Interpretation
As we all know, Polycystic ovary syndrome (PCOS) is a highly
heterogeneous endocrine disorder characterized by hyperandrogen, rare
ovulation and polycystic ovary, and its pathogenesis is
debated14-16.Previous studies have demonstrated that
the core etiology and primary endocrine characteristics of PCOS are
insulin resistance (IR) and hyperandrogenemia (HA), and they can
interplay each other leading to metabolic syndrome, especially
dyslipidemia17-21. AMH are often used as clinical
observation indicators reflecting the ovarian
reserve22,23, and the LH/FSH and T levels were
significantly higher in PCOS patients compared with control
patients24,25.Compared with those characteristics
related to PCOS, the expression level of ANGPTL4 in ovarian GCs might be
a independent factor which affected incidence of PCOS and could serve as
a new predictor for PCOS according to results of ROC cure and binary
logistic regression analysis.
As a member of angiopoietin-like proteins (Angptls) family, ANGPTL4 has
been extensively investigated, reporting its involvement in
physiological and pathological conditions including energy metabolism,
tumorigenesis, vascular homeostasis, and inflammation26-30. One of the extensively investigated roles of
ANGPTL4 is its role in lipid metabolism, specifically regulating LPL
activity to clear triglycerides (TG) from the
circulation8.In addition, a recent study demonstrated
that ANGPTL4 knock out mice markedly improved glucose tolerance with
increased insulin levels31.Güneş M et al10 revealed that there was a significant increase in
level of serum ANGPTL4 compared to control women and IR was
significantly associated with ANGPTL4 concentrations in patients. Those
were corresponding to the result in our study that the ANGPTL4
expression in ovarian GCs was positively correlated with HOMA-IR, as
well as related to lipid metabolic characteristics such as LDL/HDL,
ApoB/ApoAI and TC/HDL. In view of the finding of our study, ANGPTL4
might participant in the glucose and lipid metabolism in the ovarian
surroundings, which might affect the occurrence and development of PCOS.
In addition, ANGPTL4 also acts as an apoptosis survival factor for
vascular endothelial cells. It plays a key role in the late stages of
folliculogenesis and participant in providing oxygen and nutrients to
growing follicles 32,33. Our study showed the
positively correlation between ANGPTL4 expression and AMH, and indicated
its possible impact on follicular development. All of our findings were
preliminary, more mechanisms research are still expected.
High expression of ANGPTL4 in ovarian GCs with PCOS and its strongly
association with multiple glucose and lipid metabolism characteristics
suggests that ANGPTL4 expression level might play an important role in
pathogenesis and development of PCOS, and could offer a
granulosa-cell–derived marker for PCOS prediction. Our findings also
raise serious of important new questions. What is mechanism of ANGPTL4
expression in PCOS? What is the role of ANGPTL4 signaling for metabolism
in the ovarian GCs? All these questions have not yet been reported.