{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:12:49Z","timestamp":1789053169551,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Polycystic ovary syndrome (PCOS), affecting 5\u201315% of women of reproductive age globally, is linked to metabolic complications such as insulin resistance, obesity, and non-alcoholic fatty liver disease. While metformin helps manage PCOS, reliable biomarkers for monitoring treatment response are lacking. Fetuin-B, a liver-derived protein, has emerged as a potential candidate, as previous studies have shown increased fetuin-B levels in women with PCOS. This study examined whether serum fetuin-B levels correlated with metabolic improvements in PCOS patients undergoing metformin therapy, exploring its potential as a biomarker.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PCOS patients from the Fertility Center at the University Medical Center Mainz were assigned to two groups: metformin therapy (M-group) and alternative\/no treatment (C-group), based on their metabolic profiles. Baseline and 24-week follow-up assessments included gonadotropins and reproductive hormone levels, metabolic markers (such as lipid profile, hepatic markers, fasting and stimulated glucose levels, and the respective derived indices), and anthropometric data, including fetuin-B. A multivariate regression analysis evaluated associations between metabolic changes and fetuin-B levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 62 PCOS patients were included (31 per group). At baseline, the M-group exhibited worse metabolic parameters compared to the C-group, including higher body mass index (BMI) (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), waist circumference (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and fatty liver index (FLI) (<jats:italic>p<\/jats:italic> &amp;lt;\u202f0.001). At follow-up, the M-group showed greater improvements. Fetuin-B levels were significantly higher in the M-group at baseline (<jats:italic>p<\/jats:italic>\u202f=\u202f0.01), but at follow-up, no significant difference was observed between the groups (M-group: 3.7mcg\/mL; C-group: 4.4 mcg\/mL; <jats:italic>p<\/jats:italic>\u202f=\u202f0.13). The M-group\u2019s fetuin-B levels decreased significantly (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), while the C-group\u2019s levels increased slightly. Changes in fetuin-B levels differed significantly between groups (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), and regression analysis confirmed a strong association (B: 1.80; 95% CIs: 0.57\u20133.03; <jats:italic>p<\/jats:italic>\u202f=\u202f0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrated that metformin therapy is associated with significantly reducing fetuin-B levels in PCOS patients, underscoring its role in enhancing metabolic health. These findings highlight fetuin-B as a potential biomarker for monitoring treatment efficacy, offering a link between metabolic and reproductive health.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1567255","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T05:24:36Z","timestamp":1750829076000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Fetuin-B as a biomarker for metformin response in women with polycystic ovary syndrome: a prospective study"],"prefix":"10.3389","volume":"12","author":[{"given":"Konstantin","family":"Hofmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Singer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Christin","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Theis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Hasenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walburgis","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Skala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"100060","DOI":"10.1016\/j.eurox.2019.100060","article-title":"Polycystic ovary syndrome (PCOS) and genetic predisposition: a review article","volume":"3","author":"Ajmal","year":"2019","journal-title":"Eur J Obstet Gynecol Reprod Biol X"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"G43","DOI":"10.1093\/ejendo\/lvad096","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"189","author":"Teede","year":"2023","journal-title":"Eur J Endocrinol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"555","DOI":"10.17219\/acem\/61987","article-title":"History of discovery of polycystic ovary syndrome","volume":"26","author":"Szydlarska","year":"2017","journal-title":"Adv Clin Exp Med Off Organ Wroclaw Med Univ"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3390\/medsci7090089","article-title":"The mechanism of androgen actions in PCOS etiology","volume":"7","author":"Rodriguez Paris","year":"2019","journal-title":"Med Sci (Basel)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"340","DOI":"10.23736\/S0391-1977.17.02609-8","article-title":"Is cardiovascular risk in women with PCOS a real risk? 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