Investigating Fetuin-A and Paraoxonase-1 Activity as Markers in Polycystic Ovary Syndrome Based on Body Mass Index: A Prospective Case-Control Study

Hepatokines: the missing link in the development of insulin resistance and hyperandrogenism in PCOS?

The liver plays a critical role in several metabolic pathways, including the regulation of glucose and lipid metabolism. Non-alcoholic fatty liver disease (NAFLD), the most common chronic liver disease worldwide, is closely associated with insulin resistance (IR) and metabolic syndrome (MetS). Hepatokines, newly discovered proteins secreted by hepatocytes, have been linked to the induction of these metabolic dysregulations. Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, has been associated with NAFLD and IR, while hyperandrogenism additionally appears to be implicated in the pathogenesis of the latter. However, the potential role of hepatokines in the development of metabolic disorders in PCOS has not been fully investigated. Therefore, the aim of this review is to critically appraise the current evidence regarding the interplay of hepatokines with NAFLD, hyperandrogenism, and IR in PCOS.

R-Spondin1 and tumor necrosis factor-alpha in infertile women with polycystic ovary syndrome: relationships with insulin resistance and other parameters

Aim: To evaluate the relationship between R-spondin1 (RSPO1) and Tumor Necrosis Factor-Alpha (TNF-α) levels with insulin resistance (IR) and other parameters in infertile women with polycystic ovary syndrome (PCOS). Material and Method: This case-control prospective observational study was carried out on 84 patients admitted to the University of Health Sciences Etlik Zübeyde Hanım Training and Research Hospital Gynecology and IVF Clinic and Medistate Hospital Gynecology and IVF Clinic between September 2020 and June 2021. Women aged 18-36 years diagnosed with infertility and PCOS constituted the PCOS group. Women who were diagnosed with infertility but not PCOS formed the control group. Cases were divided according to their body mass index (BMI) values into obese (BMI≥25) and non-obese (BMI

Fetuin-A and Its Association with Anthropometric, Atherogenic, and Biochemical Parameters and Indices among Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) contributes to metabolic and endocrine complications for women of reproductive age. We set out to assess the relationship between fetuin-A and anthropometric parameters, anthropometric indices, body composition, and atherogenic indices, as well as carbohydrate and lipid profile in women with polycystic ovary syndrome (PCOS). Methods. The study included 49 women with PCOS, aged between 18 and 39 years. All patients were tested for fetuin-A, fasting glucose and insulin, and lipid parameters, after oral-glucose administration were done. All of them underwent anthropometric measurements and body composition analyses such as BMI (Body Mass Index), WHR (Waist to Hip Ratio), WHtR (Waist to Height Ratio), BAI (Body Adiposity Index), VAI (Visceral Adiposity Index), LAP (Lipid Accumulation Product), BRI (Body Roundness Index), ABSI (A Body Shape Index), ABSI z-core (ABSI with added mortality risk in correlation with age and gender), AIP (Atherogenic Risk of Plasma), AC (Atherogenic Coefficient), Castelli risk index-I, and Castelli risk index-II. Results: Obesity was diagnosed in 18 patients (36.7%) based on BMI index and 7 patients (14.3%) based on BAI index. Significantly increased risk of metabolic complications was observed among 26 patients (53.1%) based on waist circumferences. Based on VAI index, risk of metabolic disease was observed among 17 women (34.7%). Dyslipidemia such as hypercholesterolemia, hypertriglyceridemia, and mixed hyperlipidemia was detected among 14 patients (28.6%), and insulin resistance was observed among 29 (59.2%). There was a positive correlation between fetuin-A and total cholesterol (r = 0.30, p = 0.0034). There was no statistically significant correlation between fetuin-A and all of the anthropometric measurements and anthropometric indices, atherogenic indices, and other biochemical parameters. Conclusion: Fetuin-A correlates with hypercholesterolemia. It is necessary to conduct further research regarding the relationship between fetuin-A concentrations and body composition, anthropometric indices, and metabolic disorders in women with PCOS. Surprisingly, the effects of concentration of fetuin-A and anthropometric indices (BAI, VAI, LAP, ABSI, ABSI z-core) in woman with PCOS have not been closely examined. Future studies that take these variables into account will need to be undertaken. More information on the relationship between fetuin-A concentrations and anthropometric indices would aid us in establishing a greater degree of accuracy on this matter.

Cardio-Metabolic Disease and Polycystic Ovarian Syndrome (PCOS): A Narrative Review

Polycystic ovarian syndrome (PCOS) is considered the most common endocrine disorder affecting females in today's world. Although it has been primarily studied and discussed in terms of its reproductive symptoms such as infertility, amenorrhea or oligomenorrhea, acne, hirsutism, and mood disorders, there is yet another unexplored and under-diagnosed category in the PCOS spectrum of diseases: its cardio-metabolic consequences. PCOS patients are prone to these abnormalities from a very young age, increasing their morbidity and mortality rates compared to their regular counterparts. The usual pathogenesis of PCOS is a culmination of several genetic and environmental factors. Regarding its cardio-metabolic aspects, insulin resistance (IR) is said to be the single most important cause of a variety of metabolic risk factors, including type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), dyslipidemia, obesity, and hypertension (HTN), whereas a few other non-traditional factors such as C-reactive protein (CRP), carotid intima-media thickness (IMT), coronary artery calcification (CAC), and endothelial dysfunction are also said to be increased in PCOS patients, further increasing their risk of complications due to cardiovascular diseases (CVD). A timely diagnosis and adequate treatment of these risk factors by using lifestyle interventions, diet, and/or medications are essential to reduce the burden of PCOS in today's world. This article has highlighted an array of traditional and non-traditional cardio-metabolic consequences PCOS patients are prone to and their systematic pathogenesis. In addition, an outline of recommendations has been given in the pharmacological and non-pharmacological sections of this article, which may benefit doctors in managing this challenging condition.