Biodiversity conservation in Himalayan region

The Himalayas are our greatest heritage. They are storehouse of hundreds of endemic plants species and some world’s rarest wildlife species. It is one of the world’s richest ecosystems in terms of biological diversity. Biodiversity is the life support system of our planet we depend on it for the air we breathe, the food we eat and the water we drink. We literally need to conserve biodiversity like our lives depend on it. Biodiversity is threatened by a variety of global changes resulting from the combined action of human society. The most direct threats are overharvesting and loss/disturbance of habitat resulting from conversion of natural ecosystem to human use. However, other changes such as increased nutrient availability and elevated CO2, with the resulting climate changes in the form of warmer climates, less snowfall, erratic rainfall, untimely hail, retreating glaciers, movement of plant species upward, soil erosion etc. are also long – term threats. Therefore, conservation of biodiversity has become a growing concern of central significance to all sectors of society. Ensuring conservation of biodiversity is one of humankind’s important global responsibilities. It is important to conserve biodiversity for the sake of our own curiosity and aesthetic appreciation. While everyone agrees that conserving natural resources is a good idea, there is no consensus on how to go about it. Every group from governmental agencies to concerned individuals has their own idea of what measures should be taken to achieve it. Further, each group has its own agenda to purse and may regard some factors of conservation of biodiversity as threats to those agendas. The conservation of diversity is a complicated matter. Yet if it is not resolved during our lifetime, the problems we leave our descendants will be even more complicated and harder to resolve. “Peace of Sky, Peace of Mid-Region, Peace of Earth, Peace of Water, Peace of plants, Peace of Trees, Peace of All-Gods, Peace of Brahman, Peace of Peace, May that Peace come to me.”


Introduction
Polycystic ovarian syndrome is the most common endocrinopathy in the women of reproductive age with a prevalence of approximately 7-10% world-wide [1] . Caribbean, Hispanic women, migrant Asian Indians & Mexican Americans have a great prevalence of PCOS. It reflects multiple potential aetiologies and variable clinical manifestations. This syndrome is characterised by serious health implications such as diabetes, coronary heart disease and also leads to infertility. This syndrome was first described by stein and Leventhal in 1935 [2] . According to the new Rotterdam criteria, two out three criteria have at least to be met in order to fit the diagnosis of PCOS [3] . These criteria are anovulation, androgen excess and polycystic ovarian morphology in ultrasound assessment [4] . One of the major biochemical features of PCOS is insulin resistance [5] accompanied by compensatory hyperinsulinemia; that hyperinsulinemia produces hyperandrogenism of PCOS by increasing ovarian production particularly testosterone and by decreasing serum SHBG concentration. The high levels of androgenic hormones interfere with the pituitary ovarian axis leading to increased LH levels, anovulation, amenorrhea, recurrent pregnancy loss and infertility. Hyperinsulinemia has also been associated with high blood pressure and increased clot formation and appears to be a major risk factor for the development of heart disease. Insulin resistance effects 15-20% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidaemia, glucose intolerance, and diabetes [6] . Mental health disorders including depression, anxiety, bipolar disorder and binge eating disorder also occur more frequently in women with PCOS. Approximately, 25% to 30% of women with PCOS will show impaired glucose tolerance by the age of 30 and 8% of affected women will develop type 2 diabetes annually [7] . Women with PCOS are seen to have more extensive coronary artery disease by angiography [8] . It is well known that obesity is observed in about 60% of women with PCOS [9] .
Due to complexity of the syndrome, a number of metabolic and other implications of women health will have to be confronted in the near future. PCOS seem to have a long prodromal phase with detectable abnormalities throughout the life cycle of affected women and represents a major health and economic burden. Proper diagnosis and management of PCOS is essential to prevent future metabolic, endocrine, psychiatric and cardiovascular complications. The increased incidence of cardiovascular disease in women with PCOS has prompted researchers to look for indicators of early metabolic changes in these patients. The studies available at present on Sr. Uric acid and Magnesium levels in PCOS patients are very less and led to controversial results. With this background case control study was undertaken to analyse and correlate the biochemical parameters FBS, Magnesium, Sr. uric acid and lipid profile that may help to identify women with PCOS who are at risk of cardio-metabolic syndrome.

Methods
The study was conducted in the Department of Biochemistry, Rangaraya Medical College, Kakinada, Andhra Pradesh, India. The study was undertaken to determine biochemical changes in polycystic ovarian syndrome patients. Venous blood was collected to analyse the parameters magnesium, uric acid, fasting blood sugar, lipid profile. The study includes 80 cases between the age group of 18-40 years. These values are compared with 40 control groups having same age group. All of these samples were taken from the department of Obstetrics and Gynaecology, Government General Hospital, Kakinada after the consent was obtained both from cases and controls The study group consists of premenopausal women diagnosed to have polycystic ovarian syndrome (PCOS) by the Gynaecology department. The control group consists of healthy female volunteers with regular menstrual cycles.

