OXIDATIVE CAPACITY IN POLYCYSTIC OVARY SYNDROME: EXPLORATION AND WAY FORWARD
DOI:
https://doi.org/10.69656/pjp.v21i2.1810Keywords:
Alarin, Fetuin-A, Polycystic ovarian syndrome, PCOS, Total Oxidant Status, TOSAbstract
Background: Polycystic ovarian syndrome (PCOS) is a complex disorder characterized by elevated androgen levels, ovarian cysts, chronic anovulation, and infertility, with insulin resistance and hyperinsulinemia as key contributors. The study aims to explore the role of oxidative capacity in presentation of PCOS by estimating Total Oxidant Status (TOS), Alarin, and Fetuin in PCOS and non-PCOS infertile women. Methods: This cross-sectional study was conducted from Feb 2021 to Feb 2023. The study recruited 89 women with primary infertility aged 15-49 years. Participants were matched based on age and BMI, including women with a BMI ranging from normal to overweight/obese, while excluding those with secondary infertility, major health conditions, or oral contraceptive use. Healthy infertile women with regular cycles served as controls. Serum levels of TOS, Alarin, and Fetuin-A were measured using ELISA kits. Statistical analysis was performed using SPSS-23. Results: Forty-five (51%) of the participants had PCOS, with significantly higher BMI (p=0.002). Follicular Stimulating Hormone (FSH) and Latinizing Hormone (LH) levels were significantly elevated (p<0.001) in the PCOS group, while Anti-Mülarian Hormone (AMH) was significantly lower (p<0.001). Prolactin, vitamin D, and oxidative stress markers were comparable in both groups and were not significantly different as compared to the fertile females. The Spearman’s correlation computed that Prolactin significantly and negatively correlated with Fetuin-A and TOS, while positive correlations were found between Fetuin-A, Alarin, and TOS (p<0.001). Conclusion: Our findings suggest a potential link between oxidative stress and PCOS, highlighting its complexity.
Pak J Physiol 2025;21(2):16-20, DOI: https://doi.org/10.69656/pjp.v21i2.1810
Downloads
References
Azin F, Khazali H. Neuropeptide galanin and its effects on metabolic and reproductive disturbances in female rats with estradiol valerate (EV)-induced polycystic ovary syndrome (PCOS). Neuropeptides 2020;80:102026.
ElSirgany S, Badawi H, El-Khayat Z, Bibers M, Hamdy M, Hamdy A, et al. Serum fetuin a level: a new possible marker for polycystic ovarian syndrome in women with infertility. Obstet Gynecol Res 2019;2(4):100–7.
Ta?kan T, Turan T, ?ltemir Duvan ZC, Gönenç A. Effect of Fetuin-A and oxidative stress on the occurrence of unexplained infertility. Turk J Obstet Gynecol 2023;20(2):113–9.
Liu S, Hu W, He Y, Li L, Liu H, Gao L, et al. Serum Fetuin-A levels are increased and associated with insulin resistance in women with polycystic ovary syndrome. BMC Endocr Disord 2020;20(1):67.
Gorkem U, Yildirim E. Alarin: A new predictive marker in infertile women with polycystic ovary syndrome: A case–control study. J Obstet Gynaecol Res 2022;48(4):980–6.
Abebe EC, Mengstie MA, Seid MA, Malik T, Dejenie TA. The evolving roles of alarin in physiological and disease conditions, and its future potential clinical implications. Front Endocrinol 2022;13:1028982.
Klisic A, Kavaric N, Vujcic S, Spasojevic-Kalimanovska V, Kotur-Stevuljevic J, Ninic A. Total oxidant status and oxidative stress index as indicators of increased Reynolds risk score in postmenopausal women. Eur Rev Med Pharmacol Sci 2020;24(19):10126.
Singh A, Kukreti R, Saso L, Kukreti S. Oxidative stress: a key modulator in neurodegenerative diseases. Molecules 2019;24(8):1583.
Jomova K, Raptova R, Alomar SY, Alwasel SH, Nepovimova E, Kuca K, et al. Reactive oxygen species, toxicity, oxidative stress, and antioxidants: Chronic diseases and aging. Arch Toxicol 2023;97(10):2499–574.
