Relationship between serum α-klotho protein levels in patients with PCOS and glucose and lipid metabolism

doi:10.3969/j.issn.1673-8640.2026.08.007

Abstract

Abstract:

Objective To investigate the changes in serum alpha-klotho（α-klotho） protein levels in patients with polycystic ovary syndrome（PCOS） and its relation to glucose and lipid metabolism and insulin resistance（IR）. Methods A total of 258 PCOS patients（PCOS group） and 60 healthy subjects（healthy control group） were enrolled from the Affiliated Hospital of Hebei University from May 2023 to September 2023. The levels of serum α-klotho protein，fasting plasma glucose（FPG），fasting insulin（FINS），triglyceride（TG），total cholesterol（TC），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C），testosterone（T），estradiol（E₂），follicle-stimulating hormone（FSH），luteinizing hormone（LH），progesterone（P） and prolactin（PRL） were determined. The PCOS patients were classified based on body mass index（BMI） and homeostasis model assessment-insulin resistance（HOMA-IR），including PCOS non-obese non-IR group（62 cases），PCOS non-obese-IR group（59 cases），PCOS obese non-IR group（56 cases） and PCOS obese IR group（81 cases）. Multivariate linear regression analysis was used to evaluate the correlations within the PCOS group. Results The serum α-klotho protein level in PCOS group was lower than that in healthy control group（P<0.001）. There was statistical significance in BMI，waist-to-hip ratio（WHR），LH，LH/FSH ratio，T，HOMA-IR，TC，TG，HDL-C，LDL-C and α-klotho protein among all the PCOS groups and healthy control group（P<0.001）. The α-klotho protein level in PCOS non-obese non-IR group was higher than those in PCOS non-obese IR group，PCOS obese non-IR group and PCOS obese IR group（P<0.05）. The α-klotho protein levels in PCOS obese non-IR group and PCOS non-obese IR group were higher than that in PCOS obese IR group（P<0.05），and there was no statistical significance in α-klotho protein levels between PCOS obese non-IR group and PCOS non-obese IR group（P>0.05）. In all the study subjects，α-klotho protein was negatively correlated with BMI，HOMA-IR，T and LH/FSH ratio（P<0.01）. In the PCOS patients，α-klotho protein was negatively correlated with BMI，HOMA-IR，TG and TC（P<0.05），and it was positively correlated with HDL-C（P<0.01）. Conclusions The low level of α-klotho protein in PCOS patients is related to abnormal glucose and lipid metabolism and may aggravate the progression of PCOS. α-klotho protein may be a target for the diagnosis and treatment of PCOS.

Key words: Alpha-klotho protein, Glucose and lipid metabolism, Insulin resistance, Obesity, Triglyceride, Total cholesterol, Polycystic ovary syndrome

CLC Number:

R446.11

HAO Wanjiao, XUE Huiling, HAO Yumei, SONG Nan, CHEN Yun, REN Xiaopang. Relationship between serum α-klotho protein levels in patients with PCOS and glucose and lipid metabolism[J]. Laboratory Medicine, 2026, 41(8): 763-768.

Figures/Tables 4

References 28

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组别	例数		年龄/岁		BMI/（kg·m^-2）		WHR		E₂/（pg·mL^-1）		FSH/（mIU·mL^-1）
正常对照组	60		26.61±3.67		21.32±1.84		0.68（0.66，0.70）		24.38±5.26		6.00±0.38
PCOS组	258		27.41±4.60		26.38±5.07		0.75（0.68，0.86）		25.81±4.07		6.03±0.66
t值			-1.253		-12.802		-5.838		0.296		1.097
P值			0.211		<0.001		<0.001		0.768		0.273
组别	LH/（mIU·mL-1）		LH/FSH比值		T/（ng·mL-1）		P/（ng·mL-1）		PRL/（ng·mL-1）		HOMA-IR
正常对照组	6.76±0.89		1.03（1.01，1.11）		0.25±0.12		0.10±0.02		18.56±2.54		1.84±0.53
PCOS组	13.51±2.32		2.12（2.00，2.22）		0.49±0.13		0.09±0.01		19.21±3.02		3.71±2.50
t值	23.781		-11.878		-13.007		0.102		1.534		-10.961
P值	<0.001		<0.001		<0.001		0.919		0.126		<0.001
组别		TC/（mmol·L^-1）		TG/（mmol·L^-1）		HDL-C/（mmol·L^-1）		LDL-C/（mmol·L^-1）		α-klotho蛋白/（pg·mL^-1）
正常对照组		3.09±0.30		0.65±0.08		1.22±0.13		1.90±0.42		672.62±10.52
PCOS组		3.91±0.85		0.84±0.28		1.10±0.42		2.51±0.54		526.71±22.93
t值		-12.370		-9.160		-6.071		-8.976		73.817
P值		<0.001		<0.001		<0.001		<0.001		<0.001

