Serum afamin levels in women with polycystic ovary syndrome

Objective: Afamin is a special transporter of vitamin E, significantly associated with insulin resistance (IR) and inflammation. These two features are essential for the pathogenesis of polycystic ovary syndrome (PCOS). This study aimed to assess the diagnostic performance of serum afamin in PCOS and the association of IR and metabolic syndrome (MS) in patients versus controls. Methods: This cross-sectional study included 40 women with PCOS based on the International Evidence-based Guideline, 2018, and an equal number of matched healthy controls from a university hospital between July 2020 and September 2021. Along with clinical information, fasting, and OGTT, blood was drawn to measure glucose, lipid, C-reactive protein, insulin, and afamin by glucose oxidase, glycerol phosphate dehydrogenase peroxidase, immunonephelometry, chemiluminescence immunoassay, and sandwich enzyme-linked immunosorbent assay, respectively. Results: Serum afamin levels were statistically similar between PCOS and control [3.3 (0.1–10.8) vs. 0.5 (0.1–4.8), mg/l, median (IQR); p = 0.077]. Among individuals with MS, PCOS patients exhibited significantly higher afamin levels than the control group [5.0 (2.4, 11.6) vs. 0.1 (0.1, 0.1); p = 0.004]. Serum afamin levels had negative and moderate correlations with LDL cholesterol [ρ = −0.31, p = 0.049] in women with PCOS. Those with MS had lower afamin levels [0.1 (0.1, 0.1) vs. 1.3 (0.1, 5.6); p = 0.030] than those without MS among healthy controls. Afamin was a poor marker [AUC (95% CI): 0.6 (0.5–0.7); p = 0.088] of PCOS but not for IR and MS among women with PCOS. Conclusions: Afamin had a significant association with PCOS only in those with MS. However, it could not be used as a valuable marker of PCOS or a marker of IR or MS in PCOS. It may be inversely correlated with LDL cholesterol in PCOS and inversely associated with MS in healthy controls.