| Objective:The expression levels of adipokine human visceral fat-specific serine protease inhibitor（vaspin）and human kinase7（KLK7）in the circulating with polycystic ovary syndrome（PCOS）were examined,the differential expression of vaspin and KLK 7 in the serum between PCOS patients and non-PCOS patients,and performed the correlation analysis with insulin resistance（IR）.To find new ideas on IR diagnosis and treatment in PCOS.Methods:Selecting 94 PCOS patients aged 18-35 years who met the 2003 diagnostic criteria for Rotterdam,randomly selecting age-matched physical examination of healthy women and（or）due to male factors and（or）female infertility 31 patients as a control group（NC）in April 2021-August 2022 in the second hospital of Shanxi medical university.According to HOMA-IR≥6.29,the PCOS group was divided into PCOS-IR and PCOS-NIR groups.General body indices were measured for all the participants,and body mass index（BMI）,waist-to-hip ratio（WHR）,and waist-to-height ratio（WHt R）were calculated.Fasting venous blood was drawn at days 2-5 of menstruation and amenorrhea at any time,to test fasting insulin（FINS）,fasting blood glucose（FBG）,sex hormones,serum lipids,hepatic function,and insulin resistance index（HOMA-IR）was calculated.The levels of vaspin and KLK7 were tested by enzyme-linked immunosorbent assay（ELISA）.Statistical analyzed by SPSS 26.0 software,all data were tested for normality and homogeneity of variance.Normal distributed data are expressed by（mean±standard deviation）.Not normally distributed data are expressed:test or Mann-Whitney U test between the two groups.And the correlations between Vaspin,KLK 7 and other indicators by the Spearman method.The relevant risk factors for PCOS were analyzed by Logistic regression analysis,and ROC curves were drawn to calculate the AUC of the predictors.P<0.05 was statistically significant.Results:1、Comparing with NC,BMI,neck circumference,waist circumference,WHR,WHt R,FSH,LH,T,FINS,HOMA-IR,AST,Vaspin,KLK 7 were significantly higher in PCOS group(P BMI=0.037,P neck circumference<0.001,P waist circumference<0.001,P WHR<0.001PWHt R<0.001,PFSH<0.001,PLH<0.001,PT<0.001,PFINS<0.001,PHOMA-IR=0.006,PAST=0.010,P Vaspin<0.001,P KLK7<0.001)and the difference was statistically significant;FBG was significantly lower in PCOS group(P FBG<0.001)and the difference was statistically significant.Comparison of age,height,weight,PBG,PRL,E2,TC,TG,ALT,HDL-C,LDL-C was not statistically different between the two groups(Page=0.175,Pheight=0.659,Pweigh=0.109,PPBG=0.158,PPRL=0.117,PE2=0.101,PTC=0.314,PTG=0.466,PALT=0.755,PHDL-C=0.225,PLDL-C=0.611).2、Correlation analysis of vaspin and KLK 7 with general clinical data and glucose and lipid metabolism indexes in all selected populations.（1）Vaspin was positively correlated with weight,BMI,neck circumference,waist circumference,WHR,WHt R,PBG,FINS,HOMA-IR,AST,ALT,TG,LDL-C,KLK 7(rweight=0.689,r BMI=0.718,rneck circumference=0.706,rwaist circumference=0.738,r WHR=0.562,r WHt R=0.721,r PBG=0.306,r FINS=0.625,r HOMA-IR=0.591,r AST=0.336,r ALT=0.371,r TG=0.340,r LDL-C=0.242,r KLK7=0.645,P weight<0.001,P BMI<0.001,P neck circumference<0.001,P waist circumference<0.001,PWHR<0.001,PWHt R<0.001,PPBG<0.001,PFINS<0.001,PHOMA-IR<0.001,P AST<0.001,P ALT<0.001,P TG<0.001,P LDL-C=0.006,P KLK7<0.001),Vaspin had negative correlation with HDL-C(r HDL-C=-0.416,P HDL-C<0.001).And Vaspin had no significant correlation with the remaining indicators（P>0.05）.