Association Between Serum ANGPTL8 Levels and PCOS and Its Clinical Utility in Diagnosis

Abstract

Objective

To analyze the correlation between angiopoietin-like protein 8 (ANGPTL8) and polycystic ovary syndrome (PCOS) and explore the clinical diagnostic value of ANGPTL8 in PCOS.

Methods

In this retrospective case–control study, we included 94 PCOS patients (study group) from our hospital's Reproductive Center from June 2023 to December 2024 and 116 age-matched women with normal ovarian function (control group) from the Gynecology Department. Serum levels of anti-Müllerian hormone (AMH), sex hormones, and ANGPTL8 were measured in all participants.

Results

The study group exhibited higher AMH, LH, LH/FSH ratio, and E2 levels compared to the control group (p < 0.001). Serum ANGPTL8 levels were lower in PCOS patients (p < 0.001). Logistic multivariate regression analysis identified BMI, AMH, LH, and ANGPTL8 as independent influencing factors for PCOS. Elevated ANGPTL8 levels were associated with reduced PCOS risk (p < 0.001), while increased BMI, AMH, and LH levels correlated with higher PCOS risk (p < 0.05). At a cutoff value of 12.871 ng/mL, ANGPTL8 demonstrated a sensitivity of 90.4%, specificity of 77.6%, and an area under the curve (AUC) of 0.881 (95% CI: 0.836–0.926, p < 0.001), indicating moderate-to-high diagnostic efficacy. The combined use of ANGPTL8 with AMH or sex hormones improved diagnostic performance compared to individual markers. Notably, the combination of ANGPTL8 and sex hormones yielded a higher AUC (0.980) than ANGPTL8 with AMH (AUC = 0.928).

Conclusion

Serum ANGPTL8 levels are significantly lower in PCOS patients and inversely associated with PCOS risk. ANGPTL8 shows promise as a novel diagnostic biomarker for PCOS, especially when integrated into multi-marker panels with existing hormonal parameters.