The role of serum gremlin-1, bone morphogenetic protein 4 and 7 levels in the pathogenesis of polycystic ovarian syndrome

Polycystic ovary syndrome (PCOS) is defined as a reproductive and metabolic disorder that is increasingly common, especially in women of reproductive age. There are a few studies showing that the levels of BMP-4 and BMP-7, members of the TGF-β family, decrease in PCOS, while the levels of gremlin-1, a BMP antagonist, increase. However, these three parameters were evaluated separately in the studies, and at the time the thesis was planned, no study was found to our knowledge that considered all three parameters together. This study was based on the hypothesis that gremlin-1 levels increase and BMP4 and BMP-7 levels decrease in PCOS patients. Our thesis study aimed to contribute to the literature and to determine the roles of gremlin-1, BMP-4 and BMP-7 levels in the pathogenesis of PCOS. Within the scope of the thesis, 40 PCOS women and 40 healthy women who applied to the Gynecology and Obstetrics Clinic of Rize Recep Tayyip Erdoğan University Education and Research Hospital, the remaining serum samples from the blood samples studied in the hospital were collected and kept until the study day and studied with the ELISA method on the same day and at the same hours. After obtaining the data and transferring them to the statistics program, the main groups (PCOS, healthy control) and subgroups (BMI double groups, BMI triple groups, BMI quadruple groups, LH/FSH ratio 1 threshold value, LH/FSH ratio 2 threshold value, LH/FSH ratio 2.5 threshold value and PCOS phenotypes) were created. BMP-7 levels of the samples could not be measured during the study. As a result of the analyses; no significant difference was detected in terms of gremlin-1 and BMP-4 levels in PCOS patients. BMP-4 levels were detected higher in the control normal weight group compared to the PCOS normal weight group. Gremlin-1 levels were found to be higher in the preobese/obese group than in the normal weight group, independent of PCOS. As a result, the data we obtained in our study differ from the studies in the current literature that reveal the relationship between PCOS, gremlin-1 and BMP. Unlike other studies, our study revealed that gremlin-1 is not associated with PCOS but is affected by obesity. It is thought that this difference may be due to the differences in BMI characteristics of the participant profiles included in other studies. More studies are needed in this area to determine the relationship between PCOS and gremlin-1, BMP-4 and BMP7 levels and to elucidate the pathogenesis of PCOS.