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

2. 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).

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

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

5. 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)

6. 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)

7. 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)

8. 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

9. 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.

10. 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

11. 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