| Objective Polycystic ovary syndrome (PCOS) is frequently associated with insulin resistance and a consequent increased risk of metabolic disorders. Adiponectin is the most abundant adipocytokine and may play a role in regulation of insulin sensitivity and insulin resistance (IR) in PCOS. The aims of the present study were①to explore the relationship of adiponectin and IR, and the significance of serum adiponectin levels in PCOS;②to evaluate genetic influence of the rs2241766 +45G15G(G/T) and rs 1501299 +276(A/C) polymorphisms of adiponectin (ADIPOQ) gene in development of PCOS.Methods 48 patients with PCOS and 40 healthy control subjects were classified as follows: 24 obese (BMI≥25kg/m~2) with PCOS; 24 lean (BMI<25kg/m~2) with PCOS; 20 obese without PCOS; 20 lean without PCOS. In addition, PCOS patients and controls were stratified by HOMA-IR. Serum adiponectin levels, hormonal and metabolic parameters were measured. A total of 240 Han Chinese women including 120 patients with PCOS and 120 healthy control subjects were genotyped for two single nucleotide polymorphisms (SNPs) +45G15G(G/T) and +276(A/C) by PCR-RFLP, respectively, in exon 2 and intron 2 of the ADIPOQ gene.Results Adiponectin levels were found to be significantly decreased in women with PCOS, lean women with PCOS and PCOS with insulin resistance (IR) as compared with women without PCOS (6.56±3.30μg/ml vs 8.92±4.99μg/ml, P<0.05), lean women without PCOS (8.05±3.49μg/ml vs 11.52±5.24μg/ml, P<0.05) and PCOS without IR (5.45±3.24μg/ml vs 7.42±3.14μg/ml, P<0.05), respectively. Adiponectin levels correlated inversely with BMI (r=-0.491, P<0.01), FINS (r=-0.516, P<0.01), HOMA-IR (r=-0.449, P<0.01), WHR (r=-0.296, P<0.05), HOMA-IS (r=-0.242, P <0.05) and TG (r=-0.365, P<0.05), but correlated positively with GIR (r=0.390, P <0.01),ISI (r=0.463, P<0.01). The correlations were remained after adjusted by BMI.Both SNPs of +45G15G(G/T) and +276(A/C) were strongly associated with PCOS (P=0.021, OR=1.629, 95% CI=1.074-2.469 and P=0.015, OR=1.576, 95% CI=1.091 -2.279). Among the patients with PCOS, the carriers with genotype GG of SNP +45G15G(G/T) had significantly increased level of AUC insulin compared to the individuals with genotypes T/T and T/G (250.78±207.11 vs 154.84±95.32, P<0.05). And the carriers with genotypes C/C and C/A of SNP +276(A/C) had significantly decreased level of serum adiponectin (6.05±3.16μg/ml vs 8.96±3.21μg/ml, P<0.05) and GIR (13.00±6.85 vs 18.93±12.32, P<0.01) but increased level of fasting insulin (8.82±5.54 vs 6.00±2.77 mIU/L, P<0.05) and HOMA-insulin resistance index (1.95±1.30 vs 1.25±0.53, P<0.05) compared to the individuals with genotype A/A in PCOS patients.Conclusions Hypoadiponectinemia is evident in PCOS, and adiponectin levels correlated inversely with IR. Low adiponectin levels may predict women with PCOS who are at high risk for developing type 2 diabetes. SNPs +45G15G(G/T) and +276(A/C) in the ADIPOQ gene are associated with PCOS in Han Chinese women. Genetic variations of the ADIPOQ gene contribute an impact of clinical features including insulin levels, insulin resistance and serum adiponectin levels, which are implicated in the susceptibility for PCOS.
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