Investigating the relationship of serum levels of afamin and interleukin-10 with insulin resistance in infertile women with polycystic ovary syndrome

Tuğba Gürbüz; Oya Gökmen; Ergül Demirçivi Bör; Aygül Uluocak

doi:10.28982/josam.874039

Authors

Tuğba Gürbüz Private Medistate Hospital, Gynecology and Obstetric Clinic ,Istanbul/Turkey https://orcid.org/0000-0003-3555-3767
Oya Gökmen Gynecology Obstetrics & Reproductive Medicine, Medistate Kavacık Hospital, Istanbul, TURKEY; https://orcid.org/0000-0003-0020-4233
Ergül Demirçivi Bör Department of Gynecology &Obstetrics, Istanbul Medeniyet Univecity Goztepe Training- and Research Hospital,Istanbul ,TURKEY https://orcid.org/0000-0002-4448-3863
Aygül Uluocak Department of Biochemistry Clinic, Medistate Kavacık Hospital, Istanbul, TURKEY https://orcid.org/0000-0002-0417-2358

DOI:

https://doi.org/10.28982/josam.874039

Keywords:

Polycystic Ovary Syndrome,, Insulin Resistance,, Afamin,, IL-10

Abstract

Background/Aim: The prevalence of Polycystic Ovary Syndrome (PCOS) is between 6-10% globally, and more than 50% of patients with PCOS are obese. The development of insulin resistance (IR) and hyperinsulinemia due to overweight can contribute to this syndrome's clinical complications. This study aimed to investigate the relationship between serum levels of afamin and Interleukin-10 (IL-10) with IR in infertile women with PCOS. Methods: Eighty-eight participants between the ages of 18 and 36 years, with at least one year of unsuccessful attempts to have children were included in this prospective case-control study. The PCOS and healthy controls were divided into two groups based on IR. Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), Prolactin, Thyroid Stimulating Hormone (TSH), Free T4, Anti-Mullerian Hormone (AMH), Hemogram, total cholesterol, LDL, HDL, Triglyceride, fasting blood glucose, fasting insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), afamin, IL-10 values were measured. Results: The body mass indexes (BMIs) of the groups were significantly different (P<0.001); and the highest BMI was observed in the PCOS group with IR (HOMA-IR ≥2.5). Fasting insulin was significantly higher in the two groups with IR: 15.3 (6.09) in PCOS patients and 12.7 (2.8) in patients without PCOS (P=0.02). There was a weak positive correlation between BMI and Afamin (P=0.005), a strong negative correlation between BMI and IL-10 (P<0.001), a moderate negative correlation between Waist Hip Ratio (WHR) and IL-10 (P<0.001), a weak negative correlation between fasting insulin and IL-10 (P=0.001), and a weak positive correlation between monocyte and IL-10 (P=0.03). Conclusion: Our results showed an increase in Afamin and a decrease of interleukin-10 in infertile women with polycystic ovary syndrome and insulin resistance.

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References

De Groot PC, Dekkers OM, Romijn JA, Dieben SW, Helmerhorst FM. PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis. Human reproduction update. 2011;17(4):495-500.

Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. International journal of obesity. 2002;26(7):883-96.

Legro RS, editor Obesity and PCOS: implications for diagnosis and treatment. Seminars in reproductive medicine; 2012: NIH Public Access.

Li X, Shao R. PCOS and obesity: insulin resistance might be a common etiology for the development of type I endometrial carcinoma. American journal of cancer research. 2014;4(1):73.

Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine reviews. 2012;33(6):981-1030.

Dunaif A, Book CB. Insulin resistance in the polycystic ovary syndrome. Clinical research in diabetes and obesity. 1997:249-74.

Hasegawa I, Murakawa H, Suzuki M, Yamamoto Y, Kurabayashi T, Tanaka K. Effect of troglitazone on endocrine and ovulatory performance in women with insulin resistance–related polycystic ovary syndrome. Fertility and sterility. 1999;71(2):323-7.

