Evaluation of Plasma Homocysteine Levels in Patients of PCOS.

Homocysteinemia in PCOS may impair implantation by interfering with endometrial blood flow and has been documented to increase the adverse pregnancy outcome.The objective was to evaluate the relationship between insulin resistance and serum homocysteine in subjects with polycystic ovarian syndrome (PCOS).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.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.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.