The Role of Leptin and Insulin-like Growth Factor-1 in the Interplay Between NAFLD and PCOS

Michelangelo Orciga, Aybike Birerdinc, Ancha Baranova

Metabolic Syndrome (MS) is currently one of the most common disorders in the world. Recent estimates have pointed to about 25-40% of American adults as having this condition (McCullough 2011). It is characterized by the following conditions: insulin resistance, obesity, hypertension and dyslipidemia (Grundy et al 2004). Various organizations have set out different criteria for diagnosing MS with the WHO and the adult treatment panel III (ATP III) from the NCEP study as the most commonly used ones (McCullough 2011). MS may eventually progress to diabetes, which is why it is aptly referred to as the “pre-diabetes” stage. The major hallmark of MS is insulin resistance or hyperinsulinemia. Thus various pathological changes at the organ level occur in the presence of MS; these can include the development of non-alcoholic fatty liver disease (NAFLD) and polycystic ovarian syndrome (PCOS). Both of which are now believed to be manifestations of MS at each respective organ (Machesini et al 2001, Sharpless 2003). In the United States, NAFLD is estimated to be present in about 55% of women with PCOS (Gamberin et al 2007). Recent studies show differing co-prevalence rate in different ethnicities at different ages (Karolie et al 2013, Qu et al 2013, Zheng et al 2008, Cerda et al 2007). The prevalence of MS and its associated organ manifestations will only continue to rise as the predominance of obesity continues at a high rate in the presence of a continually growing population (Ogden et al 2014). Thus, the need for a clearer understanding of its pathogenesis to improve modern day therapeutics also continues to rise.