Evaluation of Plasma Homocysteine Levels in Patients of PCOS.

Background: Homocysteinemia in PCOS may impair implantation by interfering with endometrial blood flow and has been documented to increase the adverse pregnancy outcome.

Aims: The objective was to evaluate the relationship between insulin resistance and serum homocysteine in subjects with polycystic ovarian syndrome (PCOS).

Material And Methods: Cross sectional Case Control observational study done in Department of Obstetrics and Gynecology, KGMU Lucknow. Cases were 50 PCOS women as a study group and 40 women with infertility due to isolated male cause as a control group. Serum homocysteine levels compared in PCOS patients.

Results: Mean homocysteine raised in cases (11.8 ± 5.5μmol/L) than control (7.8 ± 2.2 μmol/L), p< 0.001 Considering 11 μmol/l cut off level for normal homocysteine, 36% of PCOS patients (18 of 50) and 10%of control (4 out of 40) had high homocysteine levels, p< 0.001. 8% of PCOS patients without insulin resistance (4 out of 50) had a high homocysteine level, while 28%of PCOS patients with insulin resistance (14 out of 50) had homocysteinemia. Mean plasma homocysteine level was very high in insulin resistant case group subjects (13.9 ± 5.6 μmol/L) than non insulin resistant subjects in case group (8.2 ± 2.7), p< 0.001.

Conclusion: Insulin resistance and hyperinsulinaemia in patients with PCOS is associated with elevated plasma homocysteine This finding may have important implications in the short-term reproductive outcome, and the long-term cardiovascular complications associated with insulin-resistant PCOS.