RESUMEN
CONTEXT: Adipsin, a protein secreted mainly from the adipose tissue, is a structural homologous of complement factor D, a rate-limiting enzyme of the alternative complement system. Growing evidence suggests that the alternative complement system plays a role both in the regulation of energy homoeostasis and in the atherosclerosis. Polycystic ovary syndrome (PCOS) is a reproductive and metabolic disease. OBJECTIVE: To ascertain whether circulating adipsin levels are altered in women with PCOS, and whether there is an association between adipsin and metabolic parameters or carotid intima media thickness (CIMT). PARTICIPANTS: A total of 144 women with PCOS and 144 age- and BMI-matched controls without PCOS were recruited for this cross-sectional study. MAIN OUTCOME MEASURES: Circulating adipsin levels were measured using ELISA. Metabolic, hormonal parameters and CIMT were also determined. RESULTS: Adipsin levels were significantly elevated in women with PCOS compared with controls (91·52 ± 14·11 vs 60·31 ± 9·71 ng/ml, P < 0·001). Adipsin positively correlated with BMI, homoeostasis model assessment of insulin resistance (HOMA-IR), free testosterone, high-sensitivity C-reactive protein (hs-CRP) and CIMT in both groups. Multivariate logistic regression analyses revealed that the odds ratio for PCOS was 3·25 for patients in the highest quartile of adipsin compared with those in the lowest quartile (OR=3·25, 95% CI=2·64-4·00, P = 0·016). Our findings further indicate that BMI, HOMA-IR, hs-CRP and free testosterone are independent factors influencing serum adipsin levels and that adipsin is an independent predictor for CIMT. CONCLUSION: Circulating adipsin levels are significantly higher in women with PCOS, and the peptide is closely related to increased cardiovascular risk and metabolic disturbances.