Science Health University, Dr. Sami Ulus Gynecology, Child Health and Diseases Training and Research Hospital, Pediatric Endocrinology Clinic, Ankara, Turkey.
Ankara University Medical School, Medical Biochemistry Department, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2021 Apr 23;34(7):911-916. doi: 10.1515/jpem-2020-0524. Print 2021 Jul 27.
Polycystic ovary syndrome (PCOS) is an endocrinopathy, in which hyperandrogenism and hyperinsulinism have both occurred. Fetuin-A, a natural inhibitor of tyrosine kinase, leads to insulin resistance. The aim was to evaluate the relationship between fetuin-A and hyperandrogenism and hyperinsulinism and the role of fetuin-A in the pathophysiology of PCOS.
Thirty-eight cases with PCOS and 40 healthy adolescents were included in the study. PCOS and controls were divided into obese/non-obese subgroups. LH, FSH, total and free testosterone (TT, FT), SHBG, androstenedione, DHEAS were measured in patients with PCOS. Fasting glucose, insulin, lipid profile, AST, ALT, HsCRP, and fetuin levels of PCOS patients and healthy controls were also measured.
Fetuin-A levels were higher in PCOS patients than in controls. In the obese-PCOS group, when compared to non-obese PCOS patients; the levels of SHBG and HDL were low while cholesterol, LDL, triglyceride, HOMA-IR, FT, FAI, and HSCRP levels were high, but Fetuin-A levels were similar. In the obese-PCOS group, fetuin-A levels were higher than in obese-controls. HOMA-IR and fetuin-A levels were higher in non-obese PCOS patients than in non-obese controls. In the PCOS group, fetuin-A was positively correlated with TT, FT, FAI and androstenedione and negatively correlated with SHBG. Regression analysis demonstrated that FT, SHBG, and androstenedione significantly predicted fetuin-A levels (R2=54%). In non-obese PCOS patients and controls, fetuin-A was positively correlated with insulin and HOMA-IR.
These results suggest a relationship between androgen levels and fetuin-A in PCOS cases, independent of insulin resistance, and may shed light on further studies.
多囊卵巢综合征（PCOS）是一种内分泌疾病，其中同时发生了高雄激素血症和高胰岛素血症。胎球蛋白-A 是一种天然的酪氨酸激酶抑制剂，可导致胰岛素抵抗。目的是评估胎球蛋白-A 与高雄激素血症和高胰岛素血症之间的关系，以及胎球蛋白-A 在 PCOS 病理生理学中的作用。
本研究纳入了 38 例 PCOS 患者和 40 名健康青少年。将 PCOS 患者和对照组分为肥胖/非肥胖亚组。测量 PCOS 患者的 LH、FSH、总睾酮（TT）、游离睾酮（FT）、SHBG、雄烯二酮、DHEAS；还测量了 PCOS 患者和健康对照组的空腹血糖、胰岛素、血脂谱、AST、ALT、HsCRP 和胎球蛋白-A 水平。
PCOS 患者的胎球蛋白-A 水平高于对照组。在肥胖型 PCOS 组中，与非肥胖型 PCOS 患者相比，SHBG 和 HDL 水平较低，而胆固醇、LDL、甘油三酯、HOMA-IR、FT、FAI 和 HSCRP 水平较高，但胎球蛋白-A 水平相似。在肥胖型 PCOS 组中，胎球蛋白-A 水平高于肥胖对照组。非肥胖型 PCOS 患者的 HOMA-IR 和胎球蛋白-A 水平高于非肥胖对照组。在 PCOS 组中，胎球蛋白-A 与 TT、FT、FAI 和雄烯二酮呈正相关，与 SHBG 呈负相关。回归分析表明，FT、SHBG 和雄烯二酮可显著预测胎球蛋白-A 水平（R2=54%）。在非肥胖型 PCOS 患者和对照组中，胎球蛋白-A 与胰岛素和 HOMA-IR 呈正相关。
这些结果表明 PCOS 患者的雄激素水平与胎球蛋白-A 之间存在相关性，这种相关性独立于胰岛素抵抗，可能为进一步研究提供线索。
