Indices of Low‐Grade Inflammation in Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) is probably the most common endocrinopathy of reproductive age. PCOS represents a disorder that not only enhances the risk for type 2 diabetes (T2D) but is also associated with an increased number of cardiovascular risk factors known to facilitate atherogenesis. On the other hand, inflammation is thought to play an important role in the progression and development of complications of atherosclerosis. Evidence of low-grade chronic inflammation in PCOS is indicated by the presence of elevated C-reactive protein (CRP) levels, inflammatory cytokines (i.e., IL-6 and IL-18), and increased leucocyte count. CRP, a nonspecific marker of inflammation, has been proven to be one of the strongest predictors of the risk of cardiovascular events in patients with or without cardiovascular disease. The levels of the adhesion molecules (AM), sIVAM-1, sVCAM-1, and sE-selectin in serum reflect low-grade chronic inflammation of the endothelium and independently predict coronary heart disease (CHD) and T2D. In a recent study in a large number of PCOS women we demonstrated elevated levels of sIVAM-1 and sE-selectin and we further substantiated the existence of a low-grade chronic inflammatory process in PCOS. However, it remains to be assessed with long-term studies whether the early presence of markers of chronic inflammation in young women with this syndrome has clinical significance.

The polycystic ovary syndrome (pcos) status and cardiovascular risk in young women

“…We prospectively studied 45 women with PCOS (age: 23.11± 4.14 (15)(16)(17)(18)(19)(20)(21)(22)(23), body mass index (BMI): 28.41±5.97 (15.62-40.74) kg/m 2 ), who were presented to our clinic. The study protocol was approved by the local ethics board and informed written consent was obtained from all participants.…”

“…A control group composed of 32 women (age: 23.06 ±5.37 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), BMI: 25.87± 6.89 (16.88-42.86) kg/m 2 ) was selected as to be similar to the group of patients in terms of age and BMI. In the end though, our intention was not fully accomplished because there was still a significant difference in BMI between the groups.…”

“…For example, there are reports which have demonstrated that PCOS is associated with endothelial dysfunction or increased CIMT even from a young age, while other reports have stated the contrary [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Additionally, there are authors who consider PCOS as a pro-inflammatory state due to elevated plasma concentrations of inflammatory mediators of atherogenesis, such as interleukin (IL)-6, IL-18, soluble intercellular adhesion molecule-1 (sICAM-1), sEselectin, high sensitivity C-reactive protein (hsCRP), tumoral necrosis factor-alpha (TNF-α), monocyte chemotactic protein-1 (MCP-1), and plasminogen activator inhibitor-1 (PAI-1) [17][18][19]. However, there are also studies which have not confirmed the elevated levels of inflammatory markers in PCOS [20,21].…”

Obesity, but not polycystic ovary syndrome, affects circulating markers of low-grade inflammation in young women without major cardiovascular risk factors

“…1 There is evidence that PCOS is also a proinflammatory disorder, characterized by the presence of chronic low-grade inflammation, 2,3 as variants in genes encoding several inflammatory cytokines and their receptors associated with insulin resistance (IR), obesity and/ or DM have also been found to be associated with the syndrome. [4][5][6][7][8] Cytokines are soluble molecules that are involved in intercellular communication, these produced by a wide variety of cells in the body including adipocytes, 9 and being involved in several biological processes, including atherosclerosis.…”

Circulating osteoprotegerin and soluble receptor activator of nuclear factor κB ligand in polycystic ovary syndrome: relationships to insulin resistance and endothelial dysfunction

“…There is substantial evidence that young obese and nonobese patients with PCOS present impaired endothelial function (18)(19)(20)(21), insulin resistance (20,21), and low-grade chronic inflammation (22) and are at risk for cardiovascular disease (23).…”