homocysteine level is significantly elevated in patients with PCOS, and insulin resistance compared to patients without insulin resistance. In the management of patients with PCOS, along with correction of insulin resistance, control and correction of homocysteine level should be considered, which will improve their reproductive outcome.