Effect of serum s100A4 levels on polycystic ovary syndrome in patients with polycystic ovary syndrome

doi:10.3969/j.issn.1004-583X.2023.12.004

Abstract

Abstract:

Objective To detect serum S100A4 levels in patients with polycystic ovary syndrome (PCOS) and explore the effects of S100A4 on the development. Methods One hundred twenty-nine women of childbearing age with PCOS were enrolled into PCOS group from December 2021 to June 2023 at the Department of Endocrinology of the First Affiliated Hospital of Anhui Medical University, and 47 healthy women of childbearing age with regular menstrual cycles and no hyperandrogenemia, who underwent routine medical examinations at the hospital in the same period, were as the normal control group (NC group). According to the levels of body mass index (BMI) and glucose metabolism, the PCOS group was assigned into PCOS-over BIM group, PCOS-normal BIM group, PCOS-normal glucose metabolism group and PCOS-abnormal glucose metabolism group, respectively. The general data, S100A4 levels, and other biochemical indicators were collected, and the differences of clinical data between groups were compared. Results The serum S100A4 level of PCOS group was significantly higher than that of the NC group ( $P$ <0.01). There was a significant difference in serum S100A4 levels amongNC group, PCOS-normal BIM group and PCOS-over BIM group ( $P$ <0.01), which was significantly higher in the latter two groups than that of NC group ( $P$ <0.05). There was a significant difference in serum S100A4 levels among NC group, PCOS-normal glucose metabolism group and PCOS-abnormal glucose metabolism group( $P$ <0.01), which was significantly higher in the latter two groups than that of NC group ( $P$ <0.05). Spearman related analysis results showed that serum S100A4 levels were negative correlation with homeostasis model assessment- β (HOMA-β) and positively correlated with low-density lipoprotein cholesterol (LDL-C) ( $P$ <0.05). Multi-factor logistic regression analysis showed that S100A4 was the influencing factor for the occurrence of PCOS in women of childbearing age ( $O R$ =1.046, 95% $C I$ : 1.015-1.078, $P$ <0.05). The area under receiver operating characteristic (ROC) curve for serum S100A4 levels predicting PCOS was 0.681, and its optimal cutoff value was 0.176 ng/ml ( $P$ <0.01). Conclusion The increase in serum S100A4 in PCOS patients was related to obesity, insulin resistance, and abnormal lipid metabolism, and involving the development of PCOS.

Key words: polycystic ovary syndrome, S100A4, insulin resistance, obesity, metabolize

CLC Number:

R711.75

Ren Yumei, Zhang Qiu, Hu Honglin. Effect of serum s100A4 levels on polycystic ovary syndrome in patients with polycystic ovary syndrome[J]. Clinical Focus, 2023, 38(12): 1078-1085.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.12.004

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I12/1078

Figures/Tables 8

Tab. 1 Comparison of general data between NC-group and PCOS-group(M[P25,P75])

组别	例数		年龄(岁)	身高(cm)		体重(kg)		BMI(kg/m²)
NC组	47		25.00(24.00~25.00)	163.00(160.00~168.00)		56.00(52.00~63.00)		21.03(19.49~23.34)
PCOS组	129		24.00(20.00~29.00)	164.00(160.00~166.00)		68.00(54.00~80.00)		25.95(21.295~30.47)
$Z$ 值			-1.160	-0.034		-4.081		-4.494
$P$ 值			0.246	0.486		<0.01		<0.01
组别		腰围(cm)			臀围(cm)		腰臀比
NC组		72.00(69.00~78.00)			93.00(90.00~98.00)		0.78(0.74~0.81)
PCOS组		87.00(73.00~97.00)			102.00(94.00~110.00)		0.85(0.79~0.895)
$Z$ 值		-5.012			-4.295		-4.676
$P$ 值		<0.01			<0.01		<0.01

Tab. 1 Comparison of general data between NC-group and PCOS-group(M[P25,P75])

组别	例数		年龄(岁)	身高(cm)		体重(kg)		BMI(kg/m²)
NC组	47		25.00(24.00~25.00)	163.00(160.00~168.00)		56.00(52.00~63.00)		21.03(19.49~23.34)
PCOS组	129		24.00(20.00~29.00)	164.00(160.00~166.00)		68.00(54.00~80.00)		25.95(21.295~30.47)
$Z$ 值			-1.160	-0.034		-4.081		-4.494
$P$ 值			0.246	0.486		<0.01		<0.01
组别		腰围(cm)			臀围(cm)		腰臀比
NC组		72.00(69.00~78.00)			93.00(90.00~98.00)		0.78(0.74~0.81)
PCOS组		87.00(73.00~97.00)			102.00(94.00~110.00)		0.85(0.79~0.895)
$Z$ 值		-5.012			-4.295		-4.676
$P$ 值		<0.01			<0.01		<0.01

