Extracellular Matrix Metalloproteinases-9 Profile: Shedding Light on the Polycystic Ovary Syndrome in Jordanian Females

Abstract ID 130398 Poster Board 009 Introduction: Polycystic ovary syndrome (PCOS) is a chronic endocrine and reproductive disorder that globally impacts females of reproductive age. This condition is marked by such as hyperandrogenism, polycystic ovaries, and irregular menstrual cycle. Acne, hirsutism, and alopecia are the main clinical manifestations of PCOS. Matrix metalloproteinases (MMPs), a family of 26 zinc-dependent endopeptidases, are thought to play crucial roles in follicular development and the pathogenesis of PCOS. However, conflicting results exist regarding the changes in concentrations or activities of MMP2 and MMP9 in PCOS. They are essential for biological processes such as ovulation, blastocyst implantation, embryonic development, and organ morphogenesis. To our knowledge, this study represents the initial investigation into MMP9 levels and their association with diverse clinical characteristics in Jordanian women with PCOS. The objective of this study is to measure serum MMP-9 levels and its inhibitor TIMP-1 in PCOS patients, comparing them with those in healthy controls. Additionally, we aim to analyze clinical predictors and clarify the significance of selected variables in PCOS diagnosis. Methods: In this observational study, 123 PCOS patients and 141 age-matched healthy women were enrolled. PCOS patients referred to the hospital-based Outpatient Gynecology Department in King Abdullah II University Hospital, Jordan, between January 2021 and April 2022, were diagnosed by a specialized gynecologist using the Rotterdam consensus criteria. Participants provided informed consent, and the project received approval from the Research Ethics Committee at Jordan University of Science and Technology and King Abdullah II University Hospital, Jordan. Blood samples were collected from both control and PCOS subjects. Serum MMP9 and TIMP1 concentrations were measured using ELISA kits, following the manufacturer's instructions. Results: Patients and healthy subjects were well-matched in age, body mass index (BMI), and smoking status, with no statistically significant differences. PCOS patients showed significantly higher levels of serum MMP-9 and TIMP-1, along with a higher MMP-9/TIMP-1 ratio compared to healthy controls (p ≤ 0.05). The Receiver Operating Characteristic (ROC) curves for MMP-9, TIMP-1 and the MMP-9/TIMP-1 ratio for PCOS diagnosis were generated, with areas under the curve (AUCs) of 0.617, 0.641 and 0.575, respectively. Significant correlations were noted between circulatory MMP9 levels and its inhibitor with patient's BMI, high-density lipoprotein, and menstrual cycle durations (p ≤ 0.05). However, these correlations were not observed in PCOS patients. Conclusion: Women with PCOS exhibit increased serum levels of MMP-9 and TIMP-1, along with an elevated MMP-9/TIMP-1 ratio. This imbalance favors a pro-proteolytic environment, highlighting the potential significance of the MMP-9/TIMP-1 ratio as a biomarker for PCOS diagnosis. Keywords: Matrix Metalloproteinases; Polycystic Ovary Syndrome; Receiver Operating Characteristic; Gelatinases.