Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Education Center, Clinical Skill Practice, China Medical University, Shenyang, China.
Front Endocrinol (Lausanne). 2022 Mar 9;13:845165. doi: 10.3389/fendo.2022.845165. eCollection 2022.
Leptin may have important implications in polycystic ovary syndrome (PCOS)-related metabolic disorders. However, the changes in serum leptin levels in patients with PCOS and its predictive value for PCOS remain obscure. We intend to analyze the association between leptin and PCOS in this study.
The study comprised 89 patients with PCOS and 139 individuals without PCOS. Each group was stratified as either normal- or hyper-fasting serum insulin (FSI), and lean or overweight/obese; and the patients were further categorized as normal- or hyper-androgenic. The validity of leptin toward the diagnosis of PCOS, or leptin combined with total testosterone, dehydroepiandrosterone sulfate (DHEAS), and free testosterone was estimated by receiver operating characteristic (ROC) curves, and correlations between paired variables was estimated by Spearman's rank correlation coefficient. Associations between the clinical and metabolic variables and PCOS were analyzed logistic regression.
The serum leptin levels of patients with PCOS were significantly higher than that of the control, and especially the PCOS in hyper-FSI, hyperandrogenimic and overweight/obese subgroups. The area under the ROC curve (AUC) of leptin was 74%, with cutoff value, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) 11.58 ng/mL, 77.5%, 62.6%, 57.0%, and 81.3%, respectively. Combined leptin and anti-Müllerian hormone (AMH) had the highest AUC (92.3%), excellent sensitivity (93.3%), moderate specificity (78.3%), PPV (73.5%) and NPV (94.8%). Serum leptin levels of the patients were correlated with the FSI, fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI), and total testosterone levels. Elevated serum leptin was associated with a high risk of PCOS [ = 0.015; OR (95% CI) 1.128 (1.024-1.244)].
Substantially elevated serum leptin is significantly associated with PCOS. These findings warrant further investigations into the function of leptin in the pathogenesis of PCOS.
瘦素在多囊卵巢综合征（PCOS）相关代谢紊乱中可能具有重要意义。然而，PCOS 患者血清瘦素水平的变化及其对 PCOS 的预测价值仍不清楚。本研究旨在分析瘦素与 PCOS 之间的关系。
研究纳入 89 例 PCOS 患者和 139 例非 PCOS 个体。每组均分为正常或高空腹血清胰岛素（FSI）和瘦或超重/肥胖；并进一步分为正常或高雄激素和正常或高游离睾酮。通过受试者工作特征（ROC）曲线评估瘦素对 PCOS 的诊断价值，或联合总睾酮、脱氢表雄酮硫酸酯（DHEAS）和游离睾酮评估瘦素的价值，并通过 Spearman 秩相关系数评估配对变量之间的相关性。采用 logistic 回归分析临床和代谢变量与 PCOS 的关系。
PCOS 患者的血清瘦素水平明显高于对照组，尤其是高 FSI、高雄激素和超重/肥胖亚组。瘦素的 ROC 曲线下面积（AUC）为 74%，截断值、灵敏度、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为 11.58ng/mL、77.5%、62.6%、57.0%和 81.3%。联合瘦素和抗苗勒管激素（AMH）具有最高的 AUC（92.3%），优异的灵敏度（93.3%），中等特异性（78.3%），PPV（73.5%）和 NPV（94.8%）。患者的血清瘦素水平与 FSI、空腹血糖（FPG）、稳态模型评估的胰岛素抵抗（HOMA-IR）、体重指数（BMI）和总睾酮水平相关。血清瘦素升高与 PCOS 风险增加相关[ = 0.015；比值比（95%置信区间）1.128（1.024-1.244）]。
显著升高的血清瘦素与 PCOS 显著相关。这些发现提示我们需要进一步研究瘦素在 PCOS 发病机制中的作用。
