Clinical Significance of Inflammatory Markers in Polycystic Ovary Syndrome: Their Relationship to Insulin Resistance and Body Mass Index

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 factorα(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/m2) and group II (BMI ≥ 27 Kg/m2). 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-αbetween 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-αlevels (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.

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Soluble CD36 and Risk Markers of Insulin Resistance and Atherosclerosis Are Elevated in Polycystic Ovary Syndrome and Significantly Reduced During Pioglitazone Treatment

Diabetes Care ◽

10.2337/dc07-1424 ◽

2007 ◽

Vol 31 (2) ◽

pp. 328-334 ◽

Cited By ~ 72

Author(s):

D. Glintborg ◽

K. Hojlund ◽

M. Andersen ◽

J. E. Henriksen ◽

H. Beck-Nielsen ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Risk Markers ◽

Ovary Syndrome ◽

Pioglitazone Treatment

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The Impact of Body Mass Index and Insulin Resistance on IVF Outcomes of Polycystic Ovary Syndrome

Northern Clinics of Istanbul ◽

10.14744/nci.2017.79663 ◽

2017 ◽

Author(s):

Yigit Cakiroglu

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Polycystic Ovary Syndrome ◽

Body Mass ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Ivf Outcomes ◽

The Impact

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Insulin resistance in relation to clinical, endocrine and metabolic profile of infertile women with polycystic ovary syndrome

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v14i1.50989 ◽

2021 ◽

Vol 14 (1) ◽

pp. 1-6

Author(s):

Shakeela Ishrat ◽

Marufa Hossain ◽

Subrata Kumar Biswas

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Waist Circumference ◽

Polycystic Ovary Syndrome ◽

Body Mass ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Infertile Women ◽

Significant Difference

The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to the clinical, endocrine and metabolic factors in the infertile women with polycystic ovary syndrome. This study was conducted on 121 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit from January 2017 to December 2017. They were divided into two groups: insulin resistant and insulin sensitive. There was significant difference in body mass index and waist circumference between the two groups. Serum lipids were not associated with insulin resistance. Hyperinsulinemia was significantly associated with metabolic syndrome. Reducing body mass index and waist circumference may improve insulin resistance in infertile women with polycystic ovary syndrome. Screening the infertile women with polycystic ovary syndrome for hyperinsulinemia and insulin resistance and subsequent counseling is recommended to address the long-term risks of metabolic syndrome.

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Evaluation of Inflammatory Markers in Pregnant Women at Risk, for the Prediction of Preeclampsia

Acta Medica Marisiensis ◽

10.2478/amma-2014-0019 ◽

2014 ◽

Vol 60 (3) ◽

pp. 94-98 ◽

Cited By ~ 1

Author(s):

Mihaela Daniela Oancea ◽

N. Costin ◽

Daria Maria Pop ◽

R. Ciortea ◽

Ioana Trif ◽

...

Keyword(s):

Pregnant Women ◽

Inflammatory Markers ◽

High Sensitivity ◽

Serum Levels ◽

Second Trimester ◽

Prospective Longitudinal Study ◽

Reactive Protein ◽

Group I ◽

Hs Crp ◽

Prospective Longitudinal

Abstract Introduction: A low degree of inflammation has been associated with complications in pregnancies, including preeclampsia (PE). The aim of our study was to determine the serum values of high sensitivity C Reactive Protein (hs-CRP) and Interleukin-6 (IL-6) in the first and second trimesters of pregnancy in pregnant women with risk factors for the development of PE, and to evaluate their relevance for the prediction of this disorder. Material and methods: We performed a prospective longitudinal study on 120 pregnant women, who were divided based on the pregnancy evolution, into two groups: group I - 26 pregnant women who developed preeclampsia and group II - 94 pregnant women with physiological evolution of pregnancy. Results: Our study has shown an increase in serum levels of hs-CRP and IL-6 in the first and second trimester of pregnancy in patients from group I, significant values being revealed only in the second trimester of pregnancy. The predictive power of the selected inflammatory markers was significant only for values of hs-CRP in the second trimester of pregnancy, while the association with IL-6 increased the prediction. Conclusions: Increased values of hs-CRP and IL-6 in the second trimester of pregnancy are associated with higher risk for preeclampsia, however the study provided only a modest efficiency of the prediction capacity.

