Investigation of Serum PAPP-A, IGF-II, and IGFBP-4 Levels in Patients with Polycystic Ovary Syndrome - A Prospective Case-Control Study
Mustafa Kemal OZEL, Onur EROL, Gül Alkan BULBUL, Hamit Yaşar ELLIDAG, Mehmet KARACA
Objective: The etiology of polycystic ovary syndrome involves complex interactions. Defining new
parameters will speed up the diagnostic process. Pregnancy-associated plasma Protein A, Insulin-like
Growth Factor II, and Insulin-like Growth Factor Binding Protein 4 are candidates for becoming new
parameters of the diagnostic process. The study aims to investigate the role of these parameters in the
etiopathogenesis of polycystic ovary syndrome.
Methods: The study was conducted on volunteer women of reproductive age who met the Rotterdam
diagnostic criteria. A total of 87 participants, consisting of 45 patients and 42 healthy controls, were
included in the study. The present study is a prospective, single-center study. The patients' hirsutism
scores were determined with the modified Ferriman-Gallwey scoring system. Ovaries were evaluated,
and Antral Follicle Count measurements were taken. Descriptive statistics were presented. Independent
risk factors were investigated through Logistic Regression Analyses.
Results: It was observed that the antral follicle count, Pregnancy-Associated Plasma Protein A, and
Insulin-like Growth Factor Binding Protein 4 values were significantly elevated in the PCOS group. In
the polycystic ovary syndrome cohort, Pregnancy-Associated Plasma Protein A values demonstrated a
significant positive correlation with FSH and HbA1c. The inclusion of the hirsutism score as a variable
demonstrated its significance (p=<0.001; OR=19.173, 95% CI: 6.101-60.251), whereas potential
marker levels were not independently associated with polycystic ovary syndrome risk.
Conclusion: Although some measurements between the groups differed in terms of potential markers,
the effectiveness of these three parameters did not reach the level of the hirsutism score.
