Relationship Between Metabolic Syndrome and Polycystic Ovary Syndrome with Special Reference to C-Reactive Protein.

OBJECTIVES: To estimate C-reactive protein (CRP) levels in Saudi women with and without polycystic ovary syndrome (PCOS), and to investigate the associations between CRP and metabolic syndrome (MetS) components. METHODS: We randomly recruited 200 women with and without PCOS, between 18 and 38 years, in this age-matched case-control study. Study subjects were allocated to 1 of 4 groups according to the presence or absence of MetS. Interviews were conducted with all participants, and anthropometric measurements and blood samples were obtained for subsequent analysis of biochemical variables. RESULTS: Two-thirds of the study population and all study subjects had central obesity. Fasting insulin and homeostasis model assessment insulin resistance index were significantly higher in PCOS and MetS groups than all other groups (P < 0.05). CRP levels were significantly higher among women with PCOS than their age-matched controls, regardless of the presence of MetS (P < 0.05). Body mass index was the only independent predictor of serum high-sensitivity-CRP, accounting for 17% of the variability in circulating levels (ß = 0.407; 95% CI 0.248-0.472, P < 0.0001). CONCLUSIONS: Obesity and insulin resistance are important risk factors for MetS in PCOS. The presence of MetS in PCOS subjects aggravates the proinflammatory state reflected by CRP levels.

Role of inflammatory markers in polycystic ovaries syndrome: In relation to insulin resistance.

OBJECTIVE: To evaluate the relationship between plasma levels of the inflammatory markers tumor necrosis factor-alpha (TNF-α), C reactive protein (CRP), and interlukin-6 (IL-6) with insulin resistance in Saudi women with polycystic ovaries syndrome (PCOS). METHODS: One hundred eighty Saudi women with and without PCOS, aged 22-38 years, were randomly recruited in this age and body mass index matched case-control study. Clinical assessment, anthropometric measurements, and biochemical parameters were determined for all study participants. RESULTS: Levels of TNF-α, IL-6, hs-CRP, insulin, and insulin resistance indices were significantly higher among PCOS group than their age and BMI matched controls (p < 0.05). Results showed that only QUICK-I (ß = -0.247, p < 0.0001, 95% CI: -3.009 to -0.977) independently predicted TNF-α levels after adjustment for potential confounders. CONCLUSIONS: Elevated plasma levels of TNF- α and IL-6 among PCOS women reflects a state of chronic inflammation with potential implication for insulin resistance, independent of obesity.

Impact of interlukin-6 on central obesity measures in women with polycystic ovarian syndrome.

Our aim was to investigate the relationship between plasma interleukin-6 (IL-6) levels with different measures of central obesity among Saudi women with and without polycystic ovarian syndrome (PCOS). One hundred and sixty-four Saudi females, between 22 and 38 years of age, with and without PCOS were enrolled in this case-control study. Physical examination and laboratory tests were completed for every subject. 2/3 of the study population were obese. Fasting serum insulin, plasma IL-6 levels and insulin resistance show significant increase among POCS than the controls (p<.05). Based on linear regression analysis, C-reactive protein (hs-CRP) was the only independent predictor of plasma IL-6 levels, accounting for 4% of the variability in plasma IL-6 (ß = 0.217, p=.005, 95% CI: 0.049-0.275). Coexistence of metabolic and inflammatory factors in PCOS females is accompanied by central obesity which overpowers the effect of insulin resistance, contributing to higher plasma levels of IL-6 and CRP.Impact statementWhat is already known on this subject? Polycystic ovary syndrome (PCOS) is a cluster of many cardiovascular risk factors, but is also known as an inflammatory condition. Insulin resistance and abdominal obesity are classic components of PCOS. High circulatory levels of inflammatory markers in PCOS patients have been reported but it remains unclear whether their elevation is related to PCOS itself, or are a function of abdominal adiposity.What the results of this study add? The relationship between plasma interleukin-6 levels and different measures of central obesity was investigated among Saudi women with and without PCOS. Elevations of proinflammatory cytokines and inflammatory markers were reported in PCOS patients independently of insulin resistance. It remains to be established whether the proinflammatory state in PCOS is primarily due to inflamed adipose tissue.What the implications are of these findings for clinical practice and/or further research? The present study demonstrates that coexistence of metabolic and inflammatory factors in PCOS females are accompanied by central obesity which overpowers the effect of insulin resistance, contributing to higher plasma levels of IL-6 and CRP. Future studies including a larger population are needed to investigate the mechanisms by which IL-6 and hs-CRP promote cardiovascular risk in PCOS patients.