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Inter-relationship of circulating biochemical markers of oxidative stress and comorbid condition in polycystic ovary syndrome

Mahmood Rasool, Rizwan Ahmad, Raazia Rizwan, Arif Malik, Muhammad Asif, Ahmad Zaheer, Abdul Jabbar, Maryam Zain, Muther Mansoor Qaisrani, Tahira Batool Qaisrani, Asim Mehmood, Imran Riaz Malik, Nawal Helmi, Mustafa Zeyadi, Hani Choudhry, Avi Harlev, Ashok Agarwal, Mohammad Sarwar Jamal

Introduction: Polycystic Ovarian Syndrome (PCOS), commonly found in 5% of all women of reproductive age is a heterogeneous endocrine disorder in which woman’s levels of estrogen and progesterone are imbalance leading to the growth of benign masses in the ovaries (ovarian cysts). Rotterdam criteria used to diagnose PCOS include two of three clinical features: 1) oligo- or anovulation, 2) hyperandroginism e.g., hirsutism, acne etc. and 3) sonographic morphologic evidence of polycystic ovaries.

Aim: To investigate the relationship between circulating biomarkers and their heterogeneity in PCOS.

Material and Methods: A prospective case control study was conducted including 70 females of age ranging from 20 to 35 y out of which 20 served as healthy controls and 50 were patients of PCOS. Lipid levels, renal profile and antioxidative status of Malondialdehyde (MDA), Catalase (CAT), Superoxide dismutase (SOD) and Reduced glutathione (GSH) was analysed quantitatively. Serum electrolytes (Na+, K+, Mg2+, PO4 -3), anti-oxidants vitamins C and E and steroidal hormones like Follicle Stimulating Hormone (FSH), Sex Hormone Binding Globulin (SHBG) were measured by the commercially available kits.

Results: A total of 70 patients were enrolled to the study. Serum electrolytes level like potassium (K) and Phosphorus (P) were significantly increased while antioxidants were decreased in the study group as compared to the control group. Oxidative stress was also increased with higher levels of MDA. Follicle Stimulating Hormone (FSH) and Sex Hormone Binding Globulin (SHBG) were decreased in the study group. The PCOS patients showed statistically significant correlation among the circulating biomarkers like FSH vs. prolactin (r=0.400**).

Conclusion: PCOS is found strongly associated with increased lipid peroxidation, oxidative stress, electrolyte imbalance as well as variation in lipid profile in biological system. As the lipid peroxidation increases it increases MDA (end product of lipid peroxidation), significantly it characterize PCOS by quantifying lipid hydroperoxides and therefore it may serve as a good biomarker of oxidative stress of PCOS.