The indicators of ovarian reserve in conditions of hyperleptinemia

• Karine V. Azizova
• Anna R. Volkova
• Svetlana V. Dora
• Olga V. Galkina
• Tatyana S. Ermolinskaya

Abstract

In recent years, there has been a widespread trend towards an increase in the incidence of obesity, which inevitably leads to a rise in the prevalence of a number of associated cardiovascular and metabolic diseases. Adipose tissue is an endocrine organ that produces active protein hormones – adipokines, the most studied of which are adiponectin and leptin. It has been shown that their imbalance can lead to reproductive dysfunction in women.

Purpose of research – to evaluate the concentration of leptin, adiponectin and ovarian reserve indicators in women with different body mass index (BMI).

Material and methods. A prospective observational study of 84 patients aged 18 to 44 years was conducted. According to World Health Organization criteria, the patients were divided into groups according to the presence of overweight or obesity of varying degrees and the level of Anti-Müllerian hormone (AMH). Blood sampling was performed for all participants of the study to determine the following indicators: AMH on the 3–5 day of the menstrual cycle, follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, leptin, adiponectin, glucose, insulin, the HOmeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was calculated.

Results. This study shows that overweight and obese women have increased levels of leptin compared to the control group, and decreased levels of adiponectin compared to women with normal body weight. With an increase in BMI, the HOMA-IR index also increases. Also, with an increase in BMI, the concentration of serum AMH decreased (r= -0.28, p<0.05).

According to the results of the analysis, a negative correlation was revealed between the level of leptin and FSH (r= -0.26, p<0.05), a negative correlation between the level of leptin and the level of estradiol (r= -0.34, p<0.05).

In the examined women, as the concentration of leptin increases, the level of FSH and estradiol decreases. Adiponectin, in turn, correlated with leptin levels (r= -0.33, p<0.05) and BMI (r= -0.44, p<0.05). There was no significant correlation between the level of leptin and AMH.

Conclusion. It should be assumed that timely prevention of metabolic disorders will improve fertility rates. Weight loss, intense physical activity, and lifestyle modification of a woman are necessary to restore ovulation, therefore to increase the chances of physiological conception and improve pregnancy outcomes.

Keywords: ovarian reserve; obesity; adiponectin; leptin; fertility

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