title: Increased levels of serum granzyme-B is associated with insulin resistance and increased cardiovascular risk in adolescent polycystic ovary syndrome patients.
abstract: OBJECTIVE
  Our aim was to determine serum perforin and granzyme-B levels in adolescent PCOS patients, and to investigate whether they are associated with some of the insulin sensitivity, obesity and cardiovascular (CV) risk markers and metabolic syndrome.
  
  
  METHODS
  A case-control study was carried out including a total of 172 adolescents (83 PCOS patients and 89 age-matched healthy controls). Participants were recruited consecutively. Homeostasis model assessment (HOMA-IR), lipid parameters, and anthropometric measurements were determined. Serum perforin and granzyme B levels were measured by commercially available ELISA kits. HOMA-IR>3.16 was considered to indicate the presence of insulin resistance. Logistic regression analysis was applied for the predictive value of granzyme-B for increased CV risk in PCOS patients.
  
  
  RESULTS
  As body mass index (BMI) of the PCOS patients was significantly higher than the controls (median 24.6kg/m(2) and 21.4kg/m(2), respectively, p<0.001) all parameters were evaluated after adjustment for BMI. Adolescents with PCOS had significantly higher levels of fasting glucose, insulin, HOMA-IR and granzyme-B when compared with controls. According to the results of logistic regression analysis, granzyme-B levels were found to be significantly associated with increased HOMA-IR (OR=6.120, 95% CI: 2.352-15.926, p<0.001) in adolescent PCOS patients. Additionally, elevated levels of serum granzyme-B were predictive for increased CV risk in PCOS patients (OR=0.237, 95% CI: 0.091-0.616, p=0.003).
  
  
  CONCLUSIONS
  Increased levels of serum granzyme-B are independently associated with insulin resistance and also with increased CV risk in adolescent polycystic ovary syndrome patients.
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey. Electronic address: efseroztas@gmail.com.
authors.forename: Efser
authors.initials: E
authors.lastname: Oztas
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Ozler
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Tokmak
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Nafiye
authors.initials: N
authors.lastname: Yilmaz
authors.affiliation: Turgut Ozal University Faculty of Medicine, Department of Clinical Biochemistry, Ankara, Turkey.
authors.forename: Huseyin Tugrul
authors.initials: HT
authors.lastname: Celik
authors.affiliation: Turgut Ozal University Faculty of Medicine, Department of Clinical Biochemistry, Ankara, Turkey.
authors.forename: Fatmanur Hacıevliyagil
authors.initials: FH
authors.lastname: Kazancı
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Danisman
authors.affiliation: Yildirim Beyazit University Faculty of Medicine, Department of Clinical Biochemistry, Ankara, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Ergin
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Pediatrics, Ankara, Turkey.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Yakut
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D053804:Granzymes / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D054353:Perforin / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D054353:Perforin; C509213:GZMB protein, human; D053804:Granzymes
keywords: Adolescent polycystic ovary syndrome; Cardiovascular risk; Granzyme-B; Insulin resistance; Perforin