Search Results (392)

Preeclampsia (PE) has traditionally been regarded as a pregnancy-limited hypertensive disorder; however, accumulating evidence increasingly positions it as a pivotal early-life vascular stress test that manifests underlying vulnerabilities and accelerates biological aging. Women with a history of PE exhibit a heightened susceptibility to premature-onset multi-systemic diseases, specifically cardiovascular, ovarian, renal, and metabolic decline. This suggests that PE acts as a catalyst for accelerated aging, driven by shared pathophysiological pathways that represent common mechanisms of systemic senescence. This review provides a comprehensive analysis of the epidemiological links and pathogenic drivers underpinning accelerated systemic aging following PE, with a specific focus on the cardiovascular-ovarian axis. Epidemiological data consistently demonstrate that women with prior PE exhibit significantly reduced anti-Müllerian hormone (AMH) levels, translating to an estimated 1.5-year acceleration in reproductive aging. In parallel, PE is associated with a twofold increase in lifetime cardiovascular disease (CVD) risk and the onset of chronic hypertension occurring an average of 7.7 years earlier. However, reconciling the phenotypic heterogeneity of PE and transcending the constraints of non-experimental designs are essential for firmly establishing this accelerated aging paradigm. At the molecular level, PE and ovarian aging converge on shared pathways—including mitochondrial dysfunction, oxidative stress, inflammation, and epigenetic dysregulation—collectively defining a distinct pathogenic ovarian–vascular aging axis. Proposed geroscience-based strategies advocate for refined risk stratification by incorporating molecular aging biomarkers—such as epigenetic clocks and inflammatory profiles—alongside conventional clinical indicators. This integrative framework facilitates the early identification of high-risk aging phenotypes, enabling targeted monitoring and timely interventions to preemptively modulate accelerated aging pathways. Pharmacological approaches within this framework emphasize the judicious repurposing of established agents, such as metformin, statins, and SGLT2 inhibitors, while emerging gerotherapeutics, including senolytics and senomorphics, provide a conceptual foundation for targeting the fundamental biological drivers of senescence. Although these geroprotective strategies, including the repurposing of established agents and the use of senolytics, offer innovative conceptual frameworks for targeting the fundamental drivers of senescence, they remain largely exploratory and require further clinical validation. Such strategies offer novel opportunities to shift the clinical focus from treating isolated comorbidities to modulating the shared molecular substrates of aging, ultimately promoting healthy aging and functional longevity in the elderly female population. Full article

The greater amberjack (Seriola dumerili) is a globally important aquaculture fish species belonging to the family Carangidae. However, current research on the ovarian development and regulation of the greater amberjack is limited, particularly with regard to early ovarian development in artificially bred individuals. Therefore, this study aims to analyze the ovarian transcriptomes at the primary growth stage in one-year-old fish at the chromatin nucleolar stage and two-year-old fish at the perinucleolar stage to suggest how early ovarian development takes place in artificially bred greater amberjacks. To do this, the study constructed ovarian mRNA expression profiles of different stages of artificially bred fish and identified differentially expressed genes (DEGs), Gene Ontology terms, and Kyoto Encyclopedia of Genes and Genomes pathways important for various physiological processes. A functional analysis revealed that the DEGs closely related to ovarian development were involved in cell growth and death (e.g., ccnd1, cdk1, cdc6, cdc25b, fbxo43, cdkn1a and cdkn1d), the TGF-beta signaling pathway (e.g., gdf6, bmpr1b, gsdf, amh, tgfb3, and smad6), steroid hormone biosynthesis (e.g., hsd3b1, hsd11b2, hsd17b12 and hsd20b2), and the endocrine system (e.g., mapk8a, mapk11, mapk12a, mapk13 and adcy9). These findings suggest that ovarian development is the result of the coordinated regulation of various genes responsible for various functions. This study provides a theoretical basis for exploring the underlying molecular mechanisms of early ovarian development in artificially bred greater amberjacks. Full article

