Serum Pigment Epithelium-Derived Factor Levels are Associated with Estradiol and Decrease After Adjusting for Alanine Aminotransferase in Chinese Women Based on Multiple Linear Regression Analysis

Abstract

Purpose

To assess changes in pigment epithelium-derived factor (PEDF) levels in patients with metabolic syndrome (MetS) and to investigate sexual dimorphism in serum PEDF levels and their relationships with estradiol.

Methods

A total of 318 individuals (145 men, 173 women) who underwent health examinations in our department were selected. Serum PEDF, estradiol and other metabolic parameters were determined. Homeostasis model assessment of insulin resistance (HOMA- IR) and homeostasis model assessment of β-cell function (HOMA-β) were calculated to evaluate insulin resistance and β-cell function, respectively. Multiple linear regression analysis was used to analyse the factors influencing serum PEDF.

Results

Serum PEDF levels were significantly higher in subjects with MetS in both men and women (12.09±2.75 vs 8.97±3.19 μg/mL in men and 11.31±2.79 vs 8.40±2.32 μg/mL in women, MetS vs non-MetS, P<0.001). Correlation analysis showed that serum PEDF levels were significantly correlated with body mass index (BMI), waist circumference, waist-to-hip ratio, diastolic blood pressure (DBP), fasting and 2-h postprandial glucose, fasting and 2-h postprandial insulin, HOMA-β, HOMA-IR, hemoglobin A1c (HbA1c), alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid (UA), triacylglycerol (TG) and high-density lipoprotein cholesterol (HDL-C). Elevated ALT, HOMA-IR and TG were significant predictors of increased PEDF concentrations. In women, estradiol was inversely correlated with PEDF levels (r=−0.25, P=0.011), and the association was no longer significant after adjustment for ALT.

Conclusion

PEDF could be used as a biomarker of MetS in both men and women. This study reported for the first time that circulating PEDF displays sexual dimorphism, which could be related to estrogen. The association between estrogen and circulating PEDF levels was attenuated after adjusting for ALT.

Keywords:

• pigment epithelium-derived factor
• metabolic syndrome
• sexual dimorphism
• estradiol
• alanine aminotransferase

Abbreviations

PEDF, pigment epithelium-derived factor; MetS, metabolic syndrome; NAFLD, nonalcoholic fatty liver disease; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; HOMA-IR, homeostasis model assessment of insulin resistance; HOMA-β, homeostasis model assessment of insulin secretion; HbA1c, hemoglobin A1c; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BUN, blood urea nitrogen; Cr, creatinine; UA, uric acid; TG, triacylglycerol; TC, total cholesterol; HDL-C, high density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author.

Ethical Standard Statement

The study was approved by the Ethics Committee of Cangzhou Central Hospital and and was conducted in accordance with the Declaration of Helsinki. All subjects provided written informed consent.

Acknowledgments

We are very grateful to all participants for their support of this study.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

This work was supported by the Key Research and Development Program Guidance Project of Cangzhou City (213106005).