L-Selectin and Adiponectin as Novel Biochemical-Immune Markers for the Response of Infertile Polycystic Ovary Syndrome Patients to Metformin Treatment

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women throughout their lifespan. The prevalence of PCOS varies depending on the population studied, but it is estimated to affect between 10% and 13% or ∼140 million women globally. PCOS in adults is diagnosed according to the International Evidence-based Guideline Criteria based on two of either ovulatory dysfunction, clinical or biochemical hyperandrogenism, and/or polycystic ovary morphology (PCOM) on ultrasound or elevated anti-Müllerian hormone levels. Infertility is a serious global health problem affecting an estimated 50 to 70 million couples worldwide. Infertility is a condition in which pregnancy does not occur even after regular unprotected sex for more than one yearو for women under 35 years of age, a couple's failure to conceive after 12 months of regular sexual activity without using contraception, and after 6 months for women 35 years of age or older. Infertility results in disability expressed through impaired function, social exclusion, and psychological trauma; thus, it is ranked by the World Health Organization as the fifth highest serious disability worldwide. Population of the study: This study included samples of 90 women of reproductive age (20-40 years). They were distributed into three groups. The first: included 30 patients undergoing treatment for infertility due to PCOS, the second group included 30 patients who were diagnosed with PCOS through the simultaneous appearance of 3-4 symptoms that are essential for diagnosis. The third group (the control group) included 30 women who were completely free of symptoms of PCOS and all of whom had children without any medical intervention and did not suffer from any disease, based on clinical examinations and ultrasound examinations. Kits and technique: Sandwich-ELISA technique was applied to determine the level ofL-Selectin and Adiponectin in the serum samples of the study individuals. Results: Respectable statistical differences in L-Selectin levels were observed when comparing the group of PCOS patients treated with infertility drugs (p=0.000) and those with Untreated PCOS patients group as well as the members of the control group (p=0.000).The results showed a significant increase in adiponectin levels when comparing the three study groups together (p=0.000).The present data indicate a moderately positive correlation between L Selectin and adiponectin in PCOS patients treated with infertility drugs (r=0.408 at p=0.048), and healthy women (r=0.641 at p=0.046)the indicate a very weak and practically insignificant negative correlation between L-Selectin and adiponectin in the untreated PCOS group (r=0.168 at p=0.228). The study showed the highest sensitivity (97%) and specificity (97%) for adiponectin were recorded in the Metformin-treated group. The study revealed that adiponectin exhibited the highest individual sensitivity (93%) and specificity (97%) in the group of untreated PCOS patients. Conclusions: L-Selectin and adiponectin are promising tools for differentiating PCOS patients treated with Metformin and untreated PCOS patients.