Introduction: Peroxisome proliferator activated receptor-γ (PPAR-γ) and its polymorphisms have an important role in polycystic ovary syndrome (PCOS), pathogenesis of which concentrates mainly around insulin resistance.
Aims and objectives: To identify PPAR-γ Pro12Ala Polymorphism in subjects with PCOS and controls along with an estimation of PPARγ levels and to correlate these with biochemical and anthropometric parameters of insulin resistance.
Materials and methods: A hospital-based case control study was conducted in 50 diagnosed cases of PCOS (15 to 45 years of age), as per revised Rotterdam criteria along with 50 age-matched healthy controls. PPAR-γ levels were estimated using sandwich enzyme-linked immunosorbent assay (ELISA). Polymorphism was detected through DNA extraction from whole blood followed by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 16 employing independent sample t-test for intergroup comparison of means and Pearson's correlation coefficient for correlation analysis. Categorical data analysis for polymorphism was done using chi-square test. ROC analysis was done for comparison between various markers.
Results and conclusion: Peroxisome proliferator activated receptor γ (PPAR-γ) Pro12Ala polymorphism analysis revealed a higher proportion of Pro/Pro homozygotes (78%) in contrast to a lower proportion of Pro/Ala heterozygotes (22%) in cases. Also, Pro/Pro homozygotes were associated with a higher proportion of insulin resistance (86.7%) and obesity (83.8%) as compared to Pro/Ala heterozygotes in PCOS cases. PPAR-γ levels were significantly reduced in cases [13.16 (11.78–17.08) ng/mL] as compared to controls [16.05 (12.07-33.0) ng/mL]. This strengthens the fact that insulin sensitivity is related to enhanced PPAR-γ expression. ROC analysis revealed PPAR-γ to be a better indicator of PCOS (AUC = 0.605). To conclude, this study is suggestive of a protective role of Pro/Ala (CG) heterozygotes in PCOS and their possible association with insulin resistance and obesity.
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