Correlation Of Serum IL-18 And WISP1 With Glycolipid Metabolism Indexes In PCOS Patients

Objective:To investigate the expression levels of serum IL-18 and WISP1 in patients with polycystic ovary syndrome（PCOS）,to preliminarily analyze the correlation between IL-18 and WISP1 and glycolipid metabolism indexes in PCOS patients,and to study correlation between serum IL-18,WISP1 and IR in PCOS patients.Methods:94 patients with PCOS who attended the gynecological endocrine clinic,from April2021 to September 2022,of the Second Hospital of Shanxi Medical University were selected,and another 30 women of reproductive age who were physically examined during the same period at the hospital were selected as the control group.General conditions were collected such as age,neck circumference（NC）,waist circumference（WC）,hip circumference（HC）,body mass index（BMI）,waist-to-hip ratio（WHR）,waist-to-height ratio（WHt R）,hirsutism score and quality of life score;oral glucose tolerance test and insulin release test were performed,and glucolipid metabolism index,liver and kidney function,and sex hormones were recorded in all women.The expression levels of serum IL-18 and WISP1 were determined by enzyme-linked immunosorbent assay（ELASA）.The different groups were divided according to the homeostatic model insulin resistance index（HOMA-IR）and different phenotypes of PCOS.The levels of IL-18 and WISP1 in each group were compared,and their relationship with IR and glucolipid metabolism indexes in PCOS was analyzed.Results:1.In the PCOS group,w BMI,WHR,WHt R,T,FSH,LH,PRL,FINS,INS1h,INS2h,INS3h,2h PG,LAP,HOMA-IR,WISP1,IL-18 and the hirsutism score were all higher compared with the NC group（P<0.05）,while the quality of life scores were decreased significantly（P<0.05）.2.In PCOS,compared with phenotype D,the levels testosterone of phenotype A and phenotype B were increased,the difference between phenotype A and phenotype D was statistically significant（P<0.05）only,and there was no significant difference in other clinical data among phenotype A,phenotype B and phenotype D（P>0.05）.3.Compared with the NC group,weight,BMI,w BMI,WHR,NC,hirsutism score,T,FSH,LH,FINS,INS1h,INS2h,INS3h,2h PG,LAP,AST,ALT,IL-18 and WISP1 in PCOS-IR group increased significantly（P<0.05）,while quality of life score,E₂and HDL-C decreased significantly（P<0.05）;Compared with PCOS-NIR,weight,BMI,WC,w BMI,WHR,NC,WHt R,TG,LDL-C,FINS,INS1h,INS2h,INS3h,FPG,2h PG,LAP,AST,ALT,IL-18 and WISP1 were significantly higher in the PCOS-IR group,and E₂,HDL-C and Cr were decreased significantly（P<0.05）;Compared with the NC group,in PCOS-NIR group,the hirsutism score,T,LH/FSH,INS3h,IL-18 and WISP1 increased significantly（P<0.05）,and the quality of life score and FPG level decreased significantly（P<0.05）.4.In PCOS,IL-18 was positively correlated with body weight,BMI,WC,w BMI,WHR,NC,WHt R,TG,FINS,INS1h,FPG,HOMA-IR,AST,ALT,LAP,WISP1（r=0.390,0.477,0.429,0.470,0.209,0.420,0.437,0.290,0.340,0.236,0.227,0.375,0.235,0.287,0.372,0.244,P<0.05）,and negatively correlated with HDL-C（r=-0.260,P<0.05）;WISP1 was positively correlated with body weight,BMI,WC,w BMI,NC,WHt R,T,TG,FINS,INS1h,INS2h,INS3h,FPG,2h PG,HOMA-IR,AST,ALT,LAP,IL-18（r=0.367,0.389,0.347,0.392,0.363,0.346,0.215,0.223,0.472,0.212,0.219,0.259,0.264,0.238,0.484,0.282,0.343,0.316,0.244,P<0.05）,negatively correlated with HDL-C（r=-0.249,P<0.05）.5.Binary logistic regression analysis showed that IL-18 and WISP1 were risk factors for PCOS-IR,and ROC curve analysis showed that the efficacy of serum IL-18,WISP1 individually and the combination of them in diagnosis of PCOS-IR was acceptable（P<0.05）.The area under the curve of IL-18（95%CI）was 0.700（0.590-0.809）,the optimal cut-off value was 255.89pg/ml,the sensitivity of 88.6%and specificity was49.2%;the area under the curve of WISP1（95%CI）was 0.735（0.629-0.840）,the optimal cut-off value was 319.03 pg/ml,the sensitivity was 74.3%,and the specificity was 71.2%.The area under the curve（95%CI）of combination IL-18 and WISP1 was0.782（0.683-0.880）,with a sensitivity of 60.0%and specificity of 89.8%。Conclusion:Serum IL-18 and WISP1 expression levels are elevated in PCOS patients and are closely related to metabolic indicators.IL-18 and WISP1were risk factors for PCOS combined with IR.WISP1 and IL-18 had some diagnostic value for PCOS-IR.IL-18 and WISP1 expression in PCOS were not related to different phenotypes.