Independent Elevation of Leptin and Reduction of Protective Adipokines in Polycystic Ovary Syndrome: A BMI-Matched Case–Control Study

Heqiu Yan,1,* Li Wang,1,2,* Guohui Zhang,2,3 Yuhong Zhao,2,3 Min Jiang,2,3 Jun Liu,2,3 Qin Zeng,1– 3 Jiuzhi Zeng,1– 3 Fangyi Long,3 Xia Bai,3 Mengjun Luo,4 Weixin Liu1– 3 1Key Laboratory of Reproductive Medicine, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Sichuan Provincial Women’s and Children’s Hospital, Chengdu, Sichuan, People’s Republic of China; 2Reproductive Medicine Center, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Sichuan Provincial Women’s and Children’s Hospital, Chengdu, Sichuan, People’s Republic of China; 3Laboratory Medicine Center, The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, Sichuan Provincial Women’s and Children’s Hospital, Chengdu, Sichuan, People’s Republic of China; 4Department of Clinical Laboratory, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mengjun Luo, Email [email protected] Weixin Liu, Email [email protected]: Dysregulated inflammatory cytokines and adipokines are implicated in PCOS pathogenesis, but their independent role remains unclear due to the confounding effect of obesity. This study employed a BMI-matched design to specifically investigate adipokine alterations intrinsic to PCOS, independent of body mass.Patients and Methods: This investigation employed a case-control design and included 70 PCOS patients and 82 healthy controls matched for age and BMI. Serum levels of leptin (LEP), interleukin-6 (IL-6), omentin, adiponectin (ADPN), ghrelin, retinol-binding protein 4 (RBP4), and orexin-A (OXA) were measured. Spearman correlation analysis was used to analyze the correlation between PCOS and glucose and lipid metabolism, reproductive hormones and adipokines. Multivariate logistic regression analysis identified independent risk factors for PCOS. Subsequently, the diagnostic capacity of significant variables was appraised using ROC analysis.Results: Compared with healthy controls (n = 82), women with PCOS (n = 70) exhibited significantly higher levels of LEP and IL-6, and significantly lower levels of OXA, omentin, and ADPN/LEP ratio (P < 0.05). No significant differences were observed in the levels of ADPN, Ghrelin, and RBP4. PCOS positively correlated with HOMA-IR, TG, testosterone (TSTO), Anti-Müllerian Hormone (AMH), LEP, and IL-6, and negatively correlated with omentin, OXA, ADPN/LEP ratio, and HDL-C (P < 0.05). Multivariable logistic regression analysis identified LEP as an independent risk factor for PCOS, while omentin and OXA were protective factors (P < 0.05).Conclusion: This study reveals that patients with PCOS exhibit a specific pattern of adipokine dysregulation, independent of obesity, characterized by elevated LEP coupled with reduced omentin and orexin-A, which may play a pivotal role in disease pathogenesis. These findings highlight the potential clinical value of assessing adipokine profiles and developing targeted interventions, thereby offering novel strategies for the diagnosis and treatment of PCOS.Keywords: PCOS, adipokines, inflammation, metabolic dysregulation