Obesity and insulin resistance (IR) are features of polycystic ovary syndrome (PCOS). They are related to the endothelial dysfunction which is observed before the onset of clinically manifested vascular diseases, mainly and cardiovascular risk in PCOS. The endogenous nitric oxide synthase inhibitor; asymmetric dimethylarginine (ADMA) represents an independent marker for endothelial dysfunction and cardiovascular morbidity. Purpose: This work aimed to determine ADMA levels in women with PCOS and

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... its relationship to body mass index (BMI), insulin resistance (IR) and hormonal profile in these women. Patients and methods: This work included twenty women with PCOS diagnosed by Rotterdam criteria with mean age (26.51±3.96 years) and mean BMI (26.66±4.52 kg/m²). Twenty healthy women without PCOS with matched age (25.80±4.62 years) were included as a control group. All included women underwent history taking, physical examination including determination of BMI, and the following laboratory investigations: determination of levels of fasting blood glucose (FBG), fasting insulin (F. insulin), calculation of homeostasis model of assessment-insulin resistance (HOMA-IR), serum ADMA level, hormonal parameters including: follicular stimulating hormone (FSH), luteinizing hormone (LH); calculation of FSH/LH ratio, Estradiol (E 2), Prolactin (PRL) and thyroid stimulating hormone (TSH). Routine tests as serum electrolytes, kidney and liver function tests were also done; in addition to abdominal and pelvic ultrasound. Neither the patients nor controls were smokers, taking any drugs or suffering from any chronic disease, androgen producing tumor or endocrine disorder other than PCOS. Results: Women with PCOS had significantly high mean serum ADMA levels, fasting serum insulin, HOMA-IR, serum LH, and serum Prolactin, but low FSH/LH ratio and E 2 when compared to the control. Serum ADMA levels showed significantly positive correlation with BMI, F. insulin and HOMA-IR; and showed significantly negative correlation with FSH/LH ratio. Conclusion: Serum ADMA level (being a sensitive marker of cardiovascular risk) was increased in women with PCOS and this increase was closely related to the obesity and insulin resistance. Increased F. serum insulin is the key factor in the link between metabolic syndrome disorders and PCOS.