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Erschienen in: Archives of Gynecology and Obstetrics 2/2014

01.08.2014 | General Gynecology

The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case–control study

verfasst von: Raziye Keskin Kurt, Ayşe Güler Okyay, Ali Ulvi Hakverdi, Arif Gungoren, Kenan Serdar Dolapcioglu, Atilla Karateke, Mustafa Ozcil Dogan

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2014

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Abstract

Background

Previous studies have shown increased inflammatory activity in patients with polycystic ovary syndrome (PCOS); however, it remains uncertain whether this increased inflammatory activity is a consequence of the disorder itself or of the accompanying obesity. We therefore aimed to test the inflammatory marker levels in obese and lean patients with PCOS by using two separate control groups with matching body mass index (BMI).

Method

A total of 120 women in reproductive age with (n = 62) and without (n = 60) PCOS were recruited for the study. Patients with PCOS were divided into two groups as obese (n = 32) and lean (n = 30) PCOS groups according to BMI. Two BMI-matched control groups were created. Furthermore, high sensitive CRP protein (hsCRP), neutrophils, lymphocytes, white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) were evaluated with complete blood count.

Results

The hsCRP (5.5 ± 0.8 vs. 3.1 ± 0.7, p < 0.001), neutrophil count (3.8 ± 0.4 vs. 2.9 ± 0.7, p < 0.001), leukocyte count (7.2 ± 1.8 vs. 5.6 ± 1.6, p < 0.001), and NLR (2.6 ± 1.4 vs. 1.5 ± 0.4, p < 0.001) were higher in patients with PCOS compared to the control group while lymphocyte count was lower (1.71 ± 0.65 vs. 1.98 ± 0.39, p = 0.008). Similarly, both obese and lean patients with PCOS had higher levels of hsCRP, neutrophils, leukocytes and NLR ratios compared to BMI-matched controls. The correlation analysis revealed a moderate correlation between NLR and hsCRP (r 0.459, p < 0.001), and between HOMA-IR (r 0.476 p < 0.001) and BMI (r 0.310, p 0.001).

