Circulating SFRP2 in Iranian Polycystic Ovarian Syndrome Patients with Infertility and Recurrent Pregnancy Loss and its Correlation with Insulin Resistance and Inflammation.

Abstract

Introduction: Secreted Frizzled-Related Protein 2 (SFRP2) is considered to be the most potent modulator of the Wnt signaling. This pathway is involved in the pathogenesis of Polycystic Ovary Syndrome (PCOS). This research aimed to compare the levels of SFRP2 in PCOS [infertile and Recurrent Pregnancy Loss (RPL) patients] with the control group and determine the correlation of SFRP2 with inflammation and insulin resistance.

Methods: This case-control study was conducted on 108 POCS patients (53 infertile patients and 55 women with RPL) and 54 healthy controls. The levels of biochemical factors along with SFRP2, adiponectin, Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), free testosterone, and insulin, high-sensitivity C-Reactive Protein (hs-CRP) were measured following the manufacturer's instructions.

Results: Both infertile and RPL groups presented notably higher levels of SFRP2 (49.32 ± 17.72 ng/ml and 55.89 ± 17.36 ng/ml, respectively) compared to the control group (30.21 ± 10.12 ng/ml, P<0.001 for both groups). In PCOS patients, a positive correlation was observed between SFRP2 and body mass index (BMI) (r = 0.42, P < 0.001), insulin (r = 0.19, P = 0.04), fasting blood glucose (FBG) (r = 0.24, P = 0.01), Homeostatic Model Assessment for Insulin Resistance (HOMA- IR) (r = 0.21, P = 0.03), triglyceride (r = 0.25, P = 0.009), and hs-CRP (r = 0.21, P = 0.02). Furthermore, SFRP2 increased the risk of RPL (OR [95% CI] = 1.15 [1.10 -1.20], P < 0.001) and infertility (OR [95% CI] = 1.12 [1.07 -1.17], P < 0.001) in comparison with the controls.

Conclusion: Our findings suggested that SFRP2 may have a potential involvement in the development of PCOS and might be a promising target for diagnosis, but additional research is required to confirm this.