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Prevalence of insulin resistance among American women with polycystic ovary syndrome (PCOS) as a function of body mass index (BMI)

Fertility and Sterility ◽

10.1016/j.fertnstert.2007.07.262 ◽

2007 ◽

Vol 88 ◽

pp. S78-S79

Author(s):

M.H. Dahan ◽

F. Abbasi ◽

G. Reaven

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Polycystic Ovary Syndrome ◽

Body Mass ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

American Women

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Obesity, hormonal and metabolic abnormalities in adolescent girls with polycystic ovary syndrome

Orvosi Hetilap ◽

10.1556/oh.2013.29669 ◽

2013 ◽

Vol 154 (31) ◽

pp. 1226-1234

Author(s):

László Ságodi ◽

Béla Lombay ◽

Ildikó Vámosi ◽

László Barkai

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Birth Weight ◽

Low Birth Weight ◽

Polycystic Ovary Syndrome ◽

Adolescent Girls ◽

Polycystic Ovary ◽

Metabolic Abnormalities ◽

Ovary Syndrome

Introduction: Polycystic ovary syndrome is associated with metabolic abnormalities, such as dyslipidemia, obesity, glucose intolerance, which are also components of the metabolic syndrome. Central obesity and insulin resistance appear to play an important role in the pathogenesis of polycystic ovary syndrome, perhaps via subsequent steroidogenic dysregulation. Aim: The aim of the authors was to assess metabolic and hormonal abnormalities in adolescent girls with polycystic ovary syndrome. Method: The study included 52 adolescents diagnosed with polycystic ovary syndrome based on the Rotterdam criteria. Anthropometric, hormonal and metabolic parameters were evaluated among all subjects. 20 healthy, age-matched, non-obese, regularly menstruating girls were used as controls. Of the 52 patients, 15 patients were born with low-birth-weight and 37 patients were born with normal birth weight. Oral glucose tolerance test was performed in all patients and controls. The age of patients was 16.8±3.1 years, and the age of controls was 16.95±2.1 years. Results: Among patients with polycystic ovary syndrome the prevalence of overweight and obesity was 35% (n = 18), while impaired fasting glucose occurred in one patient, impaired glucose tolerance in 8 patients, insulin resistance in 25 patients and metabolic syndrome in 12 patients. Serum triglyceride levels in patients and controls were 1.4±0.8 and 0.9±0.3 mmol/l, respectively (p<0.05), while fasting blood glucose, total cholesterol, HDL and LDL cholesterol were not different in the two groups. Metabolic abnormalities and obesity were more severe and more frequent in patients with low-birth-weight compared to those born with normal weight. There was a negative correlation between birth weight and body mass index SDS values and a positive correlation between fasting insulin levels and body mass index SDS (r = 0.37) in patients born with low-birth-weight. Conclusions: Abnormal glucose metabolism is frequently present in adolescents with polycystic ovary syndrome. It is possible that early diagnosis of polycystic ovary syndrome in adolescences may prevent some of the long-term complications associated with this syndrome. Orv. Hetil., 2013, 154, 1226–1234.

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The Relationship between Vitamin D Metabolites and Androgens in Women with Polycystic Ovary Syndrome

Nutrients ◽

10.3390/nu12051219 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1219

Author(s):

Jakub Mesinovic ◽

Helena J. Teede ◽

Soulmaz Shorakae ◽

Gavin W. Lambert ◽

Elisabeth A. Lambert ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Polycystic Ovary ◽

Total Testosterone ◽

Body Fat Percentage ◽

Vitamin D Metabolites ◽

Fat Percentage ◽

Ovary Syndrome ◽

Hs Crp ◽

The Relationship

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, with hyperandrogenism present in up to 90% of affected women. Some evidence suggests a link between vitamin D deficiency and PCOS features via insulin resistance and inflammation. Our aim was to explore the relationship between biochemical markers of vitamin D status and androgens in women with PCOS. This cross-sectional study used bio-banked samples from 46 pre-menopausal women with PCOS (mean ± SD: age 30 ± 6 years; BMI 29 ± 6 kg/m2). We measured 25-hydroxyvitamin D (25[OH]D), vitamin D-binding protein (DBP), total testosterone, sex hormone-binding globulin (SHBG), and calculated the free androgen index (FAI) and bioavailable and free 25(OH)D. Fasting glucose and insulin were used to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) and body fat percentage was determined via dual energy x-ray absorptiometry. High-sensitivity C-reactive protein (hs-CRP) was measured as a marker of inflammation. DBP was positively associated with total 25(OH)D and expectedly, negatively associated with free 25(OH)D. There were no associations between vitamin D metabolites and total testosterone, SHBG or FAI, even after adjusting for age, body fat percentage, HOMA-IR and hs-CRP. We found no associations between vitamin D metabolites and androgens in women with PCOS. Studies that have identified a vitamin D–androgen link have largely relied on methodology with numerous pitfalls; future studies should exclusively use gold-standard measures to confirm these findings in this population.

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