One of the included RCTs involved 80 PCOS patients and 80 matching controls and showed that the visfatin protein in the endometrial tissue of PCOS patients was highly upregulated and that the phosphorylation of AKT and ERK1/2 was also significantly increased, thus indicating that the malignant transformation of the endometrium in PCOS patients might be associated with the visfatin protein and the activation of the AKT and ERK1/2 signaling pathways [43]. This evidence concerns the gene NAMPT and polycystic ovary syndrome.