Pentraxin 3 levels in polycystic ovary syndrome: a meta-analysis

Pentraxin 3 (PTX3) is an immunomodulatory molecule involved in inflammation and ovarian physiology. However, its circulating levels in polycystic ovary syndrome (PCOS) remain uncertain due to inconsistent findings. This meta-analysis aimed to clarify the association between PTX3 levels and PCOS. A systematic search of PubMed, Embase, Scopus, Web of Science, CNKI, and Google Scholar was conducted up to April 2025 without language restrictions. Observational studies comparing circulating PTX3 levels between patients with PCOS and healthy controls were included. Effect sizes were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs) using a random-effects model. Nineteen studies (25 datasets) involving 1,230 women with PCOS and 1,179 controls were included. Pooled analysis showed significantly higher PTX3 levels in PCOS compared with controls (SMD = 0.993; 95% CI: 0.076 to 1.909; p = 0.034). In subgroup analysis by BMI, the most pronounced elevation in PTX3 concentrations was observed in women with a BMI between 25 and 30 kg/m² (SMD = 2.102; p = 0.008). Meta-regression analysis also identified age (β = 0.37, p = 0.026) as a positive and luteinizing hormone levels (β = − 0.33, p = 0.028) as a negative moderator of PTX3 concentrations. The observed increase in PTX3 concentrations in PCOS supports its role as a candidate biomarker for disease identification and monitoring. Future studies should clarify its relationship with infertility status, explore its role across different PCOS phenotypes, and address methodological heterogeneity to refine its clinical utility.