Skip to main navigation menu Skip to main content Skip to site footer

Clinical Research

Vol 8 No 2 (2023): December

Evaluation of Serum Fetuin-A as A Possible Marker for Polycystic Ovarian Syndrome Among Iraqi Women; Case-control Study

(*) Corresponding Author
August 31, 2023


Elevated levels of Fetuin-A, a protease inhibitor belonging to the cystatin family, have raised questions about its role in the pathogenesis of Polycystic Ovarian Syndrome (PCOS), the most prevalent endocrinopathy in reproductive-aged females. This case-control study, conducted in Iraq, aimed to assess changes in Fetuin-A levels among Iraqi women with PCOS. A convenient sample of 90 women, comprising 45 PCOS cases and 45 healthy controls, was enrolled. Fetuin-A levels were measured and found to be significantly higher in the PCOS group compared to controls. Additionally, significant positive correlations were observed between Fetuin-A levels and fasting plasma glucose, fasting serum insulin, insulin resistance, luteinizing hormone, and serum testosterone. Using a receiver operating characteristic curve, a cutoff point of 502.00 ng/mL was determined for predicting positive Fetuin-A levels, with a sensitivity and specificity of 84.4% and 73.3%, respectively. This study suggests that Fetuin-A could serve as a valuable marker for both screening and evaluating PCOS and its potential late consequences, including metabolic syndrome.


  • Elevated Fetuin-A Levels: This study reveals significantly higher Fetuin-A levels in PCOS, shedding light on its potential role in the pathogenesis of the syndrome.

  • Correlations with Metabolic Factors: Positive correlations between Fetuin-A and key metabolic markers like fasting glucose, insulin resistance, and luteinizing hormone highlight its relevance in the context of PCOS and metabolic health.

  • Screening Potential: The identified cutoff point for predicting positive Fetuin-A levels offers a promising tool for screening and evaluating PCOS and associated late consequences, particularly metabolic syndrome.