Ochratoxin A (OTA) is a globally distributed mycotoxin that poses serious threats to food safety and human health due to its nephrotoxic, hepatotoxic, and carcinogenic properties. Previous enzymatic detoxification strategies for OTA have been constrained by low degradation efficiency or poor soluble expression of highly active enzymes. In this study, a bacterial strain with strong OTA-degrading activity was isolated and identified as Acinetobacter kookii AK4, which degraded 95.44% of 1 μg/mL OTA within 6 h. The predominant OTA-degrading activity was derived from intracellular enzymes. Through genome mining and experimental validation, gene2102 was identified as encoding an amidohydrolase. The enzyme was designated AMH2102 and was heterologously expressed in Escherichia coli. Codon optimization combined with fusion of an N-terminal SUMO tag increased the soluble expression of AMH2102 by 14.81-fold, enabling complete (100%) OTA degradation within 3 min. Overall, this study achieved the identification of an efficient OTA-degrading strain and enzyme and explored strategies for improving enzyme expression, yielding effective outcomes that provide useful references for future studies on strain mining and enzyme engineering. Full article

2,9-Bis(1,2,4-triazin-3-yl)-1,10-phenanthroline (BTPhen)-based ligands show great promise in the separation of trivalent lanthanides and actinides. Experimental studies have shown that americium forms stronger complexes with the BTPhen ligands than europium; most theoretical studies have so far failed to reproduce these results. In the current study, three different metal forms (the naked cation, its nitrate or perchlorate salts and tetraaqua solvated salts) were used to study different complexation reactions. It was shown that in the case of naked cations and salts, europium forms the most stable complex with the 2,9-bis(1,2-triazin-3-yl)-1,10-phenanthroline ligand in all of the reactions compared. However, europium is also more strongly interacting (compared to americium) with anions and water molecules in the tetraaquatrinitrato or tetraaquatriperchlorato complexes. That shifts the energies of reactions like Am(NO₃)₃·4H₂O + [Eu(H₂O)₄BTPhen]³⁺ = [Am(H₂O)₄BTPhen]³⁺ + Eu(NO₃)₃·4H₂O in favor of the americium being complexed with BTPhen and europium with anions and water. Therefore, the americium complexes with BTPhen become the more stable form, in an agreement with the experimental studies. Comparison of counterion influence (nitrate vs. perchlorate) indicates that bigger preference for americium over europium complexation corresponds to the nitrate complexes and stems mainly from the fact that in M(NO₃)₃(H₂O)₄ europium is stabilized more than in M(ClO₄)₃(H₂O)₄. Full article

Anti-Müllerian hormone (AMH), a member of the transforming growth factor-β (TGF-β) superfamily, has been widely recognized for its role in reproductive endocrinology and is regarded as one of the “gold standards” for evaluating ovarian age and fertility potential. In recent years, the focus of research on AMH has gradually expanded from the reproductive system to the skeletal system. Although the specific mechanism of its action in bone-metabolism-related diseases and associated signaling pathways still requires in-depth exploration, existing studies have confirmed—through cell experiments, animal models, and clinical data—the important role of AMH in maintaining bone health. Here, the significance of AMH in research on female osteoporosis is reviewed, the current signaling pathway mechanisms by which AMH regulates bone metabolism are summarized, and the relevant clinical research results are discussed. This work features three unique contributions: first, the logical progression of AMH research from reproductive regulation to bone metabolism is explicitly clarified; second, multi-level evidence is integrated to form a complete regulatory network, avoiding fragmented discussions of individual findings; and third, concrete clinical translation pathways and targeted solutions for existing limitations are proposed, rather than merely outlining general directions. This review aims to identify new biomarkers for the early screening of osteoporosis and therapeutic targets, ultimately promoting the formulation of personalized prevention and treatment strategies. Additionally, as a key factor linking ovarian function and bone health, the AMH research concepts and methods summarized herein can be extended to other hormone-related bone metabolism disorders. Full article

Background: Endocrine complications remain a major cause of long-term morbidity in patients with transfusion-dependent β-thalassemia (TDT), with hypogonadism being the most frequently reported abnormality. Although iron overload is central to disease pathophysiology, its relationship with reproductive endocrine function in well-chelated adult women remains unclear. Methods: This retrospective longitudinal study evaluated endocrine function in 15 adult women with transfusion-dependent β-thalassemia major over a two-year follow-up period at a tertiary care center. Age, hormonal profiles, ovarian reserve markers, and clinical reproductive characteristics were assessed at baseline and follow-up. An age-matched control group of 22 healthy women was included. Endocrine and biochemical evaluation comprised gonadotropins (follicle-stimulating hormone and luteinizing hormone), estradiol, thyroid-stimulating hormone, prolactin, anti-Müllerian hormone, hemoglobin, serum iron, total iron-binding capacity, vitamin B12, folate, 25-hydroxyvitamin D, and cardiac and hepatic MRI T2* assessment of iron burden. Results: Hypogonadism was clinically prevalent, while other endocrine axes largely remained within reference ranges during follow-up. No newly emerging overt endocrine disorders were identified. Reproductive hormone levels showed no significant temporal changes and were comparable to those of healthy controls. AMH levels demonstrated marked interindividual variability and did not consistently correlate with systemic or imaging-based iron indices. Conclusions: In well-chelated adult women with transfusion-dependent β-thalassemia, reproductive endocrine parameters appear biochemically stable over short-term follow-up, yet clinically relevant hypogonadism persists. AMH variability may reflect subtle ovarian reserve impairment not captured by conventional gonadotropin measurements, supporting the need for longitudinal, phenotype-oriented endocrine surveillance. Full article

