D-lactate levels are elevated in women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a complex syndrome with various metabolic disorders. Previous studies have reported that D-lactate is commonly related to metabolic disturbances. However, the role of D-lactate in PCOS remains unclear. Methods: Serum D-lactate levels from control (n = 132) and women with PCOS (n = 132) were measured, and their relationship with several metabolic parameters were analyzed. The correlation of serum D-lactate with PCOS was assessed using logistic regression analysis, and the performance of serum D-lactate as a potential predictor for PCOS was evaluated using receiver operating characteristic curve analysis. Results: Serum D-lactate levels were markedly higher in patients with PCOS compared with those of controls (P < 0.001). The proportion of PCOS was substantially higher in increasing quartiles of serum D-lactate levels (P < 0.001). After adjusting for other confounders, there was still a correlation between D-lactate and PCOS (P < 0.001; odds ratio, 5.654; 95% confidence interval, 3.091–10.342). D-lactate levels were positively correlated with fasting serum insulin, homeostasis model assessment of insulin resistance, and triglycerides in patients with PCOS (all P < 0.01), which was not detected in controls (P > 0.05). D-lactate had an area under the curve (AUC) of 79.4% in predicting PCOS, with a similar performance as anti-Müllerian hormone (AMH) and luteinizing hormone (LH), and its combination with AMH and LH yielded a higher AUC of 90.9%. Conclusions: Substantially elevated serum D-lactate levels are significantly associated with PCOS, highlighting the importance of further research into the role of D-lactate in the pathogenesis of PCOS.