Metabolic Disturbance in Women with Polycystic Ovary Syndrome and its Impact on Bone Turnover

Background: Insulin resistance and abdominal obesity are main characteristics of polycystic ovary syndrome, women with this syndrome at high risk for prolong term metabolic disorders. Obesity, insulin resistance, and hyperinsulinemia affect the hormones that control calcium homeostasis. Lower levels of serum vitamin D and higher levels of serum parathyroid hormone were found in women with polycystic ovary syndrome. However, high levels of parathyroid hormone can reduce bone mineral density and increase bone turnover.

Objectives: The present study aimed to measure the parameters of bone metabolism including parathyroid hormone, calcium, and phosphorous in serum of women with polycystic ovary syndrome and compare their levels with healthy controls. Also, investigate the possible impact of metabolic alterations in polycystic ovary syndrome on bone turnover.

Material and Method: This case-control study included 82 women from 20 to 37 years of age. All women were selected from Infertility Center in Baghdad Teaching Hospital during the period from 1 June 2019 to 30 August 2019. Women were divided into two groups: group (1) involved 42 women with polycystic ovary syndrome and group (2) involved 40 healthy women (act as controls). Each Serum specimen was analyzed for the measuring of parathyroid hormone, calcium, phosphorous, fasting insulin, fasting glucose, and homeostasis model assessment of insulin resistance (HOMA-IR).

Results: Significantly higher serum levels of parathyroid hormone, calcium,fasting insulin, and fasting glucose with lower levels of serum phosphorous in women with polycystic ovary syndrome as compared with healthy women. In addition, significant positive correlation was found between serum parathyroid hormone and waist circumference (r=0.609, p=0.00001) as well as between serum parathyroid hormone and HOMA-IR (r= 0.781, p=0.00001).

Conclusion: The metabolic disturbance found in polycystic ovary syndrome tend to support the relation between this syndrome and defective bone metabolism. High prevalence of obesity and high levels of insulin, HOMA-IR, and parathyroid hormone were found in women with this syndrome which in turn affect bone turn over. Thus, women with polycystic ovary syndrome are at risk for the development of metabolic bone disease.