Tab. 2 Comparison of biochemical indicators between NC-group and PCOS-group(M[P25,P75])

组别	例数	FBG( mmol/L)			2hBG(mmol/L)		FINS(mU/L)		2hINS(mU/L)				FCP(μg/L)
NC组	47	4.69(4.10~5.08)			5.25(4.57~5.95)		8.03(6.09~12.04)		44.56(28.68~63.82)				1.61(1.18~1.91)
PCOS组	129	5.32(4.91~5.72)			7.28(5.84~8.78)		15.05(9.73~22.76)		141.08(66.41~249.68)				2.2(1.445~2.71)
$Z$ 值		-5.866			-6.431		-5.036		-6.691				-3.185
$P$ 值		<0.01			<0.01		<0.01		<0.01				0.01
组别	2hCP(μg/L)		HOMA-IR			HOMA-β				ISI		TG( mmol/L)
NC组	5.83(4.40~7.55)		1.66(1.20~2.58)			138.06(74.73~229.57)				0.03(0.02~0.04)		0.80(0.67~1.11)
PCOS组	8.72(6.87~12.40)		3.04(1.62~5.06)			131.61(82.95~230.73)				0.01(0.01~0.03)		1.17(0.93~1.68)
$Z$ 值	-5.565		-3.862			-0.202				-3.815		-4.772
$P$ 值	0.01		<0.01			0.84				<0.01		<0.01
组别	TC( mmol/L)			HDL-C( mmol/L)				LDL-C( mmol/L)			S100A4( ng/ml)
NC组	4.23(3.60~4.99)			1.3(1.09~1.53)				2.06(1.58~2.59)			0.14(0.12~0.16)
PCOS组	4.40(3.93~4.875)			1.26(1.10~1.46)				2.68(2.19~3.13)			0.17(0.13~0.23)
$Z$ 值	-0.757			-0.756				-3.948			-3.676
$P$ 值	0.449			0.450				<0.01			<0.01

Tab. 2 Comparison of biochemical indicators between NC-group and PCOS-group(M[P25,P75])

组别	例数	FBG( mmol/L)			2hBG(mmol/L)		FINS(mU/L)		2hINS(mU/L)				FCP(μg/L)
NC组	47	4.69(4.10~5.08)			5.25(4.57~5.95)		8.03(6.09~12.04)		44.56(28.68~63.82)				1.61(1.18~1.91)
PCOS组	129	5.32(4.91~5.72)			7.28(5.84~8.78)		15.05(9.73~22.76)		141.08(66.41~249.68)				2.2(1.445~2.71)
$Z$ 值		-5.866			-6.431		-5.036		-6.691				-3.185
$P$ 值		<0.01			<0.01		<0.01		<0.01				0.01
组别	2hCP(μg/L)		HOMA-IR			HOMA-β				ISI		TG( mmol/L)
NC组	5.83(4.40~7.55)		1.66(1.20~2.58)			138.06(74.73~229.57)				0.03(0.02~0.04)		0.80(0.67~1.11)
PCOS组	8.72(6.87~12.40)		3.04(1.62~5.06)			131.61(82.95~230.73)				0.01(0.01~0.03)		1.17(0.93~1.68)
$Z$ 值	-5.565		-3.862			-0.202				-3.815		-4.772
$P$ 值	0.01		<0.01			0.84				<0.01		<0.01
组别	TC( mmol/L)			HDL-C( mmol/L)				LDL-C( mmol/L)			S100A4( ng/ml)
NC组	4.23(3.60~4.99)			1.3(1.09~1.53)				2.06(1.58~2.59)			0.14(0.12~0.16)
PCOS组	4.40(3.93~4.875)			1.26(1.10~1.46)				2.68(2.19~3.13)			0.17(0.13~0.23)
$Z$ 值	-0.757			-0.756				-3.948			-3.676
$P$ 值	0.449			0.450				<0.01			<0.01

Tab. 3 Comparison of parameters of insulin sensitivity, glycolipid metabolic index and serum S100A4 levels among NC group, PCOS-normal BIM group and PCOS-over BIM group (M[P25,P75])

组别	例数			BMI(kg/m²)			FBG( mmol/L)			2hBG( mmol/L)		FINS(mU/L)	2hINS(mU/L)
NC组	47			21.03(19.49~23.34)			4.69(4.10~5.08)			5.25(4.57~5.95)		8.03(6.09~12.04)	44.56(28.68~63.82)
PCOS-正常体重组	56			20.93(18.96~22.13)^#			5.03(4.80~5.61)^*#			6.84(5.36~7.87)^*#		10.07(5.95~12.72)^#	95.79(44.00~173.72)^*#
PCOS-超重组	73			29.75(27.11~32.88)^*			5.48(5.03~5.98)^*			7.60(6.23~9.53)^*#		19.60(14.96~30.31)^*	179.55(90.48~260.57)^*
$H$ 值				120.850			43.352			48.252		71.007	56.660
$P$ 值				<0.01			<0.01			<0.01		<0.01	<0.01
组别		FCP(μg/L)			2hCP(μg/L)			HOMA-IR			HOMA-β				ISI
NC组		1.61(1.18~1.91)			5.83(4.40~7.55)			1.66(1.20~2.58)			198.33(140.46~294.28)				0.03(0.02~0.04)
PCOS-正常体重组		1.52(1.08~2.15)^#			7.64(5.46~10.035)^*#			2.36(1.35~3.50)^#			131.61(82.95~230.73)^#				0.02(0.01~0.03)^*
PCOS-超重组		2.52(2.08~3.38)^*			10.62(7.84~13.36)^*			4.76(3.67~7.2)^*			112.67(71.50~163.90)^*				0.01(0.01~0.01)^*
$H$ 值		44.565			44.381			74.707			28.080				74.774
$P$ 值		<0.01			<0.01			<0.01			<0.01				<0.01
组别			TG( mmol/L)			TC( mmol/L)			HDL-C( mmol/L)			LDL-C( mmol/L)		S100A4(ng/ml)
NC组			0.80(0.67~1.11)			4.23(3.60~4.99)			1.30(1.09~1.53)			2.06(1.58~2.59)		0.14(0.12~0.16)
PCOS-正常体重组			1.07(0.69~1.39)^*#			4.41(3.84~5.02)			1.40(1.20~1.76)^#			2.48(1.89~3.15)^#		0.15(0.13~0.23)^*
PCOS-超重组			1.31(1.02~1.87)^*			4.40(4.05~4.84)			1.18(1.01~1.35)^*			2.79(2.47~3.04)^*		0.17(0.14~0.25)^*
$H$ 值			31.976			0.634			22.474			18.208		14.331
$P$ 值			<0.01			0.728			<0.01			<0.01		<0.01

Tab. 3 Comparison of parameters of insulin sensitivity, glycolipid metabolic index and serum S100A4 levels among NC group, PCOS-normal BIM group and PCOS-over BIM group (M[P25,P75])

组别	例数			BMI(kg/m²)			FBG( mmol/L)			2hBG( mmol/L)		FINS(mU/L)	2hINS(mU/L)
NC组	47			21.03(19.49~23.34)			4.69(4.10~5.08)			5.25(4.57~5.95)		8.03(6.09~12.04)	44.56(28.68~63.82)
PCOS-正常体重组	56			20.93(18.96~22.13)^#			5.03(4.80~5.61)^*#			6.84(5.36~7.87)^*#		10.07(5.95~12.72)^#	95.79(44.00~173.72)^*#
PCOS-超重组	73			29.75(27.11~32.88)^*			5.48(5.03~5.98)^*			7.60(6.23~9.53)^*#		19.60(14.96~30.31)^*	179.55(90.48~260.57)^*
$H$ 值				120.850			43.352			48.252		71.007	56.660
$P$ 值				<0.01			<0.01			<0.01		<0.01	<0.01
组别		FCP(μg/L)			2hCP(μg/L)			HOMA-IR			HOMA-β				ISI
NC组		1.61(1.18~1.91)			5.83(4.40~7.55)			1.66(1.20~2.58)			198.33(140.46~294.28)				0.03(0.02~0.04)
PCOS-正常体重组		1.52(1.08~2.15)^#			7.64(5.46~10.035)^*#			2.36(1.35~3.50)^#			131.61(82.95~230.73)^#				0.02(0.01~0.03)^*
PCOS-超重组		2.52(2.08~3.38)^*			10.62(7.84~13.36)^*			4.76(3.67~7.2)^*			112.67(71.50~163.90)^*				0.01(0.01~0.01)^*
$H$ 值		44.565			44.381			74.707			28.080				74.774
$P$ 值		<0.01			<0.01			<0.01			<0.01				<0.01
组别			TG( mmol/L)			TC( mmol/L)			HDL-C( mmol/L)			LDL-C( mmol/L)		S100A4(ng/ml)
NC组			0.80(0.67~1.11)			4.23(3.60~4.99)			1.30(1.09~1.53)			2.06(1.58~2.59)		0.14(0.12~0.16)
PCOS-正常体重组			1.07(0.69~1.39)^*#			4.41(3.84~5.02)			1.40(1.20~1.76)^#			2.48(1.89~3.15)^#		0.15(0.13~0.23)^*
PCOS-超重组			1.31(1.02~1.87)^*			4.40(4.05~4.84)			1.18(1.01~1.35)^*			2.79(2.47~3.04)^*		0.17(0.14~0.25)^*
$H$ 值			31.976			0.634			22.474			18.208		14.331
$P$ 值			<0.01			0.728			<0.01			<0.01		<0.01

Tab. 4 Comparison of parameters of insulin sensitivity, glycolipid metabolic index and serum S100A4 levels among NC group, PCOS-normal glucose metabolism group and PCOS- abnormal glucose metabolism group(M[P25,P75])

组别	例数		BMI(kg/m²)			FBG(mmol/L)		2hBG(mmol/L)	FINS(mU/L)		2hINS(mU/L)
NC组	47		21.03(19.49~23.34)			4.69(4.10~5.08)		5.25(4.57~5.95)	8.03(6.09~12.04)		44.56(28.68~63.82)
PCOS-糖代谢正常组	64		23.57(19.85~29.70)^*			4.93(4.69~5.21)		6.39(5.06~7.26)^*	12.40(6.84~18.49)^*		84.09(44.50~196.71)^*
PCOS-糖代谢异常组	65		27.54(22.17~31.50)^*#			5.72(5.40~6.44)^*#		8.78(7.46~11.05)^*#	17.94(12.41~27.72)^*#		179.55(90.48~260.57)^*#
$H$ 值			25.663			85.801		82.375	39.533		57.089
$P$ 值			<0.01			<0.01		<0.01	<0.01		<0.01
组别		FCP(μg/L)		2hCP(μg/L)				HOMA-IR	HOMA-β				ISI
NC组		1.61(1.18~1.91)		5.83(4.40~7.55)				1.66(1.20~2.58)	176.07(95.49~252.56)				0.03(0.02~0.04)
PCOS-糖代谢正常组		1.73(1.08~2.33)		7.52(5.49~10.44)^*				2.65(1.63~4.23)^*	155.23(110.37~232.61)				0.02(0.01~0.03)^*
PCOS-糖代谢异常组		2.52(1.75~3.56)^*#		11.14(8.40~14.76)^*#				4.68(3.54~7.51)^*#	131.61(82.95~230.73)				0.01(0.01~0.01)^*#
$H$ 值		29.466		51.114				56.550	1.327				56.739
$P$ 值		<0.01		<0.01				<0.01	0.515				<0.01
组别		TG( mmol/L)			TC( mmol/L)		HDL-C( mmol/L)			LDL-C( mmol/L)		S100A4( ng/ml)
NC组		0.80(0.67~1.11)			4.23(3.60~4.99)		1.30(1.09~1.53)			2.06(1.58~2.59)		0.14(0.12~0.16)
PCOS-糖代谢正常组		1.10(0.84~1.41)^*			4.39(3.85~4.86)		1.36(1.17~1.50)			2.67(2.00~2.97)^*		0.15(0.13~0.22)^*
PCOS-糖代谢异常组		1.34(1.02~1.99)^*#			4.40(4.12~4.91)		1.18(1.01~1.40)^*#			2.81(2.39~3.19)^*		0.17(0.13~0.23)^*
$H$ 值		30.584			1.157		9.442			17.625		13.731
$P$ 值		<0.01			0.561		0.009			<0.01		<0.01

