Correlation between adiponectin levels, insulin resistance, and oxidative stress in polycystic ovary syndrome patients: implications for novel therapeutic approaches

Abstract

Background & objective: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder characterized by metabolic dysfunction, including insulin resistance and oxidative stress. Adiponectin, an adipokine that has anti-inflammatory and insulin-sensitizing properties, may be essential to the pathogenesis of PCOS.

Methodology: To assess the relationship between serum adiponectin levels, IR indices (insulin, fasting blood glucose, HOMA-IR), oxidative stress (as determined by the total antioxidant capacity), and lipid profile parameters in PCOS women in comparison to healthy controls. A case-control study was conducted involving 45 PCOS patients and 45 age-matched HCs. Biochemical markers, including insulin, FBG, lipid profile, adiponectin, and TAC were analyzed. Statistical tests such as t-test, Chi-square, Spearman's correlation, and Mann-Whitney U test were applied.

Results: PCOS patients exhibited significantly elevated levels of total cholesterol, LDL-C and reduced adiponectin in comparison to healthy controls (HCs). Although levels of HOMA-IR and insulin were unexpectedly lower in PCOS patients, FBG was higher. HOMA-IR and adiponectin were discovered to have a paradoxical positive relationship. TAC showed a non-significant inverse relationship with HOMA-IR in PCOS patients but a significant one in healthy controls. Higher TAC levels were associated with elevated TG and VLDL, and reduced HDL levels.

Conclusions: The findings of the study indicate a complex interaction among adiponectin, oxidative stress, and insulin resistance in PCOS, with potential dysregulation in adiponectin signaling. Elevated TAC levels may reflect compensatory mechanisms rather than protection, emphasizing the need for targeted therapeutic strategies.

Keywords: PCOS; Adiponectin; HOMA-IR; Oxidative Stress; Dyslipidemia

Abbreviations: ADP: adiponectin, BMI: body mass index, ELISA:  enzyme-linked immunosorbent assay,  FBG:  fasting blood glucose,  HDL-C:  high-density lipoprotein-cholesterol, HCs:  healthy controls,  HOMA-IR:  homeostatic model assessment of IR,  IR:  insulin resistance,  LDL:  low-density lipoprotein,  OS:  oxidative stress,  PCOS:  Polycystic ovary syndrome,  ROS:  reactive oxygen species, SD: standard deviations,  T2D:  type 2 diabetes,  TAC:  total antioxidant capacity,  TC:  total cholesterol,  TG:  triglyceride, VLDL:  very low-density lipoprotein.

Citation: Talib ZM, Hussein KR, Khudhair HAA. Correlation between adiponectin levels, insulin resistance, and oxidative stress in polycystic ovary syndrome patients: Implications for novel therapeutic approaches. Anaesth. pain intensive care 2025;29(8):919-931. DOI: 10.35975/apic.v29i8.3019.

Received: June 17, 2025; Revised: August 21, 2025; Accepted: August 21, 2025