Increased adipsin is associated with carotid intima media thickness and metabolic disturbances in polycystic ovary syndrome

ContextAdipsin, 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. ObjectiveTo 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). ParticipantsA total of 144 women with PCOS and 144 age- and BMI-matched controls without PCOS were recruited for this cross-sectional study. Main Outcome MeasuresCirculating adipsin levels were measured using ELISA. Metabolic, hormonal parameters and CIMT were also determined. ResultsAdipsin levels were significantly elevated in women with PCOS compared with controls (9152 1411 vs 6031 +/- 971 ng/ml, P < 0001). 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 325 for patients in the highest quartile of adipsin compared with those in the lowest quartile (OR=325, 95% CI=264-400, P = 0016). 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. ConclusionCirculating adipsin levels are significantly higher in women with PCOS, and the peptide is closely related to increased cardiovascular risk and metabolic disturbances.