  1. S. Arentz, J. A. Abbott, C. A. Smith, dan A. Bensoussan, "Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings," BMC complementary and alternative medicine, vol. 14, no. 1, pp. 1-19, 2014.
  2. K. Edmonds, C. Lees, dan T. Bourne, Dewhurst's Textbook of Obstetrics & Gynaecology, 9th ed., Wiley, 2018.
  3. C. C. Dennett dan J. Simon, "The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment," Diabetes Spectrum, vol. 28, no. 2, pp. 116-120, 2015.
  4. R. Azziz, "Introduction: Determinants of polycystic ovary syndrome," Fertility and Sterility, vol. 106, no. 1, pp. 4-5, 2016.
  5. M. T. Dattani dan C. G. D. Brook, Brook's Clinical Pediatric Endocrinology, 7th ed., John Wiley & Sons, 2019.
  6. R. D. Nadaraja, M. Pavai Sthaneshwar, dan M. B. Nuguelis Razali, "Establishing the cut off values of androgen markers in the assessment of polycystic ovarian syndrome," The Malaysian journal of pathology, vol. 40, no. 1, pp. 33-39, 2018.
  7. L. Ibáñez et al., "An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence," Hormone Research in Paediatrics, pp. 371-395, 2017.
  8. S. F. Witchel, S. E. Oberfield, dan A. S. Peña, "Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls," Journal of the Endocrine Society, vol. 3, no. 8, pp. 1545-1573, 2019.
  9. R. C. Fernandez et al., "Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies," Nat Sci Sleep, vol. 10, pp. 45-64, 2018.
  10. J. F. Trepanowski, J. Mey, dan K. A. Varady, "Fetuin-A: a novel link between obesity and related complications," International Journal of Obesity, vol. 39, no. 5, pp. 734-741, 2015.
  11. J. Ochieng et al., "Impact of Fetuin-A (AHSG) on Tumor Progression and Type 2 Diabetes," International Journal of Molecular Sciences, vol. 19, no. 8, p. 2211, 2018.
  12. L. Bourebaba dan K. Marycz, "Pathophysiological Implication of Fetuin-A Glycoprotein in the Development of Metabolic Disorders: A Concise Review," Journal of Clinical Medicine, vol. 8, no. 12, p. 2033, 2019.
  13. M. K. Jensen et al., "Genetically Elevated Fetuin-A Levels, Fasting Glucose Levels, and Risk of Type 2 Diabetes," The Cardiovascular Health Study, vol. 36, no. 10, pp. 3121-3127, 2013.
  14. S. Sak et al., "Associations of serum fetuin-A and oxidative stress parameters with polycystic ovary syndrome," Clin Exp Reprod Med, vol. 45, no. 3, pp. 116-121, 2018.
  15. M. E. Smet dan A. McLennan, "Rotterdam criteria, the end," Australas J Ultrasound Med, vol. 21, no. 2, p. 59, 2018.
  16. R. A. Lobo, D. M. Gershenson, G. M. Lentz, dan F. A. Valea, Comprehensive Gynecology, Elsevier, 2016.
  17. S. Liu et al., "Serum Fetuin-A levels are increased and associated with insulin resistance in women with polycystic ovary syndrome," BMC Endocr Disord, vol. 20, no. 1, p. 67, 2020.
  18. E. Bayramoğlu et al., "Evaluation of the pathophysiological role of Fetuin A levels in adolescents with polycystic ovary syndrome," Journal of Pediatric Endocrinology and Metabolism, vol. 34, no. 7, pp. 911-916, 2021.
  19. S. ElSirgany et al., "Serum Fetuin a Level: A New Possible Marker for Polycystic Ovarian Syndrome in Women with Infertility," Obstetrics and Gynecology Research, vol. 2, no. 4, pp. 100-107, 2019.
  20. N. Malini dan K. R. George, "Evaluation of different ranges of LH: FSH ratios in polycystic ovarian syndrome (PCOS)–Clinical based case control study," General and comparative endocrinology, vol. 260, pp. 51-57, 2018.
  21. O. A. Kensara, "Prevalence of hypovitaminosis D, and its association with hypoadiponectinemia and hyperfollistatinemia, in Saudi women with naïve polycystic ovary syndrome," Journal of Clinical & Translational Endocrinology, vol. 12, pp. 20-25, 2018.
  22. H. Rashidi, S. B. Ghaderian, dan L. Moradi, "The effect of vitamin D3 on improving lipid profile, fasting glucose and insulin resistance in polycystic ovary syndrome women with vitamin D deficiency," Middle East Fertility Society Journal, vol. 23, no. 3, pp. 178-183, 2018.
  23. M. R. Halawa et al., "Chemerin level in a sample of Egyptian females with PCOS and its relation to insulin resistance," The Egyptian Journal of Internal Medicine, vol. 32, no. 1, p. 18, 2020.
  24. M. Aghilla, R. Adya, B. Tan, H. Lehnert, K. Ashawesh, dan H. Randeva, "The Hepatokine Fetuin-A is increased in PCOS women. Association with metabolic syndrome and regulation by metformin," dalam Endocrine Abstracts, 2012: BioScientifica.
  25. I. Gulhan, G. Bozkaya, D. Oztekin, I. Uyar, A.G. Kebapcilar, dan B. Pamuk, "Serum Fetuin-A levels in women with polycystic ovary syndrome," Arch Gynecol Obstet, vol. 286, no. 6, hal. 1473-1476, 2012.
  26. T. Gurbuz, S.A. Tosun, A. Cebi, O. Gokmen, dan M. Usta, "Investigating Fetuin-A and Paraoxonase-1 Activity as Markers in Polycystic Ovary Syndrome Based on Body Mass Index: A Prospective Case-Control Study," Cureus, vol. 13, no. 10.
  27. Y. Enli, S.M. Fenkci, V. Fenkci, dan O. Oztekin, "Serum Fetuin-A levels, insulin resistance and oxidative stress in women with polycystic ovary syndrome," Gynecol Endocrinol, vol. 29, no. 12, hal. 1036-1039, 2013.


Download data is not yet available.