Background: Neutrophil gelatinase-associated lipocalin (NGAL) and the Matrix Metaloproteinase-9 (MMP-9) have been considered as important mediators of vascular remodeling and plaque instability. The formation of a complex with NGAL and MMP-9 is crucial for atherotic plaque erosion and thrombus formation. In women with Polycystic Ovary Syndrome (PCOS) the incidence of cardiovascular clinical events is not increased, despite the fact that they display a wide spectrum of risk factors. Since the instability of atherosclerotic plaque is a key factor in the clinical manifestations of cardiovascular disease, molecules challenging the plaque stability should be investigated.
Aim: To determine serum levels of NGAL and MMP-9/NGAL complex in women with PCOS.
Subjects and methods: Forty PCOS subjects were compared with 40 matched for age and BMI controls. In each subject, fasting levels of glucose, insulin, gonadotropins, estradiol, androgens, C-reactive protein (CRP), NGAL and MMP-9/NGAL were determined.
Results: NGAL and MMP-9/NGAL complex levels were significantly lower in PCOS group compared to control one (30.4±24.3 vs 70.7±37.9 μg/l, P<0.0001) and (31.5±26.6 vs 115.1±66.9 μg/l, P<0.0001) respectively. When patients and controls were stratified according to BMI, it was shown that NGAL and MMP-9/NGAL levels were significantly lower in lean (P<0.0002 and P<0.0001 respectively) and overweight (P<0.0004 and P<0.002 respectively) PCOS subjects compared to controls.
Conclusions: These findings indicate that NGAL and MMP-9/NGAL complex, two molecules which activate atherotic plaque erosion, are in lower concentrations in PCOS subjects. The role of NGAL and MMP-9/NGAL complex needs to be further investigated, since suppression of these atheromatous molecules might have a protective role in women with PCOS.