Aslı Güler KADIOĞLU, Gökçen Ünal KOCABAŞ, Çetin İMAMOĞLU, Yasemin ALAN

Increased fetuin-B levels are associated with carotid intima media thickness and hormonal-metabolic disturbances in women with polycystic ovary syndrome

Objective: Fetuin-B is a novel peptide hormone involves in energy metabolism, atherosclerosis and reproductive system. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disorder associated with increased cardiovascular risk factors. We aimed to ascertain whether circulating fetuin-B levels were altered in women with PCOS and whether there was any association between fetuin-B and hormonal-metabolic parameters as well as carotid intima media thickness (CIMT). Material and Methods: Eighty women with PCOS and 80 age- and BMI-matched controls without PCOS were recruited to this cross-sectional study. Circulating fetuin-B levels were measured by ELISA. Metabolic- hormonal parameters and CIMT of recruited subjects were also determined. Results: Circulating fetuin-B levels were significantly elevated in women with PCOS compared to controls (409.54 ± 32.51 vs. 325.53 ± 26.86 ng/ml, P<0.001). PCOS subjects with insulin resistance showed significantly elevated circulating fetuin-B levels compared to those PCOS subjects without insulin resistance (416.03 ± 30.41 vs. 399.27 ± 33.56 ng/ml, P = 0.024). Overweight/obese women had significantly higher circulating fetuin-B levels than lean subjects in PCOS groups (416.32 ± 30.99 vs. 400.82 ± 32.77 ng/ml, P = 0.033). Fetuin-B levels positively correlated with BMI, homeostasis model assessment of insulin resistance (HOMA-IR), free-androgen index (FAI), high sensitivity C-reactive protein (hs-CRP), triglycerides and CIMT in PCOS subjects whereas fetuin-B negatively correlated with high density lipoprotein cholesterol (HDL-C). Moreover, binary logistic regression analysis revealed that the risk of having PCOS was increased in parallel with elevation of fetuin-B levels. Conclusion: Circulating fetuin-B levels were significantly increased in PCOS subjects and fetuin-B levels were closely related to cardiovascular risk and hormonal-metabolic disturbances in women with PCOS. ÖZET Amaç :Fetuin-b enerji metabolizması, ateroskleroz ve üreme sisteminde rol oynayan yeni bir peptid hormonudur.Polikistik over sendromu (PKOS) üreme ve metabolik sistemleri içeren artmış kardivasküler risk taşıyan bir hastalıktır.Bu çalışmada PKOS'lu kadınlarda dolaşımdaki Fetuin-b düzeyinde değişiklik olup olmadığını ve Fetuin-b düzeyi ile hormonal-metabolik parametreler ile Karotis intima media kalınlığı (CIMT) arasında bir ilişki olup olmadığını tespit etmeyi amaçladık. Gereç ve Yöntemler:Kesitsel çalışmamıza 80 PKOS’lu kadın alınmıştır. Kontrol grup olarak 80 tane yaş ve BMI uyumlu kadın çalışmaya alınmıştır.Dolaşımdaki Fetuin-b seviyeleri ELISA yöntemi ile ölçüldü. Ayrıca deneklerin metabolik hormonal parametreleri ve CIMT'si de belirlenmiştir. Bulgular:Dolaşımdaki Fetuin-b düzeyleri PKOS'lu kadınlarda kontrollere göre anlamlı derecede yüksek bulundu (409.54 ± 32.51 vs. 325.53 ± 26.86 ng/ml, P<0.001).İnsülin direncine sahip PKOS denekleri, insülin direncine sahip olmayan PCOS öznelerine göre anlamlı derecede yüksek dolaşım Fetuin-B seviyeleri gösterdi (416.03 ± 30.41 vs. 399.27 ± 33.56 ng/ml, P = 0.024). Aşırı kilolu / obez kadınlarda PKOS gruplarında düşük kilolu deneklerden anlamlı derecede daha yüksek dolaşımdaki Fetuin-b düzeyleri vardı (416.32 ± 30.99 vs. 400.82 ± 32.77 ng/ml, P = 0.033).Fetuin-B düzeyleri BKİ, insülin direncinin homeostaz modelinin değerlendirilmesi (HOMA-IR), free-androgen index (FAI), high sensitivity C-reactive protein (hs-CRP) trigliseritler ve CIMT ile pozitif korelasyon gösterir iken yüksek yoğunluklu lipoprotein kolesterol (HDL-C) ile negatif korelasyon göstermektedir. Ayrıca ikili lojistik regresyon analizi, PKOS olma riskinin Fetuin-B seviyelerinin yükselmesine paralel olarak arttığını ortaya koydu. Sonuç:Dolaşımdaki Fetuin-B düzeyleri PKOS'lu hastalarda anlamlı olarak artmış olup Fetuin-B düzeyleri PKOS'lu kadınlarda kardiyovasküler risk ve hormonal metabolik bozukluklarla yakından ilişkilidir.

Anahtar Kelimeler:

Polycystic ovary syndrome, fetuin-B, insulin resistance, body mass index, carotid intima media thickness

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