Serum Cystatin C levels in adolescent females: A comparative study between PCOS and Non-PCOS groups

Background: Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrine disorder affecting 15-20% of reproductive-aged women worldwide. It is characterized by a heterogeneous constellation of clinical, hormonal, and metabolic abnormalities, including hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. While its etiology is considered polygenic and influenced by environmental factors, the disorder also shows strong familial aggregation. Recent evidence suggests that cystatin C, a cysteine protease inhibitor and emerging biomarker of cardiovascular and metabolic risk, may be elevated in PCOS independent of renal function. Objective: This study aimed to evaluate the role of serum cystatin C as a predictive marker of metabolic and cardiovascular disturbances in adolescent females with PCOS. Methods: A cross-sectional case-control study was conducted at Tikrit Teaching Hospital from October 2024 to June 2025, including 60 adolescent girls with PCOS diagnosed using the Rotterdam criteria and 60 age-matched healthy controls. Detailed clinical, anthropometric, biochemical, hormonal, and ultrasonographic evaluations were performed. Serum cystatin C was measured using ELISA. Insulin resistance was assessed by HOMA-IR, and lipid profile parameters were analyzed. Statistical analysis included correlation testing, ROC curve analysis, and multivariate logistic regression. Results: Adolescents with PCOS demonstrated significantly higher BMI, blood pressure, hirsutism, menstrual irregularities, and acne compared to controls (p