دور Neudesin و Neuregulin-4 في الآلية الحيوية لمقاومة الأنسولين بين الأنماط الظاهرية لمتلازمة تكيس المبايض

Role of Neudesin and Neuregulin-4 in the Biochemical Mechanism of Insulin Resistance Amongst Polycystic Ovary Syndrome Phenotypes

Polycystic ovarian syndrome is a syndrome of ovarian dysfunction that is characterized by the presence of cardinal features of hyperandrogenism and polycystic ovary morphology. Clinical or biochemical hyperandrogenism (HA), ovulatory dysfunction (oligo/amenorrhea) (OD), and/or polycystic ovarian morphology (PCOM) are the three criteria that have been used to characterize PCOS since the creation of the Rotterdam Consensus in 2003, PCOS presence of at least two out of three criteria. This definition results in several PCOS phenotypes, such as phenotype A (HA, OD, PCOM), phenotype B (HA, OD), phenotype C (HA, PCOM), and phenotype D (OD, PCOM).
Neudesin(NENF) and Neuregulin 4(NRG4) are adipokines members that synthesize adipose tissues, based on metabolic and cardiovascular dysfunctions, assessing abdominal obesity in patients with PCOS may be critical. Research on the NENF and NRG4 plays roles in metabolic regulation, which may be considered potential insulin resistance markers in some medical conditions, such as diabetes mellitus, obesity, and PCOS, which has recently gained interest. In spite of that the NENF, NRG4 with PCOS phenotype relationship is poorly represented in the literature. Therefore, the aim of this study would bring to light the role of Neudesin and neuregulin_4 as a biomarker for insulin resistance in females affected by different phenotypes of PCOS.
Methods: This study was designed as a case-control study, with a total of 210 participants including 140 female cases effect by different phenotypes of PCOS. Patient samples were collected from the reproductive fertility consultant of the Teaching Hospital of Obstetrics and Gynecology, Kerbala health directorate/ Iraq. Serum hormonal levels and insulin concentration were determined by the electrochemiluminescence immunoassay “ECLIA” system (Cobas e 411, Roche Diagnostic, Germany). Fasting blood glucose was determined by a clinical chemistry analyzer (Monarch 240, Biorex Diagnostic, United Kingdom). Serum lipid panel ( (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG)) were measured using fully automatic chemistry analyzer (SMART-120, Geno TEK, United States of America). Serum-free testosterone hormone was measured using a fully -auto chemiluminescence immunoassay analyzer (( MAGLUMI 600, Snibe Diagnostic, Germany). Elisa system was used for the detection of Neudesin and Neuregulin-4 protein level. Anthropometric Measurements ) Visceral Adiposity Index (VAI), lipid accumulation product (LAP) and The Body Adiposity Index (BAI) ) , Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Basal Metabolic Rate (BMR) values measurements were also evaluated.
As a result, classic PCOS (phenotype A) showed a high prevalence (49.28%). In phenotype A, NRG4 level was shown a significant increase compared to other phenotypes, while NENF level was highly significant in phenotype C, and it was twice risk factor as in phenotype B.
Results of the receiver operating curve (ROC) were shown that NRG4, has the best performance for predicting PCOS patients specially phenotypes A. BAI has a good performance for prediction group B. While LAP and BAI were the best predictions for phenotypes group C. NRG4 and NENF have a good performance for prediction group D.
In conclusion, the levels of NRG4 and NENF significantly increased in all PCOS phenotypes, the metabolic indices have a significant correlation with all phenotypes. Abdominal visceral obesity played a significant role in the development of metabolic changes, irrespective of the PCOS phenotypes.