Correlation Of Serum Glypican-4 And Clusterin With Polycystic Ovary Syndrome

Objective:To investigate the changes of serum Glypican-4(GPC4)and Clusterin(CLU)levels in patients with polycystic ovary syndrome(PCOS)as well as their correlation with sex hormones and metabolic parameters.Method:A total of 40 PCOS patients who were treated in the outpatient department of endocrinology of the Second Affiliated Hospital of Nanchang University from January 2021 to September 2021 and 40 age-matched healthy women who underwent physical examination in the physical examination center during the same period were selected.General information was collected and to detect serum adipocytokines GPC4 and CLU levels and the following clinical indicators: fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(TT).Calculating Homeostasis model of insulin resistance(HOMA-IR).To compare the levels of serum GPC4 and CLU between the two groups,and binary logistic regression was used to analyze the relative risk of PCOS at different levels of serum GPC4 and CLU.Stepwise linear regression was used to analyze the influential factors of serum GPC4 and CLU in PCOS patients.Results:1.Compared with the control group,BMI,LH,LH/FSH,TT,FPG,FINS,HOMA-IR,TC,TG,LDL-C in PCOS patients were higher,and HDL-C was lower,the difference was statistically significant(P<0.05),FSH and E2 were also lower,but not statistically significant(P>0.05).Serum GPC4(1.82±0.49 VS 1.30±0.61ng/ml,P<0.001)and CLU(468.79 ± 92.85 VS 228.59 ± 82.42ug/ml,P<0.001)in PCOS patients were significantly higher than those in healthy women.2.1 According to the level of GPC4,all subjects were divided into 3 groups from low to high: T1 group(GPC4<1.29ng/ml),T2 group(1.29≤ GPC4<1.80ng/ml),T3group(GPC4 ≥1.80ng/ml),the results showed that the risks of PCOS in T3 and T2 groups were significantly higher than in the T1 group(OR =12.6,95%CI: 3.443～46.107,P<0.001;OR= 4.9,95%CI: 1.413 ～ 16.988,P=0.012),but there was no significant difference in the risk of PCOS between T3 and T2 groups(OR= 2.571,95%CI: 0.813～8.134,P=0.108).2.2 According to the level of CLU,all subjects were divided into 3 groups from low to high: Q1 group(CLU<257.65ug/ml),Q2 group(257.65≤ CLU<442.27ug/ml),Q3 group(CLU ≥442.27ug/ml),the results showed that the risks of PCOS in the Q3 and Q2 groups were significantly higher than in the Q1 group(OR=625,95%CI:37.005～10556.023,P<0.001;OR= 25,95%CI: 2.966～210.717,P=0.003),and the risk of PCOS in the Q3 group was significantly higher than in the Q2 group(OR= 25,95%CI: 2.966～210.717,P=0.003).3.In the PCOS group,serum GPC4 was positively correlated with FSH,FPG,FINS,HOMA-IR,TG and CLU(P<0.05),and serum CLU was positively correlated with BMI,FPG,FINS and HOMA-IR(P<0.05);In the control group,serum GPC4 was positively correlated with BMI,E2,FINS,HOMA-IR and CLU(P<0.05),and serum CLU was positively correlated with BMI,E2,FPG and HOMA-IR(P<0.05).4.In women with PCOS,multiple stepwise linear regression analysis showed that HOMA-IR was independently associated factor with serum GPC4,BMI and HOMA-IR were independently associated factors with CLU(P<0.05).Conclusion:Serum GPC4 and CLU levels in PCOS patients were significantly higher than those in healthy women.GPC4 and CLU may be markers associated with insulin resistance in women with PCOS.