Aim of Work: To evaluate the rela-tionship between estimated serum lev-els of adipocytokines and insulin re-sistance (IR) parameters in women with definite gynecological disorders.
Patients & Methods: The study includ-ed 75 patients; 31 had uterine myoma (UM), 19 had endometrial carcinoma (EC) and 25 had endometriosis (EM) as diagnosed by US examination and pathological examination of hystro-scopic biopsy for EM and EC. All women gave two fasting blood samples for colorometric estimation of fasting blood glucose (FBG) and ELISA esti-mation of serum insulin (FSI), adi-ponectin (APN), leptin and YKL-40 levels. Homeostasis model assessment index of IR (HOMA-IR) and leptin/adiponectin (L/A) ratio were calculat-ed.
Results: FBG and FSI levels and HOMA-IR index were significantly higher in patients than controls and in EC patients than other patients. Se-rum YKL-40 and leptin were signifi-cantly higher with significantly lower APN levels in patients than controls. Serum YKL-40 levels in EM patients were significantly higher than other patients, but were significantly higher in EC than UM patients. Serum leptin levels were significantly lower in UM patients than other patients. Serum APN levels were significantly lower in EC patients than other patients, but were significantly lower in EM than UM patients. Calculated L/A ratio was significantly lower in UM than in oth-er patients and was non-significantly lower in EM than EC patients. ROC curve and Regression analyses showed that lower levels of APN and disturbed L/A ratio can predict the presence of EC, while elevated levels of YKL 40 and leptin can characterize patients with EM, but high HOMA-IR index can predict UM presence.
Conclusion: Elevated serum YKL-40 could be used for discrimination of EM out of other pathologies. Lower serum APN levels and high L/A ratio could be used as a significant predic-tor for presence of EC. High HOMA-IR index can predict the presence of UM. A diagnostic panel of estimation of serum YKL-40 and APN could de-fine and differentiate between EC and EM patients. |
