Skip to main content
SpringerLink
Log in

Adiponectin/leptin and HOMA/adiponectin ratios in Iranian women with polycystic ovary syndrome

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Insulin resistance and disrupted secretion of adipokines are the major contributors to the pathogenesis of polycystic ovary syndrome (PCOS). Previous research has indicated that adiponectin/leptin (A/L) and HOMA/adiponectin (H/A) ratios have a strong association with insulin resistance and metabolic syndrome. The current study aimed to assess the predictability of the A/L and H/A ratios for PCOS women infertility and recurrent pregnancy loss (RPL). In this study, we investigated the association of A/L and H/A ratios with PCOS, as well as infertility and RPL in Iranian women with PCOS.

Methods

This case–control study included 150 PCOS (60 infertile and 90 PCOS-RPL) and 50 non-PCOS women. Clinical, biochemical, and hormonal features were evaluated, and the A/L and H/A ratios were calculated.

Results

The A/L and H/A ratios were significantly decreased and increased in women with PCOS, respectively. A significant association was observed between the A/L and H/A ratios with PCOS, as well as PCOS-infertile and PCOS-RPL, even after adjusting for potential confounders. Although there was no significant difference between PCOS-infertile and PCOS-RPL subgroups, ROC curve analysis showed that A/L and H/A ratios could strongly predict PCOS with the area under the curve (AUC) of 0.867 and 0.861, respectively.

Conclusion

The ratios of A/L and H/A may serve as biomarkers to distinguish women with PCOS from non-PCOS in the Iranian population. However, it seems that they are not discriminatory markers for PCOS-associated RPL and infertility.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Abbreviations

A/L:

Adiponectin/leptin

BMI:

Body mass index

FBG:

Fasting blood glucose

FSH:

Follicle-stimulating hormone

FT:

Free testosterone

HDL-C:

High-density lipoprotein cholesterol

HOMA-IR:

Homeostasis model assessment of IR

H/A:

HOMA/adiponectin

IR:

Insulin resistance

LDL-C:

Low-density lipoprotein cholesterol

LH:

Luteinizing hormone

PCOS:

Polycystic ovary syndrome

ROC:

Receiver operator characteristic

RPL:

Recurrent pregnancy loss

TC:

Total cholesterol

References

  1. The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25

    Article  Google Scholar 

  2. Brassard M, AinMelk Y, Baillargeon J-P (2008) Basic infertility including polycystic ovary syndrome. Med Clin North Am 92:1163–1192

    Article  CAS  PubMed  Google Scholar 

  3. Koivunen R, Laatikainen T, Tomás C et al (1999) The prevalence of polycystic ovaries in healthy women. Acta Obstet Gynecol Scand 78:137–141

    CAS  PubMed  Google Scholar 

  4. Mannerås-Holm L, Leonhardt H, Kullberg J et al (2011) Adipose tissue has aberrant morphology and function in PCOS: enlarged adipocytes and low serum adiponectin, but not circulating sex steroids, are strongly associated with insulin resistance. J Clin Endocrinol Metab 96:E304–E311

    Article  PubMed  Google Scholar 

  5. Vega GL, Grundy SM (2013) Metabolic risk susceptibility in men is partially related to adiponectin/leptin ratio. J Obes

  6. Mitchell M, Armstrong D, Robker R, Norman R (2005) Adipokines: implications for female fertility and obesity. Reproduction 130:583–597

    Article  CAS  PubMed  Google Scholar 

  7. Cao H (2014) Adipocytokines in obesity and metabolic disease. J Endocrinol 220:T47–T59

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ali AT (2015) Polycystic ovary syndrome and metabolic syndrome. Ceska Gynekol 80:279–289

    PubMed  Google Scholar 

  9. Frühbeck G, Catalán V, Rodríguez A, Gómez-Ambrosi J (2018) Adiponectin-leptin ratio: a promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk Adipocyte 7:57–62

    PubMed  Google Scholar 

  10. Yamauchi T, Kamon J, Waki H et al (2001) The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med 7:941–946

    Article  CAS  PubMed  Google Scholar 

  11. Makni E, Moalla W, Lac G et al (2012) The Homeostasis Model Assessment-adiponectin (HOMA-AD) is the most sensitive predictor of insulin resistance in obese children. In Annales d'endocrinologie 73:26–33

  12. Matsuhisa M, Yamasaki Y, Emoto M et al (2007) A novel index of insulin resistance determined from the homeostasis model assessment index and adiponectin levels in Japanese subjects. Diabetes Res Clin Pract 77:151–154

    Article  CAS  PubMed  Google Scholar 

  13. Jung C-H, Rhee E-J, Choi J-H et al (2010) The relationship of adiponectin/leptin ratio with homeostasis model assessment insulin resistance index and metabolic syndrome in apparently healthy Korean male adults. Korean Diabetes J 34:237–243

    Article  PubMed  PubMed Central  Google Scholar 

  14. Zaletel J, Pongrac Barlovic D, Prezelj J (2010) Adiponectin-leptin ratio: a useful estimate of insulin resistance in patients with Type 2 diabetes. J Endocrinol Invest 33:514–518

    Article  CAS  PubMed  Google Scholar 

  15. Sadeghi A, Fadaei R, Moradi N et al (2020) Circulating levels of C1q/TNF-α-related protein 6 (CTRP6) in polycystic ovary syndrome. IUBMB Life 72:1449–1459

