Introduction: Policystic ovarian syndrome (PCOS); is an endocrinopathy characterised by overlap of hyperandrogenism and hyperinsulinism and chronic anovulation. Etiopathogenesis is still not clearly defined. Fetuin-A is aserum glycoprotein. It is shown to play regulatory functions in many inflammatory processes. We aim to define the relationship of fetuin-A levels with hyperandrogenism and hyperinsulinism in PCOS patients and study the role in pathophysiology.
Method: Adolescent patients with similar age and BMI and diagnosed as PCOS according to 'Endocrine Society Clinical Practice' guides, were included in the study. Subgroups of PCOS and control group were defined as obese and non-obese according to the BMI being above or below BMI 25kg/m2. Gonadotropin and androgen levels SHBG, results were recorded in PCOS patients. Fasting glucose, insulin, lipid profile, transaminase were recorded in all patients. Cut off value for HOMA-IR was ≥3,82. All patients had blood drawing for fetuin-A and hsCRP. Ovarian size was measured by ultrasonography.
Results: Mean age was16,4±1,1 years in 38 patients with PCOS and 16,2±0,98 years in control group(n=40), mean BMI were similar between two groups. Mean Fetuin-A level in PCOS group was significantly higher than the control group (p:0,005). (PCOS:583,1±197,45, control:460,08±164,9ng/ml).
Obese-PCOS and Non-Obese PCOS groups were compared;
Fetuin-A, all andogen and SAİ levels were similar. Obese-PCOS patients had significantly lower SHBG and HDL levels (P=0,012/p:0,017) and higher cholesterol, LDL, trigliserid, HOMA-IR and HSCRP levels when compared to non-obese PCOS patients (P=0,014-0,031-0,006-0,015-0,024).
Obese PCOS and Obese control groups: In obese-PCOS group, Fetün-A levels were significantly higher than obese-control group (p:0,016). Metabolic parameters and HSCRP levels and all other parameters were similar.
Non-obese PCOS and Non-obese control groups: Fetuin-A were nearly significantly higher in Non-obese PCOS patients (0,054). All parameters were similar.
Obese-PCOS and Non-obese healthy control groups: BMI, BMI-SDS, HSCRP and Fetuin-A were significantly higher in obese PCOS patients (0,001-0,001-0,035, 0,013).
Highest fetuin-A level was detected in obese-PCOS group. This was significantly different from obese-control and non-obese control groups (p:0,016, 0,013). Also in PCOS group fetuin-A levels was positively correlated with, trigliserid (r:0,470, p:0,003), LH (r:0,416, p:0,009), LH/FSH ratio (r:0,381, p:0,018), total testosterone (r:0,313, p:0,056), 1,4 Δ AS (r:0,441, p:0,008) and SAİ (r:0,425, p:0,05).
Conclusion: Fetuin A levels in our PCOS patients were significantly higher than the control group. In obese PCOS patients, fetuin-A levels were slightly higher than the non-obese PCOS patients and significantly higher than patients in obese control group with similar BMI, lipid profile and HOMA-IR levels. These results put forward the relationship of androgens with Fetuin-A and can direct further studies.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology