The discriminative role of angiopoietin-like protein-3 for metabolic syndrome in polycystic ovary syndrome

SUMMARY OBJECTIVE: Patients with polycystic ovary syndrome face an increased risk of developing metabolic syndrome. Identifying biomarkers that can detect metabolic syndrome in polycystic ovary syndrome is essential, as it may enable physicians to implement preventive strategies aimed at reducing the risk of metabolic complications. The aim of this study was to assess angiopoietin-like protein-3 levels in polycystic ovary syndrome and to investigate the potential of angiopoietin-like protein-3 for discriminating metabolic syndrome in polycystic ovary syndrome. METHODS: A total of 50 women with polycystic ovary syndrome and 45 controls were included in this prospective study. Then, polycystic ovary syndrome patients were categorized into two subgroups: metabolic syndrome-positive (n=15) and metabolic syndrome-negative polycystic ovary syndrome (n=35). Age, parity, body mass index, blood pressure, waist circumference, Ferriman-Gallwey scores, hormone and lipid profiles, glucose, insulin, C-reactive protein, procalcitonin, and angiopoietin-like protein-3 levels were compared between groups. RESULTS: The median angiopoietin-like protein-3 level was significantly higher in polycystic ovary syndrome as compared to controls [41.19 (15.28–69.56) vs. 29.11 (9.85–66.25) ng/mL, p<0.001]. Similarly, angiopoietin-like protein-3 levels were higher in metabolic syndrome-positive polycystic ovary syndrome patients compared to those without metabolic syndrome (p=0.010). Angiopoietin-like protein-3 >32.5 ng/mL yielded a sensitivity of 76% and a specificity of 66.7% for predicting polycystic ovary syndrome (p<0.001, AUC=0.751), while angiopoietin-like protein-3 >44.54 ng/mL provided 68.8% sensitivity and 79.4% specificity for predicting metabolic syndrome in polycystic ovary syndrome (p=0.002, AUC=0.759). No correlation was detected between angiopoietin-like protein-3 and systolic blood pressure, body mass index, waist circumference, glucose, homeostatic model assessment insulin resistance, lipids, and inflammatory markers in polycystic ovary syndrome patients with metabolic syndrome. CONCLUSION: Angiopoietin-like protein-3 could discriminate metabolic syndrome in polycystic ovary syndrome patients. However, given that the correlation analysis did not find any association between Angiopoietin-like protein-3 and any etiopathogenesis-related characteristic, we think that further research is necessary to determine how it accomplishes this.