Association Between Serum ANGPTL8 Levels and PCOS and Its Clinical Utility in Diagnosis

OBJECTIVE: To analyze the correlation between angiopoietin-like protein 8 (ANGPTL8) and polycystic ovary syndrome (PCOS) and explore the clinical diagnostic value of ANGPTL8 in PCOS. METHODS: In this retrospective case-control study, we included 94 PCOS patients (study group) from our hospital's Reproductive Center from June 2023 to December 2024 and 116 age-matched women with normal ovarian function (control group) from the Gynecology Department. Serum levels of anti-Müllerian hormone (AMH), sex hormones, and ANGPTL8 were measured in all participants. RESULTS: The study group exhibited higher AMH, LH, LH/FSH ratio, and E2 levels compared to the control group (p < 0.001). Serum ANGPTL8 levels were lower in PCOS patients (p < 0.001). Logistic multivariate regression analysis identified BMI, AMH, LH, and ANGPTL8 as independent influencing factors for PCOS. Elevated ANGPTL8 levels were associated with reduced PCOS risk (p < 0.001), while increased BMI, AMH, and LH levels correlated with higher PCOS risk (p < 0.05). At a cutoff value of 12.871 ng/mL, ANGPTL8 demonstrated a sensitivity of 90.4%, specificity of 77.6%, and an area under the curve (AUC) of 0.881 (95% CI: 0.836-0.926, p < 0.001), indicating moderate-to-high diagnostic efficacy. The combined use of ANGPTL8 with AMH or sex hormones improved diagnostic performance compared to individual markers. Notably, the combination of ANGPTL8 and sex hormones yielded a higher AUC (0.980) than ANGPTL8 with AMH (AUC = 0.928). CONCLUSION: Serum ANGPTL8 levels are significantly lower in PCOS patients and inversely associated with PCOS risk. ANGPTL8 shows promise as a novel diagnostic biomarker for PCOS, especially when integrated into multi-marker panels with existing hormonal parameters.