Red light suppresses melatonin and helps in improving reproductive efficiency in donkeys during the non-breeding season (November–February). In this study, the effects of red, blue, and white LED light were assessed. For this purpose, 40 adult Dezhou donkeys were divided into 4 groups, each receiving equal treatment for 40 days. All groups received 8 h of natural light. Additionally, the red group received 6 h of 50 lux of red LED light (468 nm) directed at a single eye. The blue group received 6 h of 50 lux of blue LED light (468 nm). The white group received 6 h of 50 lux of white LED light (468 nm), and the control group received only 8 h of natural sunlight. Blood samples were collected on the 21st, 28th, 34th, and 40th day of the experiment to analyze plasma hormone concentrations of progesterone (P4), Inhibin B (INH-B), Testosterone (T), Activin-A, Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Antimullerian Hormone (AMH), and Melatonin. In conclusion, red LED light directed at one eye showed the most promising results, elevating plasma hormone concentrations of testosterone (T), Activin A, LH, FSH, AMH, and melatonin. Full article

Background: Optimizing pregnancy outcomes while minimizing gonadotropin exposure and treatment burden remains a major goal in ovulation induction for intrauterine insemination (IUI), particularly for patients with polycystic ovary syndrome (PCOS) or high ovarian reserve. Sequential protocols combining early letrozole with late-onset recombinant FSH (rFSH) have been proposed to enhance efficiency while reducing medication requirements. However, real-world comparative data adjusting for baseline differences are limited. Methods: This retrospective comparative cohort study included 764 IUI cycles performed between January 2022 and October 2025. Cycles were stimulated either with conventional rFSH (n = 372) or letrozole plus late-onset rFSH (n = 392). The primary outcome was pregnancy per cycle, defined by a positive serum β-hCG. Secondary outcomes included clinical pregnancy, total gonadotropin dose, endometrial thickness, cycle cancelation, and obstetric outcomes. Confounding was addressed using multivariable logistic regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and doubly robust estimation. Results: The crude pregnancy rate was higher in the letrozole plus late rFSH group compared with conventional rFSH (14.8% vs. 9.9%, p = 0.042). Women in the sequential stimulation group had higher AMH levels, higher antral follicle counts, and a higher prevalence of PCOS (32.4% vs. 16.3%, p = 0.001). After adjustment for age, ovarian reserve, and other baseline characteristics using regression, PSM, and IPTW, the stimulation protocol was not independently associated with pregnancy (adjusted OR 1.09, 95% CI 0.68–1.74; p = 0.657). Female age remained the strongest predictor of pregnancy (adjusted OR 0.70 per year increase; p < 0.001). The sequential protocol required a significantly lower total gonadotropin dose (median 375 IU vs. 750 IU; p < 0.001) while maintaining comparable cycle cancellation and safety outcomes. Conclusions: Sequential stimulation with letrozole plus late-onset rFSH achieves pregnancy outcomes comparable to conventional rFSH stimulation while significantly reducing gonadotropin requirements. After adjustment for PCOS status and ovarian reserve, the protocol itself did not independently influence pregnancy, suggesting that crude differences reflected baseline imbalances rather than true treatment effects. This approach represents a clinically efficient, gonadotropin-sparing option for IUI, particularly in patients at risk for excessive ovarian response. Full article