    Article  CAS  PubMed  Google Scholar 

  16. Fouani FZ, Fadaei R, Moradi N et al (2020) Circulating levels of Meteorin-like protein in polycystic ovary syndrome: a case-control study. PLoS ONE 15:e0231943

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 19:41–47

    Article  Google Scholar 

  18. Lee RM, Silver RM (2000) Recurrent pregnancy loss: summary and clinical recommendations. Semin Reprod Med 18:433–440

  19. Kargasheh FB, Ansaripour S, Borumandnia N et al (2021) Association of leptin G2548A and leptin receptor Q223R polymorphisms and their serum levels with infertility and recurrent pregnancy loss in Iranian women with polycystic ovary syndrome. PLoS ONE 16:e0255920

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Randeva HS, Tan BK, Weickert MO et al (2012) Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev 33:812–841

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Serazin V, Duval F, Wainer R et al (2018) Are leptin and adiponectin involved in recurrent pregnancy loss? J Obstet Gynaecol Res 44:1015–1022

    Article  CAS  PubMed  Google Scholar 

  22. Obirikorang C, Owiredu WK, Adu-Afram S et al (2019) Assessing the variability and predictability of adipokines (adiponectin, leptin, resistin and their ratios) in non-obese and obese women with anovulatory polycystic ovary syndrome. BMC Res Notes 12:1–8

    Article  CAS  Google Scholar 

  23. Baldani DP, Skrgatic L, Kasum M et al (2019) Altered leptin, adiponectin, resistin and ghrelin secretion may represent an intrinsic polycystic ovary syndrome abnormality. Gynecol Endocrinol 35:401–405

    Article  CAS  PubMed  Google Scholar 

  24. Golbahar J, Das NM, Al-Ayadhi MA, Gumaa K (2012) Leptin-to-adiponectin, adiponectin-to-leptin ratios, and insulin are specific and sensitive markers associated with polycystic ovary syndrome: a case–control study from Bahrain. Metab Syndr Relat Disord 10:98–102

    Article  CAS  PubMed  Google Scholar 

  25. Sarray S, Madan S, Saleh LR et al (2015) Validity of adiponectin-to-leptin and adiponectin-to-resistin ratios as predictors of polycystic ovary syndrome. Fertil Steril 104:460–466

    Article  CAS  PubMed  Google Scholar 

  26. Xiang S-K, Hua F, Tang Y et al (2012) Relationship between serum lipoprotein ratios and insulin resistance in polycystic ovary syndrome. Int J Endocrinol

  27. De Luis DA, Aller R, Izaola O et al (2011) The ratio of adiponectin to HOMA as an index of metabolic syndrome in obese women. Ann Nutr Metab 58:301–306

    Article  PubMed  Google Scholar 

  28. Xu X, Lai Y, Yang G et al (2016) Adiponectin/(FBG × FIns) as a predictor of insulin sensitivity and metabolic syndrome in patients with polycystic ovary syndrome. Medicine 95

  29. Meera S, Senghor KA, Vinodhini V, Sunitha S (2019) Role of adiponectin and insulin resistance in android and gynoid obese infertile women. Obes Med 16:100130

    Article  Google Scholar 

  30. Senghor KA, Vinodhini V (2020) Evaluation of Leptin and HOMA-adiponectin in hypothyroid infertile females. Biomed Pharmacol J 13:1931–1937

    Article  CAS  Google Scholar 

  31. Lage M, Garcia-Mayor RV, Tomé MA et al (1999) Serum leptin levels in women throughout pregnancy and the postpartum period and in women suffering spontaneous abortion. Clin Endocrinol 50:211–216

    Article  CAS  Google Scholar 

  32. Tommaselli GA, Di Spiezio SA, Di Carlo C et al (2006) Do serum leptin levels have a role in the prediction of pregnancy outcome in case of threatened miscarriage? Clin Endocrinol 65:772–775

    Article  CAS  Google Scholar 

  33. Agostinis-Sobrinho C, Vicente SEDCF, Norkiene S et al (2022) Is the leptin/adiponectin ratio a better diagnostic biomarker for insulin resistance than leptin or adiponectin alone in adolescents? Children 9:1193

    Article  PubMed  PubMed Central  Google Scholar 

  34. Lu M, Tang Q, Olefsky JM et al (2008) Adiponectin activates adenosine monophosphate-activated protein kinase and decreases luteinizing hormone secretion in LβT2 gonadotropes. Mol Endocrinol 22:760–771

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to the University of Tehran for the support of this project.

Funding

This study was supported by the University of Tehran.

Author information

Authors and Affiliations

  1. Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran

    Akram Vatannejad & Asma Kheirollahi

Authors
  1. Akram Vatannejad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Asma Kheirollahi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AK and AV contributed to the study concept and design. AK drafted the manuscript and researched the literature. AV performed the statistical analysis. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Asma Kheirollahi.

Ethics declarations

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration as revised in 2008. The present research was approved by the Ethics Committee of Kerman University of Medical Sciences (IR.KUMS.REC.1399.208). Informed consent was obtained from all the subjects before enrollment in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vatannejad, A., Kheirollahi, A. Adiponectin/leptin and HOMA/adiponectin ratios in Iranian women with polycystic ovary syndrome. Ir J Med Sci 192, 1793–1799 (2023). https://doi.org/10.1007/s11845-023-03408-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-023-03408-4

Keywords

Search

Navigation