رسائل ماجيستير
English
2014
Effects of Metformin and Folic Acid on Homocysteine, Paraoxonase1 activity and Oxidative Stress in Patients with Polycystic Ovary Syndrome
طارق حفظي الخياط , قصي محسن كاظم, ملال محمد الجبوري
كلية الطب-جامعة بابل · العراق
Polycystic ovary syndrome (PCOS) is the most common reproductive endocrinopathy and currently considered to be a part of the metabolic syndrome. Women with PCOS cluster risk factors associated with the risk of atherosclerosis. These risk factors include insulin resistance, dyslipidemia, hyperandrogenemia, obesity, endothelial dysfunction, and oxidative stress. In the current study, we tried to establish the relationship between Hcy and PON1 in PCOS in two medical treatments (Metformin only and Metformin with Folic acid) in order to elucidate some risk factors that may lead to atherosclerosis and vascular diseases in the corresponding patients. Fifty patients with PCOS were enrolled in this study. The patients were subdivided into two groups according to the type of treatment received, i.e., G2 (comprising 25 patients) treated with Metformin only for about 6 weeks, G3 (comprising 25 patients) with Metformin and Folic acid for about 6 weeks. While, thirty apparently healthy women were taken as a control group (G1). Serum Homocysteine (Hcy), Paraoxonase 1 (PON1), Apolipoprotein A-1 (Apo A-1), and Apolipoprotein B (Apo B) were determined by using enzyme-linked immunosorbent assay (ELISA). Reduced Glutathione (GSH), Catalase (CAT), and Malondialdehyde (MDA) were determined by using the colorimetric method. The results revealed a significant increase in the serum levels of Hcy, Apo B/Apo A-1 ratio, and MDA (p<0.01), while a significant decrease in the levels of PON1, CAT, and GSH (p<0.01) in PCOS patients' groups before treatments as compared with the control group (G1). On the other hand, the mean value of BMI showed a highly significant increment (p<0.01) in patients' groups as compared with the control group. However, the results indicated a significant increase in the serum levels of Hcy (p<0.01), PON1, CAT, and GSH (p<0.05) and a significant decrease in the levels of MDA and Apo B/Apo A-1 ratio (p<0.01) in the PCOS group after Metformin only (G2-A) than the G2-B. After Metformin with Folic acid treatment (G3-A), Hcy, Apo B/Apo A-1 ratio, and MDA levels were significantly lower (p<0.01) and PON1 as well as GSH and CAT levels were significantly higher (p<0.01) than in G3-B. Whereas, a significant decrease in the level of Hcy, MDA (p<0.01), and Apo B/Apo A-1 ratio (p<0.05) and a significant increase in PON1 (p<0.01), CAT, and GSH levels (p<0.05) in (G3-A) as compared with (G2-A). The results revealed a significant positive correlation between Hcy with MDA and Apo B/Apo A-1 ratio as well as between PON1 with CAT and GSH, while a significant negative correlation between Hcy with GSH, CAT, and PON1, and also between PON1 with MDA and Apo B/Apo A-1 ratio in control and patients' groups. The above results indicated the role of Folic acid administration to PCOS patients in lowering Hcy levels in the serum of corresponding patients and in alleviation of the oxidative stress in those patients. Besides, the increase of PON1 prevents atherogenic effects by changing the Apo B/Apo A-1 ratio.