Circulating resistin and follistatin levels in obese and non-obese women with polycystic ovary syndrome: A systematic review and meta-analysis.

Tahereh Raeisi,Leonardo Roever,Shimels Hussien Mohammed,Akram Taheri,Reza Mohseni,Mina Darand,Hossein Rezaie,Shahab Alizadeh,Bahman Razi,Nazila Garousi,Stephen L Atkin

doi:10.1371/journal.pone.0246200

Abstract

This meta-analysis was performed to resolve the inconsistencies regarding resistin and follistatin levels in women with polycystic ovary syndrome (PCOS) by pooling the available evidence. A systematic literature search using PubMed and Scopus was carried out through November 2020 to obtain all pertinent studies. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between the levels of resistin and follistatin with PCOS in the overall and stratified analysis by obesity status. A total of 47 publications, 38 for resistin (2424 cases; 1906 controls) and 9 studies for follistatin (815 cases; 328 controls), were included in the meta-analysis. Resistin levels were significantly higher in PCOS women compared with non-PCOS controls (WMD = 1.96 ng/ml; 95%CI = 1.25-2.67, P≤0.001) as well as in obese PCOS women vs. obese controls, and in non-obese PCOS women compared with non-obese controls, but not in obese PCOS vs. non-obese PCOS patients,. A significantly increased circulating follistatin was found in PCOS patients compared with the controls (WMD = 0.44 ng/ml; 95%CI = 0.30-0.58, P≤0.001) and in non-obese PCOS women compared with non-obese controls and in obese PCOS women vs. obese controls, but, no significant difference in follistatin level was observed in obese PCOS compared with non-obese PCOS women. Significant heterogeneity and publication bias was evident for some analyses. Circulating levels of resistin and follistatin, independent of obesity status, are higher in women with PCOS compared with controls, showing that these adipokines may contribute to the pathology of PCOS.

Highlights

Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disease affecting about 10% of reproductive-aged women [1], which is featured by clustering of biochemical and clinical hyperandrogenemia, hirsutism, acne, oligo-or anovulation and polycystic ovaries [2]
Resistin levels were significantly higher in obese PCOS women vs. obese controls (Fig 3 and Table 2), and in non-obese PCOS women compared with non-obese controls (Fig 4 and Table 2), but not in obese PCOS vs. non-obese PCOS patients (Fig 5 and Table 2)
The results revealed that, overall, resistin and follistatin levels were significantly higher in PCOS women compared with healthy controls

Summary

Introduction

Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disease affecting about 10% of reproductive-aged women [1], which is featured by clustering of biochemical and clinical hyperandrogenemia, hirsutism, acne, oligo-or anovulation and polycystic ovaries [2]. Resistin expression is reported to be up-regulated by dehydroepiandrosterone [12], proposing that resistin and androgen synthesis, a common condition in PCOS [13], may be related In line with these findings, Seow et al [14] found that upregulation of resistin might be involved in the pathogenesis of PCOS. Another adipokine that might play an important role in metabolic and endocrine complications in PCOS is follistatin, a member of the transforming growth factor-b superfamily [15], which acts as a significant regulator of follicular development and has been identified as a candidate gene for PCOS [16].

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Results

Conclusion