International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
Gremlin-1 is associated with obesity but not polycystic ovary syndrome: Insights from a body mass index-matched analysis of bone morphogenetic protein pathway components, a cross-sectional study.
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Bakar Sevdanur, Arpa Medeni, Kuruca Nalan, Şentürk Şenol
Аннотация
OBJECTIVE: This study investigates serum levels of Gremlin-1, BMP-4, and BMP-7 in women with polycystic ovary syndrome (PCOS) and healthy controls and assesses their associations with body mass index (BMI) and with each other across different analytical models.
METHODS: This cross-sectional study included women with PCOS and BMI-matched healthy controls, stratified into four analytical models: (Model 1) PCOS versus controls (all BMI categories combined); (Model 2) normal-weight versus overweight/obese participants (PCOS and controls combined); (Model 3) normal-weight, overweight, and obese participants (three-group comparison); and (Model 4) normal-weight PCOS, overweight/obese PCOS, normal-weight controls, and overweight/obese controls (four-group comparison). Demographic, anthropometric, and biochemical data were recorded. Serum BMP-4, BMP-7, and Gremlin-1 levels were measured using ELISA. Group comparisons were performed using appropriate parametric or non-parametric tests with age adjustment. Correlations between BMP-4 and Gremlin-1 were assessed using Spearman's rho.
RESULTS: BMP-7 concentrations were below the detection limit in most participants and quantifiable in only five cases. No significant correlation was found between BMP-4 and Gremlin-1 in any model. Gremlin-1 levels were significantly higher in overweight/obese participants compared with normal-weight individuals, independent of PCOS status (Models 2 and 4). BMP-4 levels were higher in normal-weight healthy controls compared with BMI-matched normal-weight PCOS participants (P = 0.014; Model 4).
CONCLUSION: Gremlin-1 levels are associated with obesity but not with PCOS, while BMP-4 levels differ between normal-weight PCOS and BMI-matched controls. These findings provide new insights into BMP pathway components in PCOS and underscore the need for larger, phenotype-stratified studies incorporating tissue-level analyses and additional BMP antagonists.
METHODS: This cross-sectional study included women with PCOS and BMI-matched healthy controls, stratified into four analytical models: (Model 1) PCOS versus controls (all BMI categories combined); (Model 2) normal-weight versus overweight/obese participants (PCOS and controls combined); (Model 3) normal-weight, overweight, and obese participants (three-group comparison); and (Model 4) normal-weight PCOS, overweight/obese PCOS, normal-weight controls, and overweight/obese controls (four-group comparison). Demographic, anthropometric, and biochemical data were recorded. Serum BMP-4, BMP-7, and Gremlin-1 levels were measured using ELISA. Group comparisons were performed using appropriate parametric or non-parametric tests with age adjustment. Correlations between BMP-4 and Gremlin-1 were assessed using Spearman's rho.
RESULTS: BMP-7 concentrations were below the detection limit in most participants and quantifiable in only five cases. No significant correlation was found between BMP-4 and Gremlin-1 in any model. Gremlin-1 levels were significantly higher in overweight/obese participants compared with normal-weight individuals, independent of PCOS status (Models 2 and 4). BMP-4 levels were higher in normal-weight healthy controls compared with BMI-matched normal-weight PCOS participants (P = 0.014; Model 4).
CONCLUSION: Gremlin-1 levels are associated with obesity but not with PCOS, while BMP-4 levels differ between normal-weight PCOS and BMI-matched controls. These findings provide new insights into BMP pathway components in PCOS and underscore the need for larger, phenotype-stratified studies incorporating tissue-level analyses and additional BMP antagonists.