Serum Leptin Concentration is Correlated to Insulin Resistance in Polycystic Ovary Syndrome (PCOS) Patients

Arsyi Adliah Anwar, Nusratuddin Abdullah, Andi Nursanty Padjalangi, Firdaus Hamid, Nasrudin Andi Mappeware, Efendi Lukas


Background: Leptin resistance which leads to excessive circulating leptin levels is thought to affect ovarian function. This study aimed to study the correlation between serum leptin levels with insulin resistance in patients with polycystic ovary syndrome.

Materials and Methods: This cross-sectional study was undertaken in several teaching hospitals in Makassar, Indonesia. We included patients diagnosed with polycystic ovary syndrome (PCOS) aged 18-40 years old. Serum leptin levels were examined in all eligible subjects using the enzyme-linked immunosorbent assay (ELISA) method. The results obtained were further analyzed statistically.

Results: Approximately 53 PCOS subjects were included in this study, 25 subjects with insulin resistance and 28 subjects without insulin resistance. After examining serum leptin levels, we found that leptin is directly proportional to insulin resistance (p<0.001). We even found a strong positive correlation between serum leptin levels with homeostatic model assessment for insulin resistance (HOMA-IR) levels (r=0.659; p<0.001). Leptin was found to be independent of HOMA-IR, not influenced by confounding factors such as body mass index (BMI) (p=0.090).

Conclusion: There was a significant correlation between serum leptin levels and HOMA-IR values in PCOS patients. This correlation was found to be significant regardless of patient's BMI, therefore is considered to have a direct effect on insulin resistance in PCOS.

Keywords: polycystic ovary syndrome, leptin, insulin resistance, HOMA-IR

Full Text:



Azziz R, Carmina E, Chen Z, Dunaif A, Laven JSE, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Prim. 2016; 2: 16057, CrossRef.

Schachter M, Raziel A, Strassburger D, Rotem C, Ron-El R, Friedler S. Prospective, randomized trial of metformin and vitamins for the reduction of plasma homocysteine in insulin-resistant polycystic ovary syndrome. Fertil Steril. 2007; 88(1): 227–30, CrossRef.

Diamanti-Kandarakis E. Insulin resistance in PCOS. Endocrine. 2006; 30(1): 13–8, CrossRef.

McLuskie I, Newth A. New diagnosis of polycystic ovary syndrome. BMJ. 2017; 356: i6456, CrossRef.

Ramos-Lobo AM, Donato J Jr. The role of leptin in health and disease. Temperature (Austin). 2017; 4(3): 258-291, CrossRef.

Azziz R. Definition, diagnosis, and epidemiology of the polycystic ovary syndrome. In: The Polycystic Ovary Syndrome: Current Concepts on Pathogenesis and Clinical Care. New York: Springer; 2007. p. 1–15, CrossRef.

de Medeiros SF, Rodgers RJ, Norman RJ. Adipocyte and steroidogenic cell cross-talk in polycystic ovary syndrome. Hum Reprod Update. 2021; 27(4): 771-96, CrossRef.

Wołodko K, Walewska E, Adamowski M, Castillo-Fernandez J, Kelsey G, Galvão A. Leptin resistance in the ovary of obese mice is associated with profound changes in the transcriptome of cumulus cells. Cell Physiol Biochem. 2020; 54(3): 417-37, CrossRef.

Lukito AA, Bakri S, Kabo P, Wijaya A. The mechanism of coronary artery calcification in centrally obese non-diabetic men: study on the interaction of leptin, free leptin index, adiponectin, hs-C reactive protein, bone morphogenetic protein-2 and matrix gla protein. Mol Cell Biomed Sci. 2020;4(2): 88–93, CrossRef.

Henson MC, Castracane VD, Edwards DE. Leptin: from satiety signal to reproductive regulator. In: Leptin and Reproduction. New York: Springer; 2003. p. 3–11, CrossRef.

Parlak M, Parlak AE, Toslak IE. Etiologic factors and clinical characteristics of Turkish adolescent girls diagnosed with hirsutism. J Clin Anal Med. 2016; 7(2): 205–9, article.

El‑Gharib MN, Badawy TE. Correlation between insulin, leptin and polycystic ovary syndrome. J Basic Clin Reprod Sci. 2014; 3(1): 49–53, CrossRef.

Huang KC, Lin RCY, Kormas N, Lee LT, Chen CY, Gill TP, et al. Plasma leptin is associated with insulin resistance independent of age, body mass index, fat mass, lipids, and pubertal development in nondiabetic adolescents. Int J Obes. 2004; 28(4): 470–5, CrossRef.

Moonishaa TM, Nanda SK, Shamraj M, Sivaa R, Sivakumar P, Ravichandran K. Evaluation of leptin as a marker of insulin resistance in type 2 diabetes mellitus. Int J Appl basic Med Res. 2017; 7(3): 176–80, CrossRef.

Morioka T, Asilmaz E, Hu J, Dishinger JF, Kurpad AJ, Elias CF, et al. Disruption of leptin receptor expression in the pancreas directly affects β cell growth and function in mice. J Clin Invest. 2007; 117(10): 2860–8, CrossRef.

Shahid M, Naveed M, Khalid S, Atif M, Tufail T, Shahid MZ, et al. Nutritional and lifestyle modifications of polycystic ovary syndrome (pcos) in obesity. Int J Biosci. 2019; 5(6): 259-72, article.

Hoeger KM. Role of lifestyle modification in the management of polycystic ovary syndrome. Best Pract Res Clin Endocrinol Metab. 2006; 20(2): 293–310, CrossRef.

Norman RJ, Davies MJ, Lord J, Moran LJ. The role of lifestyle modification in polycystic ovary syndrome. Trends Endocrinol Metab. 2002; 13(6): 251–7, CrossRef.

Arentz S, Smith CA, Abbott J, Bensoussan A. Perceptions and experiences of lifestyle interventions in women with polycystic ovary syndrome (PCOS), as a management strategy for symptoms of PCOS. BMC Womens Health. 2021; 21(1): 107, CrossRef.

Moran LJ, Brinkworth G, Noakes M, Norman RJ. Effects of lifestyle modification in polycystic ovarian syndrome. Reprod Biomed Online. 2006; 12(5): 569–78, CrossRef.


Indexed by:




Cell and BioPharmaceutical Institute