Conclusion

Our study results demonstrated that both lean and obese patients with PCOS have increased inflammatory markers compared to BMI-matched control groups indicating that the inflammation seen in PCOS might be related with the presence of the disorder rather than with obesity.
Literatur
1.
Zurück zum Zitat Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO (2004) The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 89:2745–2749PubMedCrossRef Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO (2004) The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 89:2745–2749PubMedCrossRef
2.
Zurück zum Zitat Legro RS (2003) Diagnostic criteria in polycystic ovary syndrome. Semin Reprod Med 21:267–275PubMedCrossRef Legro RS (2003) Diagnostic criteria in polycystic ovary syndrome. Semin Reprod Med 21:267–275PubMedCrossRef
3.
Zurück zum Zitat Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N (2001) Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 86:2453–2455PubMedCrossRef Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N (2001) Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 86:2453–2455PubMedCrossRef
4.
Zurück zum Zitat Diamanti-Kandarakis E, Alexandraki K, Piperi C, Protogerou A, Katsikis I, Paterakis T et al (2006) Inflammatory and endothelial markers in women with polycystic ovary syndrome. Eur J Clin Invest 36:691–697PubMedCrossRef Diamanti-Kandarakis E, Alexandraki K, Piperi C, Protogerou A, Katsikis I, Paterakis T et al (2006) Inflammatory and endothelial markers in women with polycystic ovary syndrome. Eur J Clin Invest 36:691–697PubMedCrossRef
5.
Zurück zum Zitat Orio F Jr, Palomba S, Cascella T, Di Biase S, Manguso F, Tauchmanova L et al (2005) The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol metab 90:2–5PubMedCrossRef Orio F Jr, Palomba S, Cascella T, Di Biase S, Manguso F, Tauchmanova L et al (2005) The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol metab 90:2–5PubMedCrossRef
6.
Zurück zum Zitat Festa A, D’Agostino R Jr, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP et al (2001) The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Rel Metab Disord : J Int Assoc Study Obes 25:1407–1415CrossRef Festa A, D’Agostino R Jr, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP et al (2001) The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Rel Metab Disord : J Int Assoc Study Obes 25:1407–1415CrossRef
7.
Zurück zum Zitat Mohlig M, Spranger J, Osterhoff M, Ristow M, Pfeiffer AF, Schill T et al (2004) The polycystic ovary syndrome per se is not associated with increased chronic inflammation. Eur J Endocrinol/Eur Fed Endocr Soc 150:525–532CrossRef Mohlig M, Spranger J, Osterhoff M, Ristow M, Pfeiffer AF, Schill T et al (2004) The polycystic ovary syndrome per se is not associated with increased chronic inflammation. Eur J Endocrinol/Eur Fed Endocr Soc 150:525–532CrossRef
8.
Zurück zum Zitat Kaya A, Kaya Y, Topcu S, Gunaydin ZY, Kurt M, Tanboga IH et al (2013) Neutrophil-to-lymphocyte ratio predicts contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention. Angiology. doi:10.1177/0003319713484789 Kaya A, Kaya Y, Topcu S, Gunaydin ZY, Kurt M, Tanboga IH et al (2013) Neutrophil-to-lymphocyte ratio predicts contrast-induced nephropathy in patients undergoing primary percutaneous coronary intervention. Angiology. doi:10.​1177/​0003319713484789​
9.
Zurück zum Zitat Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ (2005) Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 91:181–184PubMedCrossRef Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ (2005) Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 91:181–184PubMedCrossRef
10.
Zurück zum Zitat Azab B, Bhatt VR, Phookan J, Murukutla S, Kohn N, Terjanian T et al (2012) Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol 19:217–224PubMedCrossRef Azab B, Bhatt VR, Phookan J, Murukutla S, Kohn N, Terjanian T et al (2012) Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol 19:217–224PubMedCrossRef
11.
Zurück zum Zitat Okyay GU, Inal S, Onec K, Er RE, Pasaoglu O, Pasaoglu H et al (2013) Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail 35:29–36PubMedCrossRef Okyay GU, Inal S, Onec K, Er RE, Pasaoglu O, Pasaoglu H et al (2013) Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail 35:29–36PubMedCrossRef
12.
Zurück zum Zitat Celikbilek M, Dogan S, Ozbakir O, Zararsiz G, Kucuk H, Gursoy S, et al. (2013) Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 27:72–6 Celikbilek M, Dogan S, Ozbakir O, Zararsiz G, Kucuk H, Gursoy S, et al. (2013) Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 27:72–6
13.
Zurück zum Zitat Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S (2012) Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 5:2PubMedCentralPubMedCrossRef Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S (2012) Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 5:2PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25
15.
