A possible connection between tumor necrosis factor alpha and adropin levels in polycystic ovary syndrome

Context Adropin is a peptide hormone implicated in the regulation of insulin sensitivity and energy homeostasis. Polycystic ovary syndrome (PCOS) is a metabolic and reproductive disease associated with insulin resistance. It has been demonstrated that various inflammatory markers increased in PCOS including TNF-alpha. TNF-alpha regulates the secretion of certain peptides which play a crucial role in glucose and lipid homeostasis. There is also some evidence of a link between TNF-alpha and adropin. Objective To ascertain whether there is an association between circulating adropin levels and TNF-alpha in PCOS. Patients and design 152 women with PCOS and 152 age- and body mass index-matched controls without PCOS were recruited for this cross-sectional study. Main outcome measures Adropin and TNF-alpha levels were measured using ELISA. Results Adropin levels were lower in the PCOS group compared with the control group (7.43 +/- 0.79 vs. 9.42 +/- 0.76 ng/ml, P < 0.001), whereas TNF-alpha levels were higher (49.93 +/- 3.39 vs. 35.83 +/- 2.47 pg/ml, P < 0.001). A strongly negative correlation was found between circulating adropin levels and TNF-alpha levels in women with PCOS (r = -0.407, P < 0.001). Binary logistic regression analysis revealed that decreased adropin levels were significantly associated with high odds of having PCOS, although, after adjustment for TNF-alpha, this link vanished. Additionally, multiple linear regression analysis showed that HOMA-IR and TFN-alpha independently predicted adropin levels. Conclusions Serum adropin levels are significantly decreased in PCOS and are inversely associated with TNF-alpha. Further dissection of the nature of this association can open new therapeutic options for metabolic diseases.