Diagnostic Value and Metabolic Association of Serum Clusterin in Women with Polycystic Ovary Syndrome

<b>Background:</b> Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and an increased prevalence of metabolic syndrome. Clusterin (CLU), a chaperone protein induced by cellular stress and known to play roles in inflammation, oxidative stress, and lipid metabolism, may be associated with the metabolic abnormalities observed in patients with PCOS. The purpose of this current study is to investigate serum CLU levels and their link with endocrine, biochemical, and metabolic parameters, such as metabolic syndrome, among women with PCOS. <b>Methods:</b> This cross-sectional study included 40 women aged 18-30 with PCOS diagnosed according to the Rotterdam criteria and 40 age- and BMI-matched healthy controls. Demographic data, Ferriman-Gallwey scores, hormonal and metabolic parameters (including TSH, prolactin, 17-OH progesterone, total testosterone, insulin, AMH, HOMA-IR, and serum CLU levels), and ultrasonographic ovarian morphology were assessed. Statistical analyses, including ROC and logistic regression, were performed. <b>Results:</b> Women with PCOS had higher follicle counts, Ferriman-Gallwey scores, LH/FSH ratios, fasting insulin levels, HOMA-IR, triglycerides, and systolic blood pressure than controls, whereas menstrual cycle frequency and HDL levels were lower (all <i>p</i> < 0.05). Serum CLU concentrations were markedly higher in the PCOS cohort. In the PCOS population, CLU showed positive relationships with the Ferriman-Gallwey score, fasting glucose, fasting insulin, HOMA-IR, and triglycerides, and a negative correlation with HDL. CLU levels were significantly higher in women with metabolic syndrome in the PCOS cohort compared to those without. In logistic regression analysis, CLU, AMH, and the LH/FSH ratio emerged as independent predictors of PCOS. Furthermore, CLU remained an independent predictor of metabolic syndrome in the PCOS cohort. In ROC analysis, CLU demonstrated strong diagnostic efficacy in detecting both PCOS (AUC = 0.834) and metabolic syndrome in patients with PCOS (AUC = 0.804). <b>Conclusions:</b> Our results show that serum CLU is higher in women with PCOS and is associated with the clinical and metabolic features peculiar to patients with PCOS. CLU was found to distinguish between patients with PCOS and healthy women and demonstrated a strong association with the presence of metabolic syndrome within the PCOS group. Overall, these findings suggest that CLU may be a valuable auxiliary biomarker for detecting women with PCOS at risk for metabolic disturbances.