Tumor necrosis factor-alpha and polycystic ovarian syndrome: a clinical, biochemical, and molecular genetic study.

BACKGROUND: Tumor necrosis factor-alpha (TNF-α) appears to be linked with hyperandrogenism (HA), increased insulin resistance (IR), and obesity (Ob), which were common features noted with polycystic ovarian syndrome (PCOS). Our aim was to study the role of TNF-α in the pathogenesis of IR and Ob in PCOS, as well as a C850T (rs1799724) polymorphism in the promoter region of the TNF-α gene, in a group of 204 PCOS patients and 204 age-matched healthy controls. RESULTS: Significant differences were observed between PCOS patients and controls. All the PCOS had elevated body mass index, waist circumference, waist-to-hip ratio, fasting insulin, homeostatic model assessment (HOMA) score, and serum TNF-α when compared with controls (p<0.05). Genotype distribution for the C-850T polymorphism was observed with the frequency of the variant T allele being 0% in the PCOS group and 9% in the control group (p=0.0032). CONCLUSIONS: In conclusion, our present results suggest that the TNF-α system might contribute to the pathogenesis of HA, Ob, and IR in PCOS independent of a polymorphism of the TNF-α C850T (rs1799724) in our population.

Anthropometric and Biochemical Characteristics of Polycystic Ovarian Syndrome in South Indian Women Using AES-2006 Criteria.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine conditions affecting women of reproductive age with a prevalence of approximately 5-10% worldwide. PCOS can be viewed as a heterogeneous androgen excess disorder with varying degrees of reproductive and metabolic abnormalities, whose diagnosis is based on anthropometric, biochemical and radiological abnormalities. To our knowledge, this is the first study investigating the anthropometric, biochemical and ultrasonographic characteristics of PCOS in Asian Indians of South India, using the Androgen Excess Society (AES-2006) diagnostic criteria. OBJECTIVES: To assess anthropometric, biochemical and ultrasonographic features of PCOS subgroups and controls among South Indian women using the AES-2006 criteria. MATERIALS AND METHODS: Two hundred and four women clinically diagnosed with PCOS, and 204 healthy women controls aged 17 to 35 years were evaluated. PCOS was diagnosed by clinical hyperandrogenism (HA), irregular menstruation (IM), and polycystic ovary (PCO). PCOS was further categorized into phenotypic subgroups including the IM+HA+PCO (n = 181, 89%), HA+PCO (n = 23, 11%), IM+HA (n = 0), and also into obese PCOS (n = 142, 70%) and lean PCOS (n = 62, 30%) using body mass index (BMI). Anthropometric measurements and biochemical characteristics were compared among the PCOS subgroups. RESULTS: The PCOS subgroups with regular menstrual cycles (HA+PCO), had more luteinizing hormone (LH), follicle stimulating hormone (FSH), fasting glucose, fasting insulin, and high insulin resistance (IR) expressed as the Homeostasis Model Assessment (HOMA) score, compared with the IM+HA+PCO subgroups and controls. Similarly, the obese PCOS had high BMI, waist to hip ratio (WHR), fasting glucose, LH, LH/FSH, fasting insulin, HOMA score (IR), and dyslipidemia, compared with lean PCOS and controls. Unilateral polycystic ovary was seen in 32 (15.7%) patients, and bilateral involvement in 172 (84.3%) patients. All the controls showed normal ovaries. CONCLUSIONS: Anthropometric, biochemical, and ultrasonographic findings showed significant differences among PCOS subgroups. The PCOS subgroups with regular menstrual cycles (HA+PCO), had high insulin resistance (IR) and gonadotropic hormonal abnormalities, compared with the IM+HA+PCO subgroups and controls.