GLYPICAN-4 LEVELS IN RELATION WITH HORMONAL AND METABOLIC PROFILE IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME Doç.Dr.Özlem ALTINKAYA

Objective The aim of the present study was to evaluate serum concentrations of glypican-4 in relation with hormonal and metabolic profile in patients with and without polycystic ovary syndrome (PCOS).

Material-Method 44 women with PCOS 44 age matched healthy controls Hirsutism scores hormonal and metabolic profile glypican-4 levels

Material-Method Glypican-4 an adipokine that affects insulin sensitivity interacts directly with the insulin receptor enhances insulin signaling in terms of adipocyte localization

Results Positive correlation Negative correlation higher serum concentrations of glypican-4 levels in PCOS group (3.1 ng/ml versus 2.6 ng/ml, p<0.001) Positive correlation Negative correlation BMI (p<0.001, r=0.971) Fasting blood glucose (p=0.031, r=0.230) Insulin (p<0.001, r=0.433) Triglyceride (p=0.006, r=0.292) Free testosterone (p<0.001, r=0.348) mFG (p<0.001, r=0.645) HOMA-IR (p<0.001, r=0.457) FSH (p=0.033, r=-0.228) HDL (p<0.001, r=-0.334)

Results Positive correlation(PCOS) Negative correlation(PCOS) BMI (p<0.001, r=0.999) Insulin (p=0.002, r=0.463) HOMA-IR (p=0.002, r=0.455) fT (p<0.001, r=0.631) TG (p=0.015, r=0.366) mFG (p<0.001, r=0.668) HDL (p<0.001, r=-0.508)

Control group (n=44) PCOS group (n=44) p-value Age 24.9±5.6 23.5±5.4 0.227 BMI 22.8±2.4 25.2±3.8 <0.001 Fasting blood glucose 88.1±5.3 91.4±10.3 0.062 Insulin 8.1 (4.0) 10.5 (8.8) 0.002 Homa-IR 1.8 (0.9) 2.4 (1.9) Total cholesterol 165.5 (33.7) 180.0 (45.2) 0.108 HDL cholesterol 53.9±9.8 49.0±12.7 0.045 LDL cholesterol 101.2±22.0 113.3±24.9 0.018 Triglyceride 80.5 (41.2) 95.5 (62.0) 0.027 fT 1.2 (1.1) 3.0 (1.9) DHEAS 258.5 (128.2) 330.0 (244.2) TSH 1.7 (1.0) 1.7 (1.5) 0.917 FSH 4.7 (1.4) 4.2 (1.2) 0.017 LH 4.8 (1.9) 7.2 (8.0) E2 65.0 (37.2) 47.5 (38.0) 0.047 mFG 3.0 (1.0) 10.0 (5.2) Glypican (ng/ml) 2.6 (2.2) 3.1 (2.1)

Results Glypican Control group (n=44) PCOSgroup (n=44) p-value BMI<25 kg/m2 1.2 (2.3) 1.8 (1.4) 0.124 BMI>25 kg/m2 2.9 (0.2) 3.9 (1.0) <0.001 The comparisons between Control and PCO groups within BMI levels, according to the Bonferroni Correction p<0.025 was considered as statistically significant

Results Regression coefficient 95% Confidence Interval t-statistic p value Lower limit Upper limit PCO 0.270 -0.128 0.667 1.350 0.181 BMI 0.220 0.162 0.277 7.565 <0.001 HOMA-IR -0.016 -0.072 0.040 -0.556 0.580 HDL cholesterol 0.005 -0.008 0.017 0.722 0.472 Triglyceride -0.001 -0.004 0.002 -0.895 0.373 fT -0.134 -0.315 0.047 -1.475 0.144 FSH 0.029 -0.061 0.119 0.638 0.525 mFG 0.004 -0.062 0.070 0.122 0.903 Whether the differences in glypican levels between control and PCO groups were keeping on or not was evaluated by Multiple Linear Regression Analyses after adjustment for all possible confounding factors.

Discussion Only one study in literature by Jedrzejuk et al. From Poland (Gynecol Endocrinol.2016) 62 PCOS, 43 controls Higher levels in PCOS group Positive correlation with BMI in both groups Positive correlation with BMI, waist circumference, total fat, android fat, gynecoid fat, insulin, HOMA-IR in PCOS group

Conclusion Serum glypican-4 levels were higher in women with PCOS as compared to controls in overweight and obese group. Glypican-4 can be used as a specific marker for insulin sensitivity and lipid profile This adipokine might play a role in the pathogenesis of PCOS Glypican-4 might also be a clinical indicator in PCOS, in which the risks of metabolic syndrome and cardiovascular event are increased