Association between FGF-19, FGF-21 and lipocalin-2, and diabetes progression in PCOS
Women with polycystic ovary syndrome (PCOS) have an increased risk of developing type 2 diabetes. FGF-19, FGF-21 and lipocalin-2 have emerged as important markers of metabolic risk. This study aims to compare the levels of FGF-19, FGF-21 and lipocalin-2 between subjects with and without PCOS, and to investigate the relationship between the proteins and diabetes progression. In this nested case-control cohort study, 128 Chinese PCOS women and 128 controls were recruited and followed up. All subjects underwent the oral glucose tolerance test for the evaluation of glycaemic status. Baseline serum protein levels were measured using ELISA. Compared with controls, PCOS subjects had higher levels of FGF-19 (P<0.001) and FGF-21 (P=0.022), but lower lipocalin-2 (P<0.001). In total, 20.8% of PCOS and 9.2% of controls developed diabetes over a mean duration of 10.4 ± 1.2 and 11.3 ± 0.5 years, respectively. Logistic regression analyses suggested FGF-19 was positively associated with diabetes progression in controls, after adjusting for age, follow-up duration, waist and fasting glucose (P=0.026, OR (95% CI): 7.4 (1.3-43.6)), and the positive relationship between FGF-21 and diabetes progression in controls was attenuated by adjusting for age and follow-up duration (P=0.183). Lipocalin-2 was positively correlated with diabetes progression in PCOS group (P=0.026, OR (95% CI)): 2.5 (1.1-5.6)), however, this became attenuated after adjusting for waist and fasting glucose (P=0.081). In conclusion, there is differential expression of FGF-19, FGF-21 and lipocalin-2 in PCOS. The serum level of FGF-19, FGF-21 are associated with diabetes progression in women without PCOS, while lipocalin-2 was related to diabetes progression in PCOS women.