Following sitagliptin intervention, the expression levels of IGFBP-1 and HOXA10 in the PCOS + MS group improved relative to the PCOS group (Fig. 4C and D, MD of IGFBP-1 and HOXA10 = − 891.5, − 1172, p = 0.0001, p < 0.0001; Fig. 4E and Supplementary Fig. 5, MD of IGFBP-1 and HOXA10 = − 0.8144, − 0.6055, p < 0.0001, p < 0.0001). Here, HOXA10 is linked to polycystic ovary syndrome.