Regulatory T cells (Tregs), particularly their phenotypically distinct subpopulations, are critical for the establishment of maternal immune tolerance during embryo implantation. Despite advances in assisted reproductive technologies, implantation failure remains a frequent and often unexplained clinical challenge. Variations in Treg frequency and phenotype have been proposed to influence implantation success, particularly under differing hormonal conditions. This study aimed to investigate peripheral blood Treg levels and their subpopulations on the day of blastocyst transfer in both stimulated in vitro fertilization (IVF/ICSI) cycles involving controlled ovarian hyperstimulation (COH) and true natural cycles with frozen embryo transfer (FET), and to examine their associations with systemic hormone levels and anti-Müllerian hormone (AMH). A prospective observational study was conducted including women undergoing IVF/ICSI with fresh embryo transfer (ET) and women undergoing natural cycle FET. Peripheral blood samples were collected on the day of ET and analyzed using 13-colour flow cytometry, enabling detailed subdivision of Tregs into multiple subpopulations based on the expression of differentiation and chemokine markers, including CXCR5. In addition, because common $\gamma$-chain cytokines may influence pregnancy success by modulating the balance between suppressive Treg and non-Treg subsets, intracellular STAT5 signaling was assessed using phospho-specific flow cytometry. Serum estradiol, progesterone, FSH, LH, and AMH levels were measured in parallel. Significant differences were observed in Treg subpopulation distributions between women who conceived and those who did not. Higher frequencies of naïve CXCR5⁻ Tregs were associated with clinical pregnancy, independent of age, and correlated with serum progesterone levels. Moreover, both naïve Treg frequency and enhanced IL-7-dependent STAT5 signaling in naïve Tregs from women undergoing COH were associated with AMH levels, suggesting a link between ovarian reserve and Treg homeostasis mediated by signal transducer and activator of transcription 5 (STAT5) signaling. In conclusion, Treg subpopulations, particularly CXCR5⁻ naïve Tregs, appear to play a central role in implantation success following ET. Their distribution differs between stimulated and natural cycles and is influenced by systemic progesterone levels and STAT5 signaling. These findings suggest that peripheral Treg profiling may represent a potential biomarker of implantation competence and could inform personalized approaches in assisted reproduction. Full article

A key objective of the dairy industry is to balance genetic progress with reproductive efficiency. Ovum pick-up followed by in vitro embryo production (OPU-IVP) is a pivotal technology for accelerating genetic gain. However, the relationship between follicle size and oocyte developmental competence in high-producing dairy cows under hormonal stimulation remains to be fully elucidated. This study systematically evaluated the effects of follicle diameter ovum pick-up on OPU-IVP outcomes and the underlying follicular fluid (FF) microenvironment. A total of 109 high-yielding Holstein cows were subjected to ovarian stimulation and OPU. Follicles were categorized as small (2.0–5.9 mm), medium (6.0–9.9 mm), or large (10.0–20.0 mm). Oocyte recovery, quality, and developmental competence were assessed. FF was analyzed for hormonal profiles, including anti-Müllerian hormone (AMH), estradiol (E2), follicle-stimulating hormone (FSH), and progesterone (PROG); oxidative stress markers, including malondialdehyde (MDA), glutathione peroxidase (GPx), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC); and untargeted metabolomics (n = 10 per group). Consistently, oocytes from medium follicles exhibited superior developmental competence, achieving the highest maturation (89.93%), cleavage (72.19%), and blastocyst rates (41.88%). In contrast, large follicles had a low recovery rate (32.64%), a high proportion of degenerated oocytes (32.00%), and reduced embryonic efficiency. Metabolomic profiling revealed distinct microenvironmental differences, with medium follicles enriched in pathways like pyruvate metabolism and arachidonic acid metabolism indicating an optimal metabolic state. Hormonally, AMH decreased while E2 and PROG increased with follicle size. Large follicles exhibited significantly elevated MDA levels, indicating oxidative stress, without a concurrent rise in antioxidant capacity. In conclusion, while small follicles provide an abundant source of morphologically good oocytes, medium follicles (6.0–9.9 mm) represent a distinct “window of competence” for OPU-IVP, characterized by a follicular microenvironment most conducive to embryo production. Excessive reliance on large follicle aspiration should be avoided due to signs of over-maturity and oxidative damage. These findings provide a physiological basis for optimizing OPU strategies to enhance IVP efficiency in high-producing dairy cows. Full article

