Investigation of Serum PAPP-A, IGF-II, and IGFBP-4 Levels in Patients with Polycystic Ovary Syndrome - A Prospective Case-Control Study

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.