Reesor Mikyla, Goudiaby Yvette, Grossett Nicole, Zand Natasha, Chichester Royon, Echevarria-Javier Luis, Vysochyn Mykhailo, Alam Amy
Clinical Sciences, Saint James School of Medicine, The Valley, AIA.
Cardiology, Saint James School of Medicine, The Valley, AIA.
Cureus. 2024 Sep 9;16(9):e69023. doi: 10.7759/cureus.69023. eCollection 2024 Sep.
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Leptin and ghrelin are important markers in PCOS due to their correlation with obesity, insulin resistance, and fertility. There is currently a debate in the literature about whether altered leptin and ghrelin levels in women with PCOS are a result of the disease itself or if they are due to factors such as the hyperinsulinemic state characteristic of PCOS. This meta-analysis aims to assess if insulin levels impact leptin and ghrelin levels in PCOS. Eight case-control studies assessing the relationship between insulin and leptin, as well as five case-control studies assessing the relationship between insulin and ghrelin, were identified in PubMed. Pearson's correlation coefficient (PCC) and the sample size were extracted, and two meta-analyses were conducted using a random-effects model. Total heterogeneity (I2) with a confidence interval of 95% was then determined. "Leave-one out" diagnostics were calculated for each case. If a study was identified as being significantly influential, the study was removed from the data set, and the trim and fill procedure was applied. Publication bias was assessed using Egger's regression test and rank correlation test. Our results showed a moderate positive relationship (r=0.56, 95% confidence interval (CI) (0.42, 0.71), with substantial heterogeneity I=81.35%, 95% CI (25.2799, 88.2451)) between insulin and leptin levels, and a moderate negative relationship (r=-0.33, 95% CI (-0.43, -0.24)), with low heterogeneity (I=0.00%, 95% CI (0.0000, 80.8159)) between insulin and ghrelin levels. Therefore, there is a significant relationship between insulin and higher leptin and lower ghrelin levels in women with PCOS. Better insulin control may have a positive effect on fertility, appetite, weight, body image, and quality of life in these women. This correlation is likely multifactorial, and further studies are needed to isolate factors influencing these hormones.
多囊卵巢综合征（PCOS）是育龄女性中最常见的内分泌紊乱疾病。瘦素和胃饥饿素是PCOS中的重要标志物，因为它们与肥胖、胰岛素抵抗和生育能力相关。目前，文献中存在关于PCOS女性瘦素和胃饥饿素水平改变是该疾病本身的结果，还是由于PCOS特征性的高胰岛素血症状态等因素所致的争论。这项荟萃分析旨在评估胰岛素水平是否会影响PCOS患者的瘦素和胃饥饿素水平。在PubMed中检索到八项评估胰岛素与瘦素关系的病例对照研究，以及五项评估胰岛素与胃饥饿素关系的病例对照研究。提取了皮尔逊相关系数（PCC）和样本量，并使用随机效应模型进行了两项荟萃分析。然后确定了95%置信区间的总异质性（I2）。对每个病例计算“留一法”诊断。如果一项研究被确定具有显著影响，则将其从数据集中剔除，并应用修剪和填充程序。使用埃格回归检验和秩相关检验评估发表偏倚。我们的结果显示，胰岛素与瘦素水平之间存在中度正相关（r = 0.56，95%置信区间（CI）（0.42，0.71），异质性较大，I = 81.35%，95% CI（25.2799，88.2451）），胰岛素与胃饥饿素水平之间存在中度负相关（r = -0.33，95% CI（-0.43，-0.24）），异质性较低（I = 0.00%，95% CI（0.0000，80.8159））。因此，PCOS女性的胰岛素与较高的瘦素水平和较低的胃饥饿素水平之间存在显著关系。更好地控制胰岛素可能对这些女性的生育能力、食欲、体重、身体形象和生活质量产生积极影响。这种相关性可能是多因素的，需要进一步研究以分离影响这些激素的因素。