Diminished ovarian reserve (DOR) is a major cause of female infertility with limited treatment options, and lifestyle interventions such as supervised, structured exercise therapy may support ovarian function. In this pilot study, we evaluated the effect of a supervised, physiotherapy-based exercise program combined with antioxidant supplementation on ovarian reserve markers and spontaneous pregnancy rates in 24 infertile women aged 20–42 years, with body mass index (BMI) 18.5–30 kg/m², regular menstruation, anti-Müllerian hormone (AMH) < 1.1 ng/mL, and antral follicle count ≥3 measured on days 2–4 of the cycle. Participants were randomized into two groups of 12: Both groups received standardized oral therapy, while the intervention group additionally participated in a three-month supervised, structured exercise therapy programme. Analysis of covariance was used to adjust for baseline differences in AMH and BMI, as groups differed significantly in BMI at baseline. At post-treatment assessment, AMH levels were significantly higher in the intervention group, whereas FSH, LH, estradiol, prolactin, and TSH levels did not change significantly. Spontaneous pregnancies were recorded both during the intervention period and throughout a follow-up period of up to six months. Spontaneous pregnancy occurred in 7 out of 12 participants in the intervention group versus 1 out of 12 in the control group, resulting in four and one live births, respectively. These findings suggest that combining supervised, structured exercise therapy with antioxidant supplementation may enhance ovarian reserve and improve the likelihood of spontaneous pregnancy in women with diminished ovarian reserve. Full article

Hemibagrus guttatus is a large omnivorous fish of significant economic value, listed as a Class II protected species in the National Key Protected Wildlife List in 2021 in China. To provide a theoretical foundation for the artificial breeding of H. guttatus, this study employs high-throughput transcriptome sequencing of testes and ovaries to elucidate the molecular regulatory pathways involved in sex differentiation. Because H. guttatus exhibits no obvious sexual dimorphism even during the breeding season, the distinctive contribution of this study compared with previous gonadal-transcriptomic investigations in other Siluriformes lies not only in documenting sex-biased genes but also in providing a molecular foundation for developing non-lethal sex-identification methods for this morphologically indistinguishable species. A total of 303,192,896 raw reads were obtained, with an effective data rate of 98.4%, indicating high sequencing quality. Differential expression analysis identified 8694 genes, including 6369 upregulated in testes and 2325 upregulated in ovaries. Among these, 88 genes were functionally annotated as sex-related, with 62 testis-biased genes such as spata17, sox9, and dmrt1, and 26 ovary-biased genes including cyp19a, wnt8, and sox12. KEGG pathway enrichment analysis revealed that the TGF-β signaling pathway, insulin secretion, and steroid hormone biosynthesis may play crucial roles in gonadal development and differentiation in H. guttatus. The expression patterns of key genes such as hsd11b1, amh, and insl3 were validated by quantitative real-time PCR, showing consistency with the transcriptome results. These findings lay a molecular foundation for understanding the regulatory mechanisms of sex differentiation in H. guttatus, and provide candidate genes for further investigation into the genetic basis of gonadal development, which is essential for improving artificial reproduction and selective breeding practices. Full article

Background and Objectives: Klotho (KL) is a multifunctional protein involved in reproductive physiology; however, its precise role in ovarian reserve and in vitro fertilization (IVF) outcomes remains unclear. This study aimed to evaluate the relationship between follicular fluid KL levels, ovarian reserve markers, and key IVF success parameters. Materials and Methods: This prospective study included a total of 150 women undergoing IVF, of whom 82 had diminished ovarian reserve (DOR) and 68 had normal ovarian reserve (NOR). All participants underwent controlled ovarian stimulation using a standard antagonist protocol. During oocyte pick-up (OPU), the first aspirated follicular fluid sample was collected, processed, and analyzed for KL concentrations using a Human Klotho ELISA kit. Hormonal profiles, ovarian reserve markers, and IVF outcomes were compared between groups. Results: Follicular fluid KL levels were significantly lower in the DOR group compared with the NOR group (117.07 ± 28.88 pg/mL vs. 266.13 ± 58.29 pg/mL; p < 0.001). Anti-Müllerian hormone (AMH) levels were reduced, whereas follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels were significantly higher in the DOR group (all p < 0.001). Implantation and clinical pregnancy rates were also significantly lower in the DOR group compared with the NOR group (p < 0.001 and p = 0.003, respectively). KL levels showed a strong positive correlation with the number of fertilized oocytes in both groups (DOR: r = 0.690; NOR: r = 0.552). Each one-unit increase in KL was associated with a 3.7% increase in implantation probability and a 3.2% increase in clinical pregnancy probability in the DOR group, and with corresponding increases of 4.4% and 1.2% in the NOR group (all p < 0.05). Conclusions: This study demonstrates significant associations between follicular fluid KL levels and fertilization, implantation, and clinical pregnancy outcomes. These associations appear to be more pronounced than those observed with traditional ovarian reserve markers such as AMH and antral follicle count. Reduced KL levels are associated with fewer fertilized oocytes, whereas higher KL concentrations correspond to increased implantation and clinical pregnancy probabilities. Nevertheless, similar to other non-invasive biomarkers, current evidence is insufficient to support routine clinical use of KL. Large-scale, well-designed, multicenter studies are therefore required to validate its clinical relevance and to determine whether KL can serve as a reliable and practical predictor of IVF success. Full article