Kauffman RP, Baker VM, DiMarino P, Gimpel T, Castracane VD. Polycystic ovarian syndrome and insulin resistance in white and Mexican American women: a comparison of two distinct populations. American journal of obstetrics and gynecology. 2002;187(5):1362-9.

Park K, Kim J, Ahn C, Song Y, Lim S, Lee H. Polycystic ovarian syndrome (PCOS) and insulin resistance. International Journal of Gynecology & Obstetrics. 2001;74(3):261-7.

Yang D, Li N, Ma A, Dai F, Zheng Y, Hu X, et al. Identification of Potential Biomarkers of Polycystic Ovary Syndrome via Integrated Bioinformatics Analysis. Reproductive Sciences. 2020:1-9.

Seeber B, Morandell E, Lunger F, Wildt L, Dieplinger H. Afamin serum concentrations are associated with insulin resistance and metabolic syndrome in polycystic ovary syndrome. Reproductive Biology and Endocrinology. 2014;12(1):1-7.

Polkowska A, Pasierowska IE, Pasławska M, Pawluczuk E, Bossowski A. Assessment of Serum Concentrations of Adropin, Afamin, and Neudesin in Children with Type 1 Diabetes. BioMed research international. 2019;2019.

Köninger A, Mathan A, Mach P, Frank M, Schmidt B, Schleussner E, et al. Is afamin a novel biomarker for gestational diabetes mellitus? A pilot study. Reproductive Biology and Endocrinology. 2018;16(1):1-11.

Köninger A, Iannaccone A, Hajder E, Frank M, Schmidt B, Schleussner E, et al. Afamin predicts gestational diabetes in polycystic ovary syndrome patients preconceptionally. Endocrine connections. 2019;8(5):616-24.

Köninger A, Enekwe A, Mach P, Andrikos D, Schmidt B, Frank M, et al. Afamin: an early predictor of preeclampsia. Archives of gynecology and obstetrics. 2018;298(5):1009-16.

Köninger A, Edimiris P, Koch L, Enekwe A, Lamina C, Kasimir-Bauer S, et al. Serum concentrations of afamin are elevated in patients with polycystic ovary syndrome. Endocrine connections. 2014;3(3):120-6.

Chen J, Guo Q, Pei Y-h, Ren Q-l, Chi L, Hu R-k, et al. Effect of a short-term vitamin E supplementation on oxidative stress in infertile PCOS women under ovulation induction: a retrospective cohort study. BMC women's health. 2020;20:1-9.

Ansari RM. Potential use of durian fruit (Durio zibenthinus Linn) as an adjunct to treat infertility in polycystic ovarian syndrome. Journal of integrative medicine. 2016;14(1):22-8.

Xing G, Sun Y, Wang F, Gao G, Zhou X. Role of interleukin-10 polymorphisms and haplotypes in polycystic ovary syndrome risk. International journal of clinical and experimental pathology. 2017;10(7):7956.

Wu H, Yu K, Yang Z. Associations between TNF-α and interleukin gene polymorphisms with polycystic ovary syndrome risk: a systematic review and meta-analysis. Journal of assisted reproduction and genetics. 2015;32(4):625-34.

Vural P, Değirmencioğlu S, Saral NY, Akgül C. Tumor necrosis factor α (− 308), interleukin-6 (− 174) and interleukin-10 (− 1082) gene polymorphisms in polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2010;150(1):61-5.

Talaat RM, Mohamed YA, Mohamad EH, Elsharkawy M, Guirgis AA. Interleukin 10 (− 1082 G/A) and (− 819 C/T) gene polymorphisms in Egyptian women with polycystic ovary syndrome (PCOS). Meta gene. 2016;9:254-8.

Karadeniz M, Erdogan M, Zengi A, Tamsel S, Berdeli A, Saygili F, et al. Polymorphism of the interleukin‐10 gene in polycystic ovary syndrome. International journal of immunogenetics. 2008;35(2):119-23.

