Irisin as a Novel Marker for Insulin Resistance in Iraqi Women with Polycystic Ovary Syndrome Before and After Metformin Therapy

  • Fatin Shallal FarhanEmail author
  • Shatha Sami Hussien
Original Article



Polycystic ovarian syndrome affects 5–10% of women; it represents the most common cause of hyperinsulinemia with anovulation. Many biomarkers are used to assess insulin resistance. Irisin is a newly discovered myokine associated with insulin resistance and other metabolic syndromes.


To measure the serum level of irisin in polycystic ovary syndrome patients and assess the effect of metformin treatment on its level.


This study was a prospective interventional study conducted in a private clinic and Al-Yarmouk Teaching Hospital in Baghdad City from January 1, 2017, till April 1, 2018. A hundred women were enrolled in the study. Fifty of them suffered from PCOS and other fifty were normal. They were randomly selected according to computer-based randomization and assigned as a control group. Hormonal, biochemical and oral glucose tolerance tests were performed on all patients, including Irisin. The results have been compared for both groups. Twenty-nine women of PCOS patients received metformin for a course period of 4 months as the changes in their biochemical results were evaluated.


Serum irisin level was higher in patients group compared to control group (312 ± 134.3 and 188.4 ± 53.8 μg/l, respectively), and the difference was statistically significant as the p value < 0.001. After 4 months treatment with metformin for twenty-nine polycystic patients, there was a significant reduction in irisin level by (165.8 ± 55.6 μg/l) and the p value was significant.


Irisin might be used as a simple test for the prediction of insulin resistance in PCOS patients.


Polycystic ovary syndrome Hyperinsulinemia Irisin and myokine 



Funding was provided by Fatin Shallal (Grant No. 07901761136).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standards

This manuscript has not been submitted anywhere before, and it was approved by all authors to be submitted in this journal. The protocol of the study has been approved by the Scientific Researches Committee in Obstetrics and Gynecology at Al-Yarmouk Hospital. Informed consent has been taken from all participants who were 100 Iraqi women enrolled in this study.


  1. 1.
    Spritzer PM. Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances. Arq Bras Endocrinol Metab. 2014;58(2):182–7.CrossRefGoogle Scholar
  2. 2.
    Johnson NP. Metformin use in women with polycystic ovary syndrome. Ann Transl Med. 2014;2(6):56.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Polak K, Czyzyk A, Simoncini T, et al. New markers of insulin resistance in polycystic ovary syndrome. J Endocrinol Invest. 2017;40(1):1–8.CrossRefGoogle Scholar
  4. 4.
    Shanshan G, Yan Ch, Lingling Z, et al. The relationships of Irisin with bone mineral density and body composition in PCOS patients. Diabetes Metab Res Rev. 2016;32: 421–8.CrossRefGoogle Scholar
  5. 5.
    Chang CL, Huang SY, Soong YK, et al. Circulating Irisin and glucose-dependent insulinotropic peptide are associated with the development of polycystic ovary syndrome. J Clin Endocrinol Metab. 2014;99(12):E2539–48.CrossRefGoogle Scholar
  6. 6.
    Minyan L, Mengliu Y, Xiaoxin Z, et al. Elevated circulating levels of irisin and the effect of metformin treatment in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2015;100(4):1485–93.CrossRefGoogle Scholar
  7. 7.
    Kyritsi EM, Dimitriadis GK, Kyrou I, et al. PCOS remains a diagnosis of exclusion: a concise review of key endocrinopathies to exclude. Clin Endocrinol (Oxf). 2017;86:1–6.CrossRefGoogle Scholar
  8. 8.
    Bostanci MS, Akdemir N, Cinemre B, et al. Serum Irisin levels in patients with polycystic ovary syndrome. Eur Rev Med Pharmacol Sci. 2015;19:4462–8.PubMedGoogle Scholar
  9. 9.
    Adamska A, Karczewska-Kupczewska M, Lebkowska A, et al. Serum Irisin and its regulation by hyperinsulinemia in women with polycystic ovary syndrome. Endocr J. 2016;63(12):1107–12.CrossRefGoogle Scholar
  10. 10.
    Katarzyna P, Łukasz Ł, Katarzyna K, et al. Irisin plasma concentration in PCOS and healthy subjects is related to body fat content and android fat distribution. J Gynecol Endocrinol 2015;31(11):907–11.Google Scholar
  11. 11.
    Gouni-Berthold I, Berthold HK, Huh JY, et al. Effects of lipid-lowering drugs on irisin in human subjects in vivo and in human skeletal muscle cells ex vivo. PLoS One. 2013;8(9):e72858CrossRefGoogle Scholar
  12. 12.
    Qiua S, Cai X, Yinab H, et al. Association between circulating Irisin and insulin resistance in non-diabetic adults: a meta-analysis. Metabolism. 2016;65(6):825–34.CrossRefGoogle Scholar
  13. 13.
    Chen JQ, Huang YY, Gusdon AM, et al. Irisin: a new molecular marker and target in metabolic disorder. Lipids Health Dis. 2015;14:2.CrossRefGoogle Scholar
  14. 14.
    Abali R, Temel Y, Yuksel MA, et al. Implications of circulating Irisin and Fabp4 levels in patients with polycystic ovary syndrome. J Obstet Gynaecol. 2016;36(7):897–901.CrossRefGoogle Scholar
  15. 15.
    Benedini S, Dozio E, Invernizzi PL, et al. Irisin: a potential link between physical exercise and metabolism: an observational study in differently trained subjects, from elite athletes to sedentary people. J Diabetes Res. 2017. Scholar
  16. 16.
    Foda AA, Foda EA, Abel-Aal I, et al. Serum Irisin levels as a marker in some phenotypes of PCOS. Middle East Fert Soc J. 2018;23(2):112–6. Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2018

Authors and Affiliations

  1. 1.Gynecology and Obstetrics Department, Al Yarmouk Teaching HospitalAl Mustansiriyah Medical CollegeBaghdadIraq

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