Zurück zum Zitat Pangaribuan B, Yusuf I, Mansyur M, Wijaya A (2011) Serum adiponectin and resistin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome. Ther Adv Endocrinol Metab 2:235–245PubMedCentralPubMedCrossRef Pangaribuan B, Yusuf I, Mansyur M, Wijaya A (2011) Serum adiponectin and resistin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome. Ther Adv Endocrinol Metab 2:235–245PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Boulman N, Levy Y, Leiba R, Shachar S, Linn R, Zinder O et al (2004) Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab 89:2160–2165PubMedCrossRef Boulman N, Levy Y, Leiba R, Shachar S, Linn R, Zinder O et al (2004) Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab 89:2160–2165PubMedCrossRef
17.
Zurück zum Zitat Zahorska-Markiewicz B, Janowska J, Olszanecka-Glinianowicz M, Zurakowski A (2000) Serum concentrations of TNF-alpha and soluble TNF-alpha receptors in obesity. Int J Obes Relat Metabol Disord: J Int Assoc Study Obes 24:1392–1395CrossRef Zahorska-Markiewicz B, Janowska J, Olszanecka-Glinianowicz M, Zurakowski A (2000) Serum concentrations of TNF-alpha and soluble TNF-alpha receptors in obesity. Int J Obes Relat Metabol Disord: J Int Assoc Study Obes 24:1392–1395CrossRef
18.
Zurück zum Zitat Kim JW, Han JE, Kim YS, Won HJ, Yoon TK, Lee WS (2012) High sensitivity C-reactive protein and its relationship with impaired glucose regulation in lean patients with polycystic ovary syndrome. Gynecol Endocrinol 28:259–263PubMedCrossRef Kim JW, Han JE, Kim YS, Won HJ, Yoon TK, Lee WS (2012) High sensitivity C-reactive protein and its relationship with impaired glucose regulation in lean patients with polycystic ovary syndrome. Gynecol Endocrinol 28:259–263PubMedCrossRef
19.
Zurück zum Zitat Kahal H, Aburima A, Ungvari T, Rigby AS, Dawson AJ, Coady AM et al (2013) Polycystic ovary syndrome has no independent effect on vascular, inflammatory or thrombotic markers when matched for obesity. Clin Endocrinol 79:252–258CrossRef Kahal H, Aburima A, Ungvari T, Rigby AS, Dawson AJ, Coady AM et al (2013) Polycystic ovary syndrome has no independent effect on vascular, inflammatory or thrombotic markers when matched for obesity. Clin Endocrinol 79:252–258CrossRef
20.
Zurück zum Zitat Escobar-Morreale HF, Luque-Ramirez M, Gonzalez F (2011) Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and meta analysis. Fertil Steril 95(1048–58):e1–e2 Escobar-Morreale HF, Luque-Ramirez M, Gonzalez F (2011) Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and meta analysis. Fertil Steril 95(1048–58):e1–e2
21.
Zurück zum Zitat Nunez J, Nunez E, Bodi V, Sanchis J, Minana G, Mainar L et al (2008) Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 101:747–752PubMedCrossRef Nunez J, Nunez E, Bodi V, Sanchis J, Minana G, Mainar L et al (2008) Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 101:747–752PubMedCrossRef
22.
Zurück zum Zitat Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS (2008) Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102:653–657PubMedCrossRef Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS (2008) Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102:653–657PubMedCrossRef
23.
Zurück zum Zitat Ibanez L, Jaramillo AM, Ferrer A, de Zegher F (2005) High neutrophil count in girls and women with hyperinsulinaemic hyperandrogenism: normalization with metformin and flutamide overcomes the aggravation by oral contraception. Hum Reprod 20:2457–2462PubMedCrossRef Ibanez L, Jaramillo AM, Ferrer A, de Zegher F (2005) High neutrophil count in girls and women with hyperinsulinaemic hyperandrogenism: normalization with metformin and flutamide overcomes the aggravation by oral contraception. Hum Reprod 20:2457–2462PubMedCrossRef
24.
Zurück zum Zitat Herlihy AC, Kelly RE, Hogan JL, O’Connor N, Farah N, Turner MJ (2011) Polycystic ovary syndrome and the peripheral blood white cell count. J Obstet Gynaecol: J Inst Obstet Gynaecol 31:242–244CrossRef Herlihy AC, Kelly RE, Hogan JL, O’Connor N, Farah N, Turner MJ (2011) Polycystic ovary syndrome and the peripheral blood white cell count. J Obstet Gynaecol: J Inst Obstet Gynaecol 31:242–244CrossRef
25.
Zurück zum Zitat Tarkun I, Arslan BC, Canturk Z, Turemen E, Sahin T, Duman C (2004) Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and low-grade chronic inflammation. J Clin Endocrinol Metab 89:5592–5596PubMedCrossRef Tarkun I, Arslan BC, Canturk Z, Turemen E, Sahin T, Duman C (2004) Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and low-grade chronic inflammation. J Clin Endocrinol Metab 89:5592–5596PubMedCrossRef
Metadaten
Titel
The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case–control study
verfasst von
Raziye Keskin Kurt
Ayşe Güler Okyay
Ali Ulvi Hakverdi
Arif Gungoren
Kenan Serdar Dolapcioglu
Atilla Karateke
Mustafa Ozcil Dogan
Publikationsdatum
01.08.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2014
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3199-3

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