ESHRE TR, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and sterility. 2004;81(1):19-25.

Seeber B, Czech T, Buchner H, Kurzthaler D, Wildt L, Dieplinger H. Afamin, a Vitamin E-binding protein elevated in Metabolic Syndrome, is significantly increased in women with polycystic ovarian syndrome, regardless of insulin resistance. Fertility and Sterility. 2008;90:S14-S5.

Li L, Zhang J, Zeng J, Liao B, Peng X, Li T, et al. Proteomics analysis of potential serum biomarkers for insulin resistance in patients with polycystic ovary syndrome. International journal of molecular medicine. 2020;45(5):1409-16.

Yeon Lee J, Baw C-K, Gupta S, Aziz N, Agarwal A. Role of oxidative stress in polycystic ovary syndrome. Current women's health reviews. 2010;6(2):96-107.

Macut D, Bjekić-Macut J, Savić-Radojević A. Dyslipidemia and oxidative stress in PCOS. Polycystic Ovary Syndrome. 2013;40:51-63.

Bannigida DM, Nayak BS, Vijayaraghavan R. Insulin resistance and oxidative marker in women with PCOS. Archives of physiology and biochemistry. 2020;126(2):183-6.

Huang J, Liu L, Chen C, Gao Y. PCOS without hyperandrogenism is associated with higher plasma Trimethylamine N-oxide levels. BMC endocrine disorders. 2020;20(1):1-9.

Fulghesu AM, Sanna F, Uda S, Magnini R, Portoghese E, Batetta B. IL-6 serum levels and production is related to an altered immune response in polycystic ovary syndrome girls with insulin resistance. Mediators of inflammation. 2011;2011.

Covington JD, Tam CS, Pasarica M, Redman LM. Higher circulating leukocytes in women with PCOS is reversed by aerobic exercise. Biochimie. 2016;124:27-33.

Artimani T, Karimi J, Mehdizadeh M, Yavangi M, Khanlarzadeh E, Ghorbani M, et al. Evaluation of pro-oxidant-antioxidant balance (PAB) and its association with inflammatory cytokines in polycystic ovary syndrome (PCOS). Gynecological endocrinology. 2018;34(2):148-52.

Wijeyaratne CN, Balen AH, Barth JH, Belchetz PE. Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: is there a difference? Clinical endocrinology. 2002;57(3):343-50.

Robinson S, Henderson A, Gelding S, Kiddy D, Niththyananthan R, Bush A, et al. Dyslipidaemia is associated with insulin resistance in women with polycystic ovaries. Clinical endocrinology. 1996;44(3):277-84.

Diamanti-Kandarakis E, Christakou CD. Insulin resistance in PCOS. Diagnosis and management of polycystic ovary syndrome. 2009:35-61.

Corbould A, Kim Y-B, Youngren JF, Pender C, Kahn BB, Lee A, et al. Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling. American Journal of Physiology-Endocrinology and Metabolism. 2005;288(5):E1047-E54.

Venkatesan AM, Dunaif A, Corbould A. Insulin resistance in polycystic ovary syndrome: progress and paradoxes. Recent progress in hormone research. 2001;56:295-308.

Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertility and sterility. 2012;97(1):18-22.

Panidis D, Kourtis A, Farmakiotis D, Mouslech T, Rousso D, Koliakos G. Serum adiponectin levels in women with polycystic ovary syndrome. Human reproduction. 2003;18(9):1790-6.

Ardawi MSM, Rouzi AA. Plasma adiponectin and insulin resistance in women with polycystic ovary syndrome. Fertility and sterility. 2005;83(6):1708-16.

Tarkun İ, Çetinarslan B, Türemen E, Cantürk Z, Biyikli M. Association between circulating tumor necrosis factor-alpha, interleukin-6, and insulin resistance in normal-weight women with polycystic ovary syndrome. Metabolic syndrome and related disorders. 2006;4(2):122-8.