Yang B, Chen Y, Shi J. Reactive oxygen species (ROS)-based nanomedicine. Chem Rev 2019;119(8):4881–985.
Forman HJ, Zhang H. Targeting oxidative stress in disease: Promise and limitations of antioxidant therapy. Nat Rev Drug Discov 2021;20(9):689–709.
Sharifi-Rad M, Anil Kumar NV, Zucca P, Varoni EM, Dini L, Panzarini E, et al. Lifestyle, oxidative stress, and antioxidants: back and forth in the pathophysiology of chronic diseases. Front Physiol 2020;11:694.
Azhar A, Alam SM, Ashraf M, Malick A, Riffat S, Rehman R. Vitamin D status and its relationship with oxidative stress markers in infertile women with polycystic ovary syndrome. Pak J Pharm Sci 2023;36(1):331–5.
Wang R, Mol BW. The Rotterdam criteria for polycystic ovary syndrome: evidence-based criteria? Hum Reprod 2017;32(2):261–4.
Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS). Hum Reprod 2012;27(1):14–24.
Neubronner SA, Indran IR, Chan YH, Thu AWP, Yong E-L. Effect of body mass index (BMI) on phenotypic features of polycystic ovary syndrome (PCOS) in Singapore women: a prospective cross-sectional study. BMC Womens Health 2021;21(1):135.
Gurbuz T, Tosun SA, Cebi A, Gokmen O, Usta M. Investigating fetuin-a and paraoxonase-1 activity as markers in polycystic ovary syndrome based on body mass index: a prospective case-control study. Cureus 2021;13(10):e18553.
Saadia Z. Follicle stimulating hormone (LH:FSH) ratio in polycystic ovary syndrome (PCOS)-obese vs. non-obese women. Med Arch 2020;74(4):289–93.
Pratama G, Wiweko B, Asmarinah, Widyahening IS, Andraini T, Bayuaji H, et al. Mechanism of elevated LH/FSH ratio in lean PCOS revisited: a path analysis. Sci Rep 2024;14(1):8229.
Malini NA, George KR. Evaluation of different ranges of LH: FSH ratios in polycystic ovarian syndrome (PCOS)–Clinical based case control study. Gen Comp Endocrinol 2018;260:51–7.
Casadei L, Fanisio F, Sorge RP, Collamarini M, Piccolo E, Piccione E. The diagnosis of PCOS in young infertile women according to different diagnostic criteria: the role of serum anti-Müllerian hormone. Arch Gynecol Obstet 2018;298:207–15.
Stracquadanio M, Ciotta L, Palumbo MA. Relationship between serum anti-Mullerian hormone and intrafollicular AMH levels in PCOS women. Gynecol Endocrinol 2018;34(3):223–8.
Liu S, Hu W, He Y, Li L, Liu H, Gao L, et al. Serum Fetuin-A levels are increased and associated with insulin resistance in women with polycystic ovary syndrome. BMC Endocr Disord 2020;20(1):67.
Davoudi Z, Araghi F, Vahedi M, Mokhtari N, Gheisari M. Prolactin Level in Polycystic Ovary Syndrome (PCOS): An approach to the diagnosis and management. Acta Biomed 2021;92(5):e2021291.
Yildirim E, Derici MK. A case-control study on the oxidative status in women with polycystic ovary syndrome treated with clomiphene citrate. Med Sci Monit 2019;25:3910–17.
Mazloomi S, Sheikh N, Sanoee Farimani M, Pilehvari S. Association of Prx4, total oxidant status, and inflammatory factors with insulin resistance in polycystic ovary syndrome. Int J Endocrinol 2021;2021:9949753.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Arfa Azhar, Sumaira Riffat, Rabiya Ali, Mussarat Ashraf, Haq Nawaz Khan, Rehana Rehman

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The author(s) retain the copyrights and allow their publication in Pakistan Journal of Physiology, Pak J Physiol, PJP to be FREE for research and academic purposes. It can be downloaded and stored, printed, presented, projected, cited and quoted with full reference of, and acknowledgement to the author(s) and the PJP. The contents are published with an international CC-BY-ND-4.0 License.