Prostasin: A Proteolytic Enzyme Increased in Women with Polycystic Ovary Syndrome

Prostasin is a proteolytic enzyme associated with inflammation, metabolism, hormone release, and tumoural events. We investigated the relationship between prostasin and various inflammatory, hormonal, and metabolic parameters in women with polycystic ovary syndrome (PCOS). Body mass index (BMI), biochemical, and hormonal parameters were analyzed in 80 healthy and 80 PCOS women aged 18–35. The free androgen index (FAI) and homeostatic model assessment for insulin resistance (HOMA-IR) score were calculated. Serum prostasin was measured by enzyme-linked immunosorbent assay (ELISA). Prostasin levels were significantly higher in patients with PCOS compared to control (15.00 ± 4.20 ng/mL vs. 7.47 ± 1.52 ng/mL, P < 0.0001). Among patients with PCOS, those with insulin resistance had higher prostasin levels than those without (17.0 ± 3.47 ng/mL vs. 12.52 ± 3.49 ng/mL, P < 0.0001). Prostasin levels were increased in PCOS patients with BMI ≥ 25 kg/m2 compared to those with low BMI (16.2 ± 3.87 ng/mL vs. 13.8 ± 4.04 ng/mL, P = 0.001). Correlation analysis revealed a positive correlation between prostasin levels and HOMA-IR, BMI, total testosterone levels, high-sensitivity C-reactive protein (hs-CRP), FAI, and dehydroepiandrosterone sulfate (DHEA-S). A negative correlation exists between prostasin levels and sex hormone-binding globulin (SHBG). Regression analysis showed an independent association between prostasin and FAI, hs-CRP, HOMA-IR, and BMI in women with PCOS. Our study showed that prostasin levels are increased in patients with PCOS. Total testosterone, DHEA-S, FAI, and hs-CRP levels were increased, while SHBG levels were decreased in women with PCOS compared to controls. Our findings suggest a possible role of high circulating prostasin levels in the pathophysiology of PCOS.