（2）KLK 7 had positively correlation with weight,BMI,neck circumference,waist circumference,WHR,WHt R,LH,T,PBG,FINS,HOMA-IR,AST,ALT,Vaspin rweight=0.412,r BMI=0.387,rneck circumference=0.544,rwaist circumference=0.477,r WHR=0.403,r WHt R=0.468,r LH=0.181,r T=0.201,r PBG=0.265,r FINS=0.524,r HOMA-IR=0.463,r AST=0.281,r ALT=0.194,r Vaspin=0.645;Pweight<0.001,P BMI<0.001,Pneck circumference<0.001,Pwaist circumference<0.001,PWHR<0.001,PWHt R<0.001,PLH=0.037,PT=0.025,PPBG=0.003,PFINS<0.001,PHOMA-IR<0.001,P AST=0.002,P ALT=0.030,P Vaspin<0.001).KLK7 had negative correlation with HDL-C(r HDL-C=-0.259,P HDL-C=0.004),and had no obvious correlation with others（P>0.05）.3、Comparison of Vaspin,KLK 7 and general clinical indicators in PCOS with IR,PCOS without IR,and NC groups.（1）HOMA-IR≥2.69 was diagnosed as IR,and 35 patients in PCOS with IR,59 patients in PCOS with no IR.About 37%of PCOS with IR.（2）Comparing with the NC group,body weight,BMI,neck circumference,waist circumference,WHR,WHt R,FSH,LH,T,PBG,FINS,HOMA-IR,AST,ALT,Vaspin,and KLK 7 were significantly increased in the PCOS-IR group and the differences were statistically significant(P body weight<0.001,P BMI<0.001,P neck circumference<0.001,Pwaist-circumference<0.001,P WHR<0.001,P WHt R<0.001,P FSH=0.002,P LH=0.001,P T=0.021,P PBG<0.001,P FINS<0.001,P HOMA-IR<0.001,P AST=0.001,P ALT<0.001,P Vaspin<0.001,P KLK7<0.001),and the decreased levels of E2,HDL in the PCOS-IR group were statistically significant(P E2=0.042、P HDL-C=0.001);neck circumference,WHR,WHt R,FSH,LH,T,Vaspin,and KLK 7 were increased (P neck circumference<0.001,P WHR=0.002,P FSH=0.001,P LH<0.001,P T=0.004 P Vaspin<0.001,P KLK7<0.001)and the FBG levels were decreased in the PCOS-NIR group(P FBG<0.001),and the differences were statistically significant.（3）Comparing with the PCOS-NIR group,the levels of body weight,BMI,neck circumference,waist circumference,WHR,WHt R,FBG,PBG,FINS,HOMA-IR,AST,ALT,TG,LDL-C,Vaspin,KLK7 were increased(P body weight<0.001,P BMI<0.001,P neck-circumference<0.001,P waist-circumference<0.001,P WHR=0.00 1,P WHt R<0.001,P FBG=0.001,P PBG<0.001,P FINS<0.001,P HOMA-IR<0.01,P AST=0.00 3,P ALT<0.001,P TG<0.001,P LDL-C<0.001,P Vaspin<0.001,P KLK7<0.001),but E2,LH,HDL-C were decreased in PCOS-IR group(P E2=0.029,P LH=0.026,P HDL-C<0.001),and the differences were statistically significant.（4）Age,height,PRL,and TC were compared between the respective groups,there were no statistically significant differences（P>0.05）.4、Binary Logistic regression analysis.After correction of other variables,the results with a binary Logistic regression analysis prompted that KLK 7 and LH were independent risk factors for PCOS(P KLK7=0.01,P LH=0.003).5、Through the ROC curve analysis,KLK 7（AUC:0.885,sensitivity:1,specificity:0.628,cutoff value:5.07ng/ml）mand LH（AUC:0.757,sensitivity:0.968,specificity:0.521,cutoff value:9.68m IU/m L）have certain value in the diagnosis of PCOS.Conclusion:1、The serum levels of Vaspin and KLK 7 were higher in PCOS women than in no-PCOS women,Vaspin and KLK7 were positively associated with HOMA-IR,suggesting that the high expression of Vaspin and KLK 7 were involved in the development of IR in PCOS;2、The elevated Vaspin in PCOS serum was correlated with KLK 7;3、KLK 7 level was positively correlated with HOMA-IR and Vaspin,binary Logistic regression analysis concluded that KLK 7 was an independent risk factor for PCOS,and ROC curve analysis of KLK 7 had certain predictive value for PCOS,which further suggested the value of KLK 7 as a predictor of PCOS. |
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