Inclusion criteria
Age group: between 18-40 years. Body mass index. Presence of polycystic ovaries on ultra sound scan, Oligo menorrhoea/amenorrhea, Clinical/Biochemical signs of hyperandrogenism a. Hirsutism b. Acne

Exclusion Criteria
Diabetes mellitus, Hypertension, Cardiovascular diseases Thyroid disorders, renal diseases, Pregnant or lactating women Oral contraceptive medication, Hormonal medication within previous 2 months Lipid lowering drugs medication, all the subjects' height and weight were recorded without shoes using standard apparatus.

Statistical analysis
The observed values were compared with control group for statistical analysis. All data were expressed as mean ± SD. Statistical analysis was done by student T test. Differences with 'p' value less than 0.05 were considered to be statistically significant. The following methods were used for analysing the serum sample Serum magnesium by calmagite method, Serum uric acid by uricase method

Observations and Results
The present study comprises of 80 patients with polycystic ovarian syndrome between the age group 18 -40 years and 40 normal healthy women as controls. All the study group and control group are from the outpatient department of the obstetrics and gynaecology, Government General Hospital, Kakinada. The following parameters were analysed, BMI, Fasting blood sugar, Uric acid, Magnesium, TC, TGL, HDL-C, LDL-C, and VLDL-C.

Discussion
PCOS is a common female endocrine disorder with prevalence ranging from 2.2% to 26% in India [10] . This draws attention to the issue of early diagnosis in adolescent girls. It is multisystem endocrinopathy in women of reproductive with the ovarian expression of various metabolic disturbances. PCOS is not only the reproductive endocrinopathy but also metabolic disorder. Hypergonadism was thought to be a main underlying factor. Women with PCOS are known to be at increased risk of insulin resistance. There is a risk factor for developing type 2 diabetes mellitus, in these women. Adiposity plays a crucial role in the development and maintenance of PCOS and strongly influences the severity of both its clinical & endocrine features in many women with this condition. Women with PCOS have disturbed lipid profile the causes of dyslipidaemia in PCOS are multifactorial. PCOS is a chronic disease with manifestation across the lifespan and represents a major health and economic burden.
In this study FBS, T.C, TGL, HDL-C, LDL-C, VLDL-C, serum magnesium and serum uric acid, were analysed and compared with control groups to know the values of these parameters in PCOS. In this study, serum uric acid levels in PCOS were significantly raised when compared to healthy controls. The raise was statistically significant (p value < 0.0001). Similar results were observed by N. Swetha et al in their correlative study of biochemical parameters in PCOS [11] . It is due to endothelial dysfunction and chronic inflammation. Uric acid exerting prooxidant and pro inflammatory action at the endothelial cell. The main determinant of serum uric acid level was the BMI. In PCOS, androgens may increase serum uric acid levels by inducing hepatic metabolism of purine [12] . In this study, Serum magnesium levels in PCOS were decreased when compared to controls. The decrease was statistically highly significant (p value<0.0001). Similar results were observed by N.Swetha et al, pourteymour Fard tabrizi and Kauffman RP et al.
Magnesium, a cofactor for many enzymes is induced in glucose metabolism. It is required for proper glucose utilization and insulin signalling. It has been shown that magnesium plays an important role of 2 nd messenger for insulin action [13] . Low magnesium concentration are associated with impaired glucose tolerance and increased risk of type 2 diabetes mellitus. Present study showed negative correlation between glucose and magnesium which were statistically significant. (r=-0.412, p=0.0001). Therefore, intracellular magnesium deficiency may affect the development of insulin resistance. In this study, FBS levels were increased when compared to controls. The increase was statistically highly significant (p value <0.0001 In PCOS, uric acid, FBS and lipid profile except HDL and magnesium shows increased levels, which was statistically highly significant. PCOS patients are prone for diabetes mellitus due to insulin resistance. Because of dyslipidaemia, they are prone for vascular diseases.

Conclusion
Fasting blood sugar levels were significantly increased in PCOS patients suggesting impaired glucose tolerance and impaired fasting glucose levels. Serum magnesium levels were significantly decreased in PCOS patients suggesting increased urinary excretion of magnesium in the presence of elevated insulin. Impaired oxidative metabolism contributed by in adequacies of magnesium. Magnesium showed a significantly negative correlation with FBS, TC, TGL, LDL, uric acid and nonsignificant positive correlation with HDL.
Serum uric acid levels were significantly increased due to pro-oxidant nature. Measurements of uric acid levels may predict non classic cardiovascular risk in PCOS patients. Uric acid showed significant positive correlation with FBS, TC, TGL, LDL and VLDL & significant negative correlation with magnesium Lipid profile levels were significantly increased when compared to controls. The major lipid abnormality showed in PCOS patients is that triglycerides, total cholesterol, LDL-C, were significantly increased but HDL was significantly decreased, as well as decreased insulin response to glucose challenge and marked decrease activity of the LCAT, that clears the triglycerides from the blood. Daily supplementation of magnesium may improves insulin mediated glucose uptake and insulin secretion in patients who have established with PCOS. Present study conclude that the administration of magnesium is acts as a beneficial effects on dyslipidaemia of PCOS patients by through the activation of LCAT and suppression of adrenergic activity. So, Magnesium acts as a prognostic biomarker in PCOS patients.