Mesencephalic astrocyte-derived neurotrophic factor (MANF) is a novel
neurotrophic factor. Although recent studies have suggested that MANF
appeared to be associated with insulin resistance, the results have been
inconsistent. The aim of our study was to determine the serum MANF levels in
women with PCOS and controls, to investigate their relationship to insulin
resistance, and to evaluate circulating MANF changes with metformin
intervention in PCOS women. We conducted a series of cross-sectional and
interventional studies in 90 newly diagnosed patients with PCOS and 60 age-
and gender-matched controls. Oral glucose tolerance test and
euglycemic-hyperinsulinemic clamps were performed to assess the glucose
tolerance and insulin sensitivity. Forty-three women with PCOS were randomly
assigned to six months of oral metformin therapy. Serum MANF levels were
significantly lower in women with PCOS than in controls. Serum MANF levels
were positively correlated with M-value and negatively correlated with body
mass index (BMI), body fat percentage (FAT), homeostatic model assessment of
insulin resistance (HOMA-IR), and free androgen index (FAI). Multivariate
stepwise regression demonstrated that serum MANF levels were independently
associated with M-value and FAI. After six months of metformin treatment,
there was a significant increase in serum MANF levels in PCOS women. Serum
MANF levels are decreased in women with PCOS, and are reversely related to
insulin resistance and hyperandrogenism. Metformin treatment elevates serum
MANF levels and alleviates insulin resistance and hyperandrogenism in PCOS
women.