ارتباط الزنك ألفا 2 كلايكوبروتين وبروتين الصدمة الحرارية 70 مع متلازمة تكيس المبايض لدى النساء العراقيات المصابات بالعقم

Association of Zinc Alpha 2 Glycoproteins and Heat Shock Protein 70 with Polycystic Ovarian Syndrome in Iraqi Infertile Women

Abstract

Polycystic ovary syndrome (PCOS) is imbalance hormone due to high level of androgen (male hormone) in females; Signs including absence of evolution of eggs (pre mature) and ovarian cysts and irregular menstrual periods, infertility, excess hair growth on face (hirsutism) and acne . Excessive insulin in the body stimulates the ovaries to produce excess androgen and increase the risk of development of type 2 diabetes.
Zinc alpha 2 glycoprotein (ZAG) is a single chain polypeptide with a molecular weight of 40-43 KiloDalton that is present in the majority of bodily fluids. Reduced ZAG levels lead to a reduced rates of lipolysis and associated with fat accumulating.
Heat Shock Proteins (HSP) are molecular chaperones that play a key role in maintaining protein homeostasis and transport. Heat shock proteins with a molecular weight of approximately 70 kD (Hsp70) are involved in assisting protein folding, preventing protein aggregation and transporting proteins across membranes . Inflammation causes the release of Hsp70 into the blood., serum Hsp70 levels might provide a marker for inflammatory processes .
The objective of study to evaluate ZAG levels in sera of PCOS patients and their association with infertility in comparison to those in the controls group, study the association between ZAG level with hormonal biomarkers and insulin resistance, Assessment of HSP70 levels in PCOS patients’ sera and compare them to those in the controls group, Investigate their relationship with hormonal biomarkers and insulin resistance.

A case-control study included 81 females, in reproductive age [18-45 years old] 50 of them were diagnosed with polycystic ovarian syndrome, while the other 31 were healthy controls which was divided in to three groups depending on fertility to primary infertility, secondary infertility for patients group and fertility for controls group the samples were collected from November 2020 till May 2021.
ZAG levels and HSP70 levels were measured by ELISA technique from Bioassay Lab company-china and biochemical variables BMI calculated weight divided on square height in meter (Kg/m2); hormonal LH, FSH, testosterone and HbA1c were measured by fluorescence Immunoassay ( Boditech –Korea), fasting blood glucose (FBG) level was measured by spectrophotometer (Liner-SPAIN), Fasting insulin by Cobas e411 (Roche-Germany).
The results of this study shows the mean of ZAG levels (μg/ml) were highly significant decrease in women with PCOS group as compare to controls group (P<0.001), and found that highly significant elevation in hormonal biomarkers that measured testosterone, LH, LH/FSH ratio and metabolic biomarkers FBG, fasting Insulin, HOMA-IR, HbA1c and BMI in patients group as compare to healthy groups while significant decrease in FSH in patients groups as compare to controls groups in P≤0.05. Also there is negative significant correlation between ZAG level, BMI, insulin resistance and LH p<0.001. The results observed in this study after dividing the groups according fertility degree (primary infertility, secondary infertility , fertility ) that the hormonal disorder and BMI in primary was higher than secondary infertility in patient groups. Also We found a significant decrease between groups primary infertility and secondary infertility in P≤0.05 that’s may be mean in lower ZAG level lead to increase infertility degree.
The mean of HSP70 levels (ng/ml) in patient group was significantly higher than that in the control group in (P<0.001). also found positive significant correlation between HSP70 and IR , F insulin in P≤0.05, p<0.001 respectively.
the observed data conclusion that ZAG level is decreased in PCOS patient and had negative correlation with BMI, IR, LH and it decrease with abnormal hormones levels, so it effects the fertility, when it’s decreased that leads to increase the degree of infertility. That mean levels of ZAG in primary infertility is lower than it’s levels in secondary infertility .
HSP70 level is increased in PCOS patient and had positive correlation with IR, F insulin level. and a significant high levels of the all hormones and parameters including LH, total testosterone, FBG, F insulin and HbA1c were found in women with PCOS as compared with the control, except the FSH values were decreased .
The reduction in ZAG levels in the sera of women with PCOS increase the risk of metabolic disorder, and it’s association with increase the risk of infertility.
The increase in HSP70 levels in sera of women with PCOS associated with increased risk of metabolic disorder and their complication in increase the infertility.