Widecka Justyna, Ozegowska Katarzyna, Banaszewska Beata, Kazienko Anna, Safranow Krzysztof, Branecka-Wozniak Dorota, Pawelczyk Leszek, Kurzawa Rafal
Pomeranian Medical University in Szczecin, Poland.
The Fertility Partnership, Vitrolive Fertility Clinic, Szczecin, Poland.
Ginekol Pol. 2019;90(3):115-121. doi: 10.5603/GP.2019.0021.
O: BJECTIVES: Copeptin has been reported to play an important role in metabolic response in women with PCOS. However, the optimal cut-off value for detecting subjects with insulin resistance (IR) remains undetermined. We investigated whether copeptin can serve as an indicator of IR and tried to determine the optimal cut-off value of plasma copeptin concentration in detecting subjects with PCOS and IR.
We carried out a case-control study on 158 women with PCOS and HOMA-IR < 2.5, 96 women with PCOS with HOMA-IR ≥ 2.5, and 70 healthy volunteers. Plasma copeptin, as well as hormonal, biochemical, metabolic, and IR parameters, were measured. To investigate whether copeptin allows IR to be predicted in PCOS, we used logistic regression models and ROC curve analysis.
Median plasma copeptin concentration was the highest in the women with PCOS and HOMA-IR ≥ 2.5. Logistic regression analysis revealed that copeptin was the strongest predictor of HOMA ≥ 2.5 (OR: 53.34 CI 7.94-358.23, p < 0.01). Analysis of ROC curves indicated that the cut-off value above 4 pmol/L of plasma copeptin concentration had high (99%) specificity but very low (21%) sensitivity in diagnosing of IR (AUC 0.607 (95% CI 0.53-0.68.
Our findings suggest that copeptin is associated with IR in PCOS patients, but due to low sensitivity should not be considered as a marker of IR.
目的：据报道，copeptin在多囊卵巢综合征（PCOS）女性的代谢反应中起重要作用。然而，检测胰岛素抵抗（IR）受试者的最佳临界值仍未确定。我们研究了copeptin是否可作为IR的指标，并试图确定血浆copeptin浓度在检测PCOS和IR受试者时的最佳临界值。
我们对158例HOMA-IR<2.5的PCOS女性、96例HOMA-IR≥2.5的PCOS女性和70名健康志愿者进行了病例对照研究。测量了血浆copeptin以及激素、生化、代谢和IR参数。为了研究copeptin是否能预测PCOS中的IR，我们使用了逻辑回归模型和ROC曲线分析。
血浆copeptin浓度中位数在HOMA-IR≥2.5的PCOS女性中最高。逻辑回归分析显示，copeptin是HOMA≥2.5的最强预测因子（OR：53.34，CI 7.94-358.23，p<0.01）。ROC曲线分析表明，血浆copeptin浓度高于4 pmol/L的临界值在诊断IR时具有高（99%）特异性但非常低（21%）的敏感性（AUC 0.607（95%CI 0.53-0.68）。
我们的研究结果表明，copeptin与PCOS患者的IR相关，但由于敏感性低，不应被视为IR的标志物。
