Correlation between alteration of MFAP5 level and improvement of clinical indicators in patients with overweight polycystic ovary syndrome treated with metformin combined with liraglutide

Abstract

Objective To explore the role and underlying mechanism of microfibrillar associated protein 5 (MFAP5) in the treatment of overweight polycystic ovary syndrome (PCOS) with metformin combined with glucagon-like peptide-1 receptor agonist (GLP-1RA), liraglutides, by analyzing the correlation of the molecule alteration with improvement of metabolic indexes. Methods Twenty-three overweight or obese PCOS patients who were treated with metformin combined with liraglutide for 12 weeks in our hospital during December 2019 and February 2021 were retrospectively enrolled. According to body mass index (BMI), the subjects were divided into obese group (n=12) and overweight group (n=11). They were all given oral administration of metformin hydrochloride enteric-coated tablet (0.5 g, 3 times/day) and subcutaneous injection of liraglutide injection (primarily, 0.6 mg, once/day, and then increased to 1.2 mg, once/day, 1 week later, with the maximum dose of 1.8 mg). Physical measurement indicators, metabolic and inflammatory related indicators and sex hormone levels of the 2 groups were collected before and after 12 weeks of treatment. Plasma MFAP5 level was detected by ELISA. Results After 12 weeks of treatment, physical measurement indicators, glucose and lipid metabolism indicators, inflammatory indicators and sex hormone levels were all improved in both groups (P < 0.05). Correlation analysis showed that the alteration of plasma MFAP5 level in all patients were positively correlated with the changes of body weight (r=0.520, P=0.011), BMI (r=0.469, P=0.024), waist circumference (r=0.634, P=0.001), hip circumference (r=0.587, P=0.001), fasting insulin (r=0.602, P=0.002) and triglyceride (r=0.556, P=0.002). For the patients form the overweight group, their change of plasma MFAP5 level had a positive correlation with the changes of glucolipid metabolism related indicators, including insulin at 60 min in insulin releasing test (r=0.602, P=0.002) and triglyceride (r=0.655, P=0.029). In the obese group, the change of plasma MFAP5 level was positively correlated with the changes of waist circumference (r=0.495, P=0.002), hip circumference (r=0.508, P=0.010), glucolipid metabolism related indicators, such as fasting insulin (r=0.578, P=0.001), insulin at 180 min (r=0.656, P=0.021), HOMA-IR (r=0.497, P=0.012), triglyceride (r=0.595, P=0.041), and sex hormone. Conclusion In overweight PCOS patients, plasma MFAP5 level is related to the improvement of glucolipid metabolism. MFAP5 may be a related molecule involved in the treatment of overweight PCOS with liraylutide combined with metformin, and may serve as a reliable indicator in monitoring of therapeutic efficacy.

Keywords

• metformin
• glucagon-like peptide-1 receptor agonist
• liraylutide
• overweight polycystic ovary syndrome
• glucolipid metabolisim
• microfibrillar associated protein 5