组别	例数		年龄/岁		BMI/（kg·m^-2）		WHR		E₂/（pg·mL^-1）		FSH/（mIU·mL^-1）
正常对照组	60		26.61±3.67		21.32±1.84		0.68（0.66，0.70）		24.38±5.26		6.00±0.38
PCOS组	258		27.41±4.60		26.38±5.07		0.75（0.68，0.86）		25.81±4.07		6.03±0.66
t值			-1.253		-12.802		-5.838		0.296		1.097
P值			0.211		<0.001		<0.001		0.768		0.273
组别	LH/（mIU·mL-1）		LH/FSH比值		T/（ng·mL-1）		P/（ng·mL-1）		PRL/（ng·mL-1）		HOMA-IR
正常对照组	6.76±0.89		1.03（1.01，1.11）		0.25±0.12		0.10±0.02		18.56±2.54		1.84±0.53
PCOS组	13.51±2.32		2.12（2.00，2.22）		0.49±0.13		0.09±0.01		19.21±3.02		3.71±2.50
t值	23.781		-11.878		-13.007		0.102		1.534		-10.961
P值	<0.001		<0.001		<0.001		0.919		0.126		<0.001
组别		TC/（mmol·L^-1）		TG/（mmol·L^-1）		HDL-C/（mmol·L^-1）		LDL-C/（mmol·L^-1）		α-klotho蛋白/（pg·mL^-1）
正常对照组		3.09±0.30		0.65±0.08		1.22±0.13		1.90±0.42		672.62±10.52
PCOS组		3.91±0.85		0.84±0.28		1.10±0.42		2.51±0.54		526.71±22.93
t值		-12.370		-9.160		-6.071		-8.976		73.817
P值		<0.001		<0.001		<0.001		<0.001		<0.001

组别	例数	年龄/岁		BMI/ （kg·m^-2）		WHR		LH/ （mIU·mL^-1）		LH/FSH比值		T/（ng·mL^-1）
正常对照组	60	26.61±3.67		21.32±1.84		0.68（0.66，0.70）		6.76±0.89		1.03（1.01.1.11）		0.25±0.12
PCOS非肥胖非IR组	62	28.03±4.63		21.78±1.56		0.68（0.67，0.70）		13.46±5.43^*		2.10（2.00，2.22）^*		0.47±0.15^*
PCOS-IR非肥胖组	59	26.71±4.38		22.21±1.92		0.70（0.68，0.75）		13.39±7.22^*		2.21（2.10，2.50）^*		0.48±0.13^*
PCOS肥胖非IR组	56	27.39±4.90		29.82±3.80^*#△		0.85（0.82，0.87）^*#△		13.47±7.41^*		2.14（2.00，2.22）^*		0.50±0.13^*
PCOS肥胖IR组	81	27.46±4.5		30.57±3.59^*#△		0.87（0.85，0.88）^*#△		13.88±8.71^*		2.11（2.00，2.19）^*		0.50±0.12^*
统计值		1.064		185.344		219.580		58.460		151.910		39.049
P值		0.375		<0.001		<0.001		<0.001		<0.001		<0.001
组别	HOMA-IR		TC/（mmol·L^-1）		TG/（mmol·L^-1）		HDL-C/（mmol·L^-1）		LDL-C/（mmol·L^-1）		α-klotho蛋白/（pg·mL^-1）
正常对照组	1.84±0.53		3.09±0.30		0.65±0.08		1.20±0.13		1.90±0.42		672.62±10.52
PCOS非肥胖非IR组	2.02±0.47		2.99±0.15		0.71±0.22		1.21±0.13		2.00±0.44		555.34±14.22^*
PCOS-IR非肥胖组	3.89±1.09^*#		3.48±0.70^*#		0.76±0.26^*		1.16±0.11^*#		2.33±0.52^*#		524.64±14.56^*#
PCOS肥胖非IR组	2.02±0.47^△		4.27±0.70^*#△		0.88±0.26^*#△		1.03±0.11^*#△		2.80±0.38^*#△		528.60±14.60^*#
PCOS肥胖IR组	5.89±3.24^*#△▲		4.66±0.42^*#△▲		0.98±0.29^*#△▲		1.02±0.07^*#△		2.75±0.44^*#△		505.01±14.22^*#△▲
统计值	70.596		148.802		20.788		46.397		54.162		686.161
P值	<0.001		<0.001		<0.001		<0.001		<0.001		<0.001