Sex determination and differentiation in teleosts are governed by complex genetic regulatory networks that include evolutionarily conserved mechanisms. In this study, we investigated Boleophthalmus pectinirostris, a Gobiidae species lacking heterogametic sex chromosomes, using comparative gonadal transcriptome analysis to identify sex differentially expressed genes (DEGs). RNA sequencing of ovarian and testicular tissues identified 17,214 DEGs, including 14,302 upregulated in males and 2912 upregulated in females. These DEGs were primarily associated with male (e.g., dmrt1, amh, amhr2) or female (e.g., bmp15, gdf9, rspo1) sex determination and differentiation, steroidogenesis (e.g., hsd17b1, hsd3b1, cyp17a1), and meiosis (e.g., cyp26b1, aldh1a2, piwil2). Functional enrichment analysis revealed that male upregulated DEGs were involved in spermatogenesis pathways such as calcium signaling, while female upregulated DEGs were associated with oogenesis pathways including oocyte meiosis and progesterone-mediated oocyte maturation. Conserved regulators, notably dmrt1 and amh, were predicted to act as key hubs in protein–protein interaction networks, being primarily associated with reproductive processes and sex differentiation in B. pectinirostris. The amh gene produces two alternatively spliced isoforms that differ by a partial deletion in the second exon, both expressed in ovaries and testes. Collectively, this study provides the first comprehensive molecular framework of sex determination and differentiation in Gobiidae species, offering critical insights into the regulatory mechanisms of B. pectinirostris reproductive development. Full article

Background: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and an increased prevalence of metabolic syndrome. Clusterin (CLU), a chaperone protein induced by cellular stress and known to play roles in inflammation, oxidative stress, and lipid metabolism, may be associated with the metabolic abnormalities observed in patients with PCOS. The purpose of this current study is to investigate serum CLU levels and their link with endocrine, biochemical, and metabolic parameters, such as metabolic syndrome, among women with PCOS. Methods: This cross-sectional study included 40 women aged 18–30 with PCOS diagnosed according to the Rotterdam criteria and 40 age- and BMI-matched healthy controls. Demographic data, Ferriman–Gallwey scores, hormonal and metabolic parameters (including TSH, prolactin, 17-OH progesterone, total testosterone, insulin, AMH, HOMA-IR, and serum CLU levels), and ultrasonographic ovarian morphology were assessed. Statistical analyses, including ROC and logistic regression, were performed. Results: Women with PCOS had higher follicle counts, Ferriman–Gallwey scores, LH/FSH ratios, fasting insulin levels, HOMA-IR, triglycerides, and systolic blood pressure than controls, whereas menstrual cycle frequency and HDL levels were lower (all p < 0.05). Serum CLU concentrations were markedly higher in the PCOS cohort. In the PCOS population, CLU showed positive relationships with the Ferriman–Gallwey score, fasting glucose, fasting insulin, HOMA-IR, and triglycerides, and a negative correlation with HDL. CLU levels were significantly higher in women with metabolic syndrome in the PCOS cohort compared to those without. In logistic regression analysis, CLU, AMH, and the LH/FSH ratio emerged as independent predictors of PCOS. Furthermore, CLU remained an independent predictor of metabolic syndrome in the PCOS cohort. In ROC analysis, CLU demonstrated strong diagnostic efficacy in detecting both PCOS (AUC = 0.834) and metabolic syndrome in patients with PCOS (AUC = 0.804). Conclusions: Our results show that serum CLU is higher in women with PCOS and is associated with the clinical and metabolic features peculiar to patients with PCOS. CLU was found to distinguish between patients with PCOS and healthy women and demonstrated a strong association with the presence of metabolic syndrome within the PCOS group. Overall, these findings suggest that CLU may be a valuable auxiliary biomarker for detecting women with PCOS at risk for metabolic disturbances. Full article