Abstract
PURPOSE: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder, and the role of fibroblast growth factor 21 (FGF21), a metabolic regulator, in its pathophysiology remains unclear. In this context, this study aims to evaluate the FGF21 levels in women with PCOS compared to healthy control subjects and investigate the relationship between FGF21 and obesity. PATIENTS AND METHODS: The population of this prospective, non-randomized, controlled study comprised consecutive female patients aged 18-55 years who presented to the outpatient clinics of a tertiary hospital between October 2017 and February 2018. At least two of the three parameters of the Rotterdam Consensus Criteria were regarded in diagnosing PCOS. Ninety-two patients with (n=62) and without PCOS (n=30) were categorized based on their BMI values. Participants' serum FGF21 levels were measured, and the relationships between FGF21 levels and parameters such as age, body mass index (BMI), waist circumference, body fat percentage, and homeostasis model assessment insulin resistance (HOMA-IR) were analyzed. The study's primary and secondary outcomes were the difference in serum FGF21 levels between the patient and control groups and the impact of obesity on FGF21 levels in both groups. RESULTS: The median age of the patient group was significantly lower than the control group (31.5 years vs 24.0 years, p<0.001). There was also a significant difference between the groups in HOMA-IR (p=0.020). On the other hand, there was no significant difference between the groups in FGF21 level (p>0.05). Analysis revealed no significant effects of age or HOMA-IR on FGF21 levels. BMI had a marginal impact on FGF21 levels regardless of PCOS status. Statistically significant positive correlations between FGF21 and DHEAS were detected in the study population (rho=0.282, p=0.007) and all PCOS patients (rho=0.364, p=0.004). CONCLUSION: FGF21 does not appear to play a significant role in the pathophysiology of PCOS or its associated metabolic abnormalities.