Original Study
The Predictive Role of Serum Cystatin C Levels in Polycystic Ovary Syndrome in Adolescents

https://doi.org/10.1016/j.jpag.2015.12.005Get rights and content

Abstract

Study Objective

To evaluate the correlation between serum cystatin levels and clinical parameters in adolescents with polycystic ovary syndrome (PCOS).

Design, Setting, Participants, Interventions, and Main Outcome Measures

This prospective case-control study included 89 adolescents with PCOS. Demographic characteristics and hormonal and biochemical parameters were compared between study (89 patients with PCOS) and control (84 subjects without PCOS) groups. Risk factors recorded were age, body mass index (BMI), waist to hip ratio (WHR), Ferriman–Gallwey score, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein (LDL), high-sensitivity C-reactive protein, cystatin C, follicle stimulating hormone, luteinizing hormone, estradiol, dehydroepiandrosterone sulfate, homeostatic model assessment insulin resistance index, free testosterone, and progesterone levels.

Results

BMI, WHR, Ferriman–Gallwey score, and triglyceride, LDL, total cholesterol, estradiol, dehydroepiandrosterone sulfate, free testosterone, luteinizing hormone, high-sensitivity C-reactive protein, and cystatin C levels, and homeostatic model assessment insulin resistance index scores were significantly higher, and high-density lipoprotein levels were lower in the PCOS patients compared with healthy subjects (P < .05). We also found positive correlations between the cystatin C levels and BMI, WHR, estradiol, high-sensitivity C-reactive protein, and LDL levels in the study group.

Conclusion

The serum cystatin C level is a promising marker for diagnosing adolescent patients with PCOS and suggests an inflammatory etiology for these patients. Further studies with more participants should examine this potential association with inflammation.

Introduction

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy causing anovulatory infertility, and it affects approximately 5% of women of reproductive age.1 The clinical spectrum of PCOS includes hyperandrogenism, menstrual irregularities, and infertility.2 Rotterdam consensus criteria (2 of the 3 following criteria: oligo or anovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovaries) are used to diagnose PCOS.3 PCOS might be a proinflammatory state related to inflammation at the molecular level and insulin resistance.4, 5

The extracellular cysteine protease inhibitor, cystatin C, belongs to the cystatin superfamily and consists of 122 amino acids. It is a basic, low molecular weight, cationic protein, known for its involvement in intracellular protein catabolism. Recent studies have shown that cystatin C is not only a more sensitive indicator of renal function but also a strong independent predictor of cardiovascular disease, diabetes, and all-cause mortality.6, 7 Cystatin is related to low-intensity inflammation and tumor metastasis.8

In this prospective case-control study, we evaluated the association between the clinical parameters of PCOS and serum cystatin levels in adolescents, to examine a possible inflammatory pathogenesis.

Section snippets

Ethics Statement

This study was approved by the Ethics Committee of Ankara Zekai Tahir Burak Women's Health Research and Education Hospital. Informed consent was obtained from each participant before enrolling in the study.

Study Population and Design

In this prospective case-control study we enrolled 89 adolescents seen between January 1, 2014 and December 31, 2015 at the outpatient adolescence clinic of Ankara Zekai Tahir Burak Women's Health Research and Education Hospital, a tertiary referral hospital, and a group of 84 healthy control

Results

In Table 1 the demographic, clinical, and laboratory findings of the subjects are summarized. Patients with PCOS had significantly higher BMI, WHR, and FGS compared with the control participants (P < .05). The triglyceride and LDL cholesterol levels were higher and the HDL cholesterol levels were lower in the PCOS patients (P < .05). The HOMA-IR index scores and DHEA-S, hs-CRP, free testosterone, and cystatin C levels were significantly higher in the study group (P < .05).

Correlation analysis

Discussion

In this study we evaluated the possible association between inflammation and the pathogenesis of PCOS. To our knowledge, this is the first study to evaluate the association between adolescent PCOS and the proinflammatory marker cystatin C. The clinical parameters evaluated were age, BMI, WHR, FGS, triglyceride, total cholesterol, HDL, LDL, hs-CRP, cystatin C, follicle-stimulating hormone, LH, estradiol, HOMA-IR, DHEA-S, free testosterone, and progesterone levels.

The BMI, WHR and FGS,

References (21)

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The authors indicate no conflicts of interest.

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© 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.