Abstract
BackgroundHigh plasma concentrations of the vitamin E-binding protein afamin have been previously shown to be associated with insulin resistance and metabolic syndrome. We set out to determine whether the concentration of afamin in the serum of women with polycystic ovarian syndrome (PCOS) is elevated in relation to the presence and severity of insulin resistance (IR).MethodsThis cross-sectional study looked at 53 patients with PCOS and 49 non-PCOS patients. IR was diagnosed as a HOMA Index >2.4 and confirmed with a three-hour glucose tolerance test. Serum concentrations of afamin were determined using enzyme-linked immunosorbent assay (ELISA). Clinical characteristics, hormone and metabolic parameters were correlated to afamin concentrations.ResultsSerum concentrations of afamin did not differ between women with PCOS and controls. When separated according to the presence of IR a significant difference in median afamin levels was seen between PCOS with IR and PCOS without IR (73.06+/-27.36 mg/L and 64.25+/-17.41 mg/L, p = 0.033). No difference in afamin levels was detected when comparing the few controls with IR and the controls without IR (76.20+/-27.96 mg/L and 60.44+/-21.03 mg/L, p = 0.235). On univariate analyses, afamin serum concentrations significantly correlated with BMI, triglycerides, HOMA Index, and AUC–Insulin. On multivariate linear regression analysis, only triglyceride concentration was seen to be an independent predictor of afamin. Subjects with metabolic syndrome had higher median afamin concentrations than did those without metabolic syndrome (77.43+/-28.60 mg/L and 65.08+/-18.03 mg/L, p = 0.010).ConclusionsElevated afamin concentrations are associated with the presence of metabolic syndrome in young women and may potentially serve as an independent predictor for the development of metabolic syndrome in at-risk women, especially those with IR.
Highlights
High plasma concentrations of the vitamin E-binding protein afamin have been previously shown to be associated with insulin resistance and metabolic syndrome
On multivariable linear regression including as independent variables selected parameters that significantly correlated with afamin (BMI, LDL cholesterol, triglycerides, HOMA Index and fasting insulin) only triglyceride concentration was seen to be an independent predictor of afamin concentration (β coefficient = 0.271, p = 0.019, Durbin-Watson 1.468)
We found markedly elevated afamin concentrations in women with metabolic syndrome versus without, values that were more than 12 mg/L higher than in women without metabolic syndrome, as shown in Figure 2 (77.43+/−28.60 mg/L and 65.08+/−18.03 mg/L, respectively, (p = 0.010))
Summary
High plasma concentrations of the vitamin E-binding protein afamin have been previously shown to be associated with insulin resistance and metabolic syndrome. We set out to determine whether the concentration of afamin in the serum of women with polycystic ovarian syndrome (PCOS) is elevated in relation to the presence and severity of insulin resistance (IR). PCOS is a heterogeneous syndrome of unclear etiology with a prevalence of up to 20%, making it the most frequent endocrine disorder in women of reproductive age [2,3]. Women with PCOS exhibit a four-fold higher incidence of metabolic syndrome. The prevalence of metabolic syndrome in PCOS is reported to be 8%-50%, depending on study design and population [7,8,9]
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