组别	例数		BMI(kg/m²)			FBG(mmol/L)		2hBG(mmol/L)	FINS(mU/L)		2hINS(mU/L)
NC组	47		21.03(19.49~23.34)			4.69(4.10~5.08)		5.25(4.57~5.95)	8.03(6.09~12.04)		44.56(28.68~63.82)
PCOS-糖代谢正常组	64		23.57(19.85~29.70)^*			4.93(4.69~5.21)		6.39(5.06~7.26)^*	12.40(6.84~18.49)^*		84.09(44.50~196.71)^*
PCOS-糖代谢异常组	65		27.54(22.17~31.50)^*#			5.72(5.40~6.44)^*#		8.78(7.46~11.05)^*#	17.94(12.41~27.72)^*#		179.55(90.48~260.57)^*#
$H$ 值			25.663			85.801		82.375	39.533		57.089
$P$ 值			<0.01			<0.01		<0.01	<0.01		<0.01
组别		FCP(μg/L)		2hCP(μg/L)				HOMA-IR	HOMA-β				ISI
NC组		1.61(1.18~1.91)		5.83(4.40~7.55)				1.66(1.20~2.58)	176.07(95.49~252.56)				0.03(0.02~0.04)
PCOS-糖代谢正常组		1.73(1.08~2.33)		7.52(5.49~10.44)^*				2.65(1.63~4.23)^*	155.23(110.37~232.61)				0.02(0.01~0.03)^*
PCOS-糖代谢异常组		2.52(1.75~3.56)^*#		11.14(8.40~14.76)^*#				4.68(3.54~7.51)^*#	131.61(82.95~230.73)				0.01(0.01~0.01)^*#
$H$ 值		29.466		51.114				56.550	1.327				56.739
$P$ 值		<0.01		<0.01				<0.01	0.515				<0.01
组别		TG( mmol/L)			TC( mmol/L)		HDL-C( mmol/L)			LDL-C( mmol/L)		S100A4( ng/ml)
NC组		0.80(0.67~1.11)			4.23(3.60~4.99)		1.30(1.09~1.53)			2.06(1.58~2.59)		0.14(0.12~0.16)
PCOS-糖代谢正常组		1.10(0.84~1.41)^*			4.39(3.85~4.86)		1.36(1.17~1.50)			2.67(2.00~2.97)^*		0.15(0.13~0.22)^*
PCOS-糖代谢异常组		1.34(1.02~1.99)^*#			4.40(4.12~4.91)		1.18(1.01~1.40)^*#			2.81(2.39~3.19)^*		0.17(0.13~0.23)^*
$H$ 值		30.584			1.157		9.442			17.625		13.731
$P$ 值		<0.01			0.561		0.009			<0.01		<0.01

Tab. 5 Correlation analysis of serum S100A4 levels with age, BMI, WHR, insulin sensitivity and glycolipid metabolic index

项目	年龄 (岁)	BMI (kg/m²)	腰臀比	FBG (mmol/L)	2hBG (mmol/L)	FINS (mU/L)	2hINS (mU/L)	FCP (μg/L)
PCOS组	0.038	-0.137	0.091	0.064	0.120	-0.075	-0.023	0.003
项目	2hCP (μg/L)	HOMA-IR	HOMA-β	ISI	TG (mmol/L)	TC (mmol/L)	HDL-C ( mmol/L)	LDL-C (mmol/L)
PCOS组	0.047	-0.042	-0.190^*	0.090	0.046	-0.087	-0.034	0.190^*

Tab. 6 Logistic regression analysis of the influence of S100A4 on PCOS before correction

项目	β	SE	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
截距	-1.594	0.735	4.697	0.030	0.0203
S100A4水平(pg/ml)	0.016	0.005	11.161	0.001	1.017	(1.007,1.026)

Tab. 6 Logistic regression analysis of the influence of S100A4 on PCOS before correction

项目	β	SE	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
截距	-1.594	0.735	4.697	0.030	0.0203
S100A4水平(pg/ml)	0.016	0.005	11.161	0.001	1.017	(1.007,1.026)

Tab. 7 Logistic regression analysis of the influence of S100A4 on PCOS after correction

项目	β	SE	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
截距	-28.365	12.481	5.165	0.023	0.000
S100A4水平	0.045	0.015	8.578	0.003	1.046	(1.015,1.078)

Tab. 7 Logistic regression analysis of the influence of S100A4 on PCOS after correction

项目	β	SE	Wald χ²值	$P$ 值	$O R$ 值	95% $C I$
截距	-28.365	12.481	5.165	0.023	0.000
S100A4水平	0.045	0.015	8.578	0.003	1.046	(1.015,1.078)

Fig. 1 ROC curves for serum S100A4 levels predicting PCOS

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