PMID- 23700477
OWN - NLM
STAT- MEDLINE
DCOM- 20131125
LR  - 20220410
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 5
DP  - 2013
TI  - Recurrent pregnancy loss in polycystic ovary syndrome: role of 
      hyperhomocysteinemia and insulin resistance.
PG  - e64446
LID - 10.1371/journal.pone.0064446 [doi]
LID - e64446
AB  - Recurrent pregnancy loss (RPL) in polycystic ovary syndrome (PCOS), which occurs 
      in  approximately 50% of total pregnancies is a frequent obstetric complication. Among the 
      several hypotheses, insulin resistance (IR), obesity and hyperhomocysteinemia 
      (HHcy) play significant role/s in RPL. This study was conducted to assess the 
      link between elevated levels of homocysteine and IR in PCOS-associated women with 
      RPL in Kolkata, India. A retrospective study was conducted of one hundred and 
      twenty six PCOS women (<30 years) who experienced two or more spontaneous 
      abortions during the first trimester presenting to Institute of Reproductive 
      Medicine (IRM) in Kolkata during the period of March 2008 through February 2011. 
      One hundred and seventeen non-PCOS subjects with matching age range were randomly 
      chosen as controls. Incidence of HHcy and IR was 70.63% (n = 89) and 56.34% 
      (n = 71), respectively, in RPL-affected PCOS population which was significantly 
      higher (p<0.04; p<0.0001) when compared to the non-PCOS set (HHcy: 57.26%; IR: 
      6.83%). Rates of miscarriage were significantly higher (p<0.008; p<0.03) in 
      hyperhomocysteinemia-induced miscarriage when compared to the 
      normohomocysteinemic segment (PCOS: 70.63% vs.29.36% & non-PCOS: 57.26% vs. 
      42.73%) along with the insulin resistant (p<0.04; p<0.0001) population (PCOS: 
      70.63% vs. 56.34% & non-PCOS: 57.26% vs. 6.83%) in both groups. A probabilistic 
      causal model evaluated HHcy as the strongest plausible factor for diagnosis of 
      RPL. A probability percentage of 43.32% in the cases of HHcy- mediated RPL 
      suggests its increased tendency when compared to IR mediated miscarriage 
      (37.29%), further supported by ROC-AUC (HHcy: 0.778vs. IR: 0.601) values. Greater 
      susceptibility towards HHcy may increase the incidence for miscarriage in women 
      in India and highlights the need to combat the condition in RPL control programs 
      in the subcontinent.
FAU - Chakraborty, Pratip
AU  - Chakraborty P
AD  - Department of Infertility, Institute of Reproductive Medicine, Kolkata, India.
FAU - Goswami, S K
AU  - Goswami SK
FAU - Rajani, Shweta
AU  - Rajani S
FAU - Sharma, Sunita
AU  - Sharma S
FAU - Kabir, Syed N
AU  - Kabir SN
FAU - Chakravarty, Baidyanath
AU  - Chakravarty B
FAU - Jana, Kuladip
AU  - Jana K
LA  - eng
PT  - Journal Article
DEP - 20130521
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Abortion, Habitual/*etiology
MH  - Adult
MH  - Female
MH  - Humans
MH  - Hyperhomocysteinemia/complications/metabolism
MH  - Insulin Resistance
MH  - Polycystic Ovary Syndrome/*complications/*metabolism
MH  - Pregnancy
MH  - Prognosis
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Young Adult
PMC - PMC3660299
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/05/24 06:00
MHDA- 2013/12/16 06:00
PMCR- 2013/05/21
CRDT- 2013/05/24 06:00
PHST- 2012/09/29 00:00 [received]
PHST- 2013/04/15 00:00 [accepted]
PHST- 2013/05/24 06:00 [entrez]
PHST- 2013/05/24 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
PHST- 2013/05/21 00:00 [pmc-release]
AID - PONE-D-12-29978 [pii]
AID - 10.1371/journal.pone.0064446 [doi]
PST - epublish
SO  - PLoS One. 2013 May 21;8(5):e64446. doi: 10.1371/journal.pone.0064446. Print 2013.