Affiliations: Biochemistry Department -National Research Center,
Cairo, Egypt | Obstetrics and Gynecology Department, Faculty of
medicine, Ain Shams University, Cairo, Egypt
Note: [] Corresponding author: Dr. Nervana Samy, Biochemistry Department,
National Research Center, El Bohos street, Cairo, Egypt. Tel.: +202 2630815;
E-mail: nervana91@hotmail.com
Abstract: Background: Women with polycystic ovary syndrome (PCOS) have an
increased prevalence of insulin resistance (IR) and related disorders. Elevated
serum levels of high sensitivity CRP (hs-CRP), interleukin-6 (IL-6) and tumor
necrosis factor α (TNF-α) reflect low-grade chronic inflammation
and have been associated with several insulin-resistant states; they are useful
cardiovascular risk markers. The objective of this study was to investigate
whether soluble inflammatory markers are altered in PCOS focusing on its
relationship with obesity and indexes of insulin resistance. Patients and methods: One hundred and eight women with PCOS and 75
healthy women were recruited. Patients were divided according to body mass
index (BMI) into two groups; group I (BMI < 27 kg/m^{2})
and group II (BMI ⩾ 27 Kg/m^{2}). Serum levels of
hs-CRP, IL-6, and TNF-α, lipid and hormone profiles were measured. Results: PCOS patients had increased levels of testosterone,
luteinizing hormone (LH), androstendione, insulin level and HOMA index compared
to healthy BMI matched controls. High-density lipoprotein (HDL) concentrations
were significantly reduced in both patient groups compared to their controls,
while triglyceride levels were significantly increased in obese group compared
to controls. There were no significant difference in serum inflammatory markers
hs-CRP, IL-6 and TNF-α between group I and their matched controls. On the
other hand, there were significant increase in these markers between group II
and their matched controls. There were highly significant positive correlation
between hs-CRP and IL-6 (r=0.702, P< 0.001) and between hs-CRP and
TNF-α (r=0.621, P<0.001), also between IL-6 and TNF-α (r=0.543,
P< 0.001). These inflammatory markers correlated significantly with BMI and
HOMA index. Multiple regression analysis revealed that BMI and HOMA were
predictors of IL-6 levels (b=11.173, P< 0.001, b=13.564, P< 0.001
respectively) and BMI was the only predictor of hs-CRP levels (b=12.578,
P< 0.001) and TNF-α levels (b=0.134, P<0.001). Conclusion: PCOS and obesity induce an increase in serum inflammatory
cardiovascular risk markers. The precise mechanisms underlying these
associations require additional studies to clarify the state of the
cardiovascular system in women with PCOS compared with controls in large
numbers of patients to determine the relative contribution of different factors
including insulin resistance, androgen status and BMI.