组别	例数	年龄/岁		BMI/ （kg·m^-2）		WHR		LH/ （mIU·mL^-1）		LH/FSH比值		T/（ng·mL^-1）
正常对照组	60	26.61±3.67		21.32±1.84		0.68（0.66，0.70）		6.76±0.89		1.03（1.01.1.11）		0.25±0.12
PCOS非肥胖非IR组	62	28.03±4.63		21.78±1.56		0.68（0.67，0.70）		13.46±5.43^*		2.10（2.00，2.22）^*		0.47±0.15^*
PCOS-IR非肥胖组	59	26.71±4.38		22.21±1.92		0.70（0.68，0.75）		13.39±7.22^*		2.21（2.10，2.50）^*		0.48±0.13^*
PCOS肥胖非IR组	56	27.39±4.90		29.82±3.80^*#△		0.85（0.82，0.87）^*#△		13.47±7.41^*		2.14（2.00，2.22）^*		0.50±0.13^*
PCOS肥胖IR组	81	27.46±4.5		30.57±3.59^*#△		0.87（0.85，0.88）^*#△		13.88±8.71^*		2.11（2.00，2.19）^*		0.50±0.12^*
统计值		1.064		185.344		219.580		58.460		151.910		39.049
P值		0.375		<0.001		<0.001		<0.001		<0.001		<0.001
组别	HOMA-IR		TC/（mmol·L^-1）		TG/（mmol·L^-1）		HDL-C/（mmol·L^-1）		LDL-C/（mmol·L^-1）		α-klotho蛋白/（pg·mL^-1）
正常对照组	1.84±0.53		3.09±0.30		0.65±0.08		1.20±0.13		1.90±0.42		672.62±10.52
PCOS非肥胖非IR组	2.02±0.47		2.99±0.15		0.71±0.22		1.21±0.13		2.00±0.44		555.34±14.22^*
PCOS-IR非肥胖组	3.89±1.09^*#		3.48±0.70^*#		0.76±0.26^*		1.16±0.11^*#		2.33±0.52^*#		524.64±14.56^*#
PCOS肥胖非IR组	2.02±0.47^△		4.27±0.70^*#△		0.88±0.26^*#△		1.03±0.11^*#△		2.80±0.38^*#△		528.60±14.60^*#
PCOS肥胖IR组	5.89±3.24^*#△▲		4.66±0.42^*#△▲		0.98±0.29^*#△▲		1.02±0.07^*#△		2.75±0.44^*#△		505.01±14.22^*#△▲
统计值	70.596		148.802		20.788		46.397		54.162		686.161
P值	<0.001		<0.001		<0.001		<0.001		<0.001		<0.001

项目	B值	标准误	β值	t值	P值	VIF^①
年龄	-0.034	0.165	-0.007	-0.209	0.835	1.056
BMI	-2.363	1.023	-0.200	-2.310	0.022	9.136
HOMA-IR	-3.086	0.848	-0.122	-3.638	<0.001	1.655
LH/ FSH比值	-65.597	3.801	-0.579	-17.258	<0.001	1.670
T	-44.481	11.738	-0.121	-3.789	<0.001	1.521
TG	-5.363	8.474	-0.024	-0.633	0.527	2.101
TC	-2.654	4.220	-0.037	-0.629	0.530	5.103
HDL-C	23.240	19.072	0.049	1.219	0.224	2.374
LDL-C	-3.008	4.225	-0.029	-0.712	0.477	2.399