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CHRONIC INFLAMMATION MARKERS hs-CRP, sICAM-1, sVCAM-1 AND sE-SELECTIN LEVELS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME

Year 2010, Volume: 73 Issue: 4, 97 - 101, 10.11.2011

Abstract

Objective: Patients with polycystic ovary syndrome have many risk factors associated with development of cardiovascular
disease development. Presence of low grade chronic inflammation has been indicated as a risk factor for cardiovascular disease.
We investigated the levels of hs-CRP, sICAM-1, sVCAM-1 and sE-Selektin as markers of chronic inflammation.
Materials and methods: 40 women with diagnosis of PCOS (Polycystic ovary syndrome) according to Rotterdam 2003 PCOS
defining criteria and 39 premenauposal otherwise healthy women taken as a control group were included in the study. Insulin
resistance was estimated by fasting glucose/insulin ratio and HOMA index. Plasma hs-CRP, sICAM-1, sVCAM-1 and sE-selektin
levels were determined by sandwich ELISA method. Mann Whitney U and spearman‟s correlation tests were used statistics.
Results: Insulin resistance was deteced in 40% of patients with polycystic ovary syndrome.When compared wih control patients
total cholesterol (p<0.05), VLDL (p<0.0001) and triglyceride (p<0.01) were higher in patients with PCOS. There were no
significant differences in the levels the LDL and HDL. The levels of hs-CRP (p<0.001), sICAM-1 (p<0.001) and sE-selectin
(p<0.0001) in patients with PCOS were higher than control group but there was no difference in sVCAM-1 levels between the
groups. There was positive correlation according to Spearman‟s test between hs-CRP/sICAM-1 (r=0.251; p<0.05) and sEselektin/sICAM-1 (r=0.317; p<0.05).
Conclusion In patients with PCOS the presence of chronic low grade inflammation which is a risk factor for endothelial
dysfunction hence cardiovascular disease is demonstrated. But there is yet no prospective randomised study dealing with
mortality due to cardiovascular disease in patients with PCOS.

References

  • Blankenberg S, Barbaux S, Tiret L. Adhesion molecules and atherosclerosis. Atherosclerosis 2003,170:191-203.
  • BoulmanN, Levy Y, Leiba R, Shachar S, Linn R, Zinder O and Blumenfeld Z. Increased C-reactive protein levels in the polycystic ovary syndrome: A marker of cardiovascular disease. J Clin Endocrinol Metab 2004, 89: 2160–2165.
  • Cockerill GW, Huehns TY, Weerasinghe A, Stocker C, Lerch PG, Miller NE, Haskard DO. Elevation of plasma high-density lipoprotein concentration reduces interleukin-1-induced expression of E-selectin in an in vivo model of acute inflammation. Circulation 2001, 10.
  • Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004, 350:1387– 1397.
  • Diamanti-Kandarakis E, Alexandraki K, Protogerou A, Piperi C, Papamichael C, Aessopos A, Lekasis J, Mavrikakis M. Metformin administration improves endothelial function in women with polycystic ovary syndrome. Eur J Endocrinol 2005, 152:749-756.
  • Dokras A, Bochner M, Hollinrake E, Markham S,Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005, 106:131–1378.
  • Ehrmann DA. Polycystic ovary syndrome. N Engl J Med 2005, 352:1223–1236.
  • Escobar-MorrealeHF, Calvo RM, Villuendas G, Sancho J and San Millan JL. Association of polymorphisms in the interleukin 6 receptor complex with obesity and hyperandrogenism. Obes Res 2003, 987-996.
  • Festa A, D‟Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000;102:42-47.
  • Karatzis EN. The role of inflammatory agents in endothelial function and their contribution to atherosclerosis. Hell J Cardiol 2005, 46:232-239.
  • Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 2001, 86:2453-2455.
  • Orio F, Palomba S, Cascella T, De Simone B, Di Biase S, Russo T, Labella D, Zullo F, Lombardi G, Coala A. Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89:4588- 4593.
  • Orio F Jr, Palomba S, Cascella T, Di Biase S, Manguso F, Tauchmanova L, Nardo LG, Labella D, Savastano S, Russo T, Zullo F, Colao A, Lombardi G. 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 2005, 2-5.
  • Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000, 102:2165-2168.
  • Pierpoint T, McKeigue PM, Isaacs AJ, Wild SH, Jacobs HS. Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol 1998, 51:581-586.
  • Ridker PM, Hennekens CH, Roitman-Johnson B, Stampfer MJ, Allen J. Plasma concentration of soluble intercellular adhesion molecule-1 and risks of future myocardial infarction in apparently healthy men. Lancet 1998, 351:88-92.
  • Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.N Engl J Med 2002, 347:1557- 1565.
  • Ridker PM, Wilson PW, Grundy SM. Should Creactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk? Circulation 2004, 109:2818-2825.
  • Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: An 8-year follow-up of 14, 719 initially healthy American women. Circulation 2003, 107:391–7.
  • Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999, 340:115-126.
  • 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.
  • Sam S, Dunaif A. Polycystic ovary syndrome: Syndrome XX? Trends Endocrinol Metab 2003, 14:365-370.
  • Sattar N, Gaw A, Scherbakova O, Ford I, O‟Reilly DS, Haffner SM et al. Metabolic syndrome with and without Creactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003, 108:414-419.
  • Shimokawa H. Primary endothelial dysfunction: Atherosclerosis. J Mol Cell Cardiol 1999, 31:23-37.
  • Tarkun I, Arslan BC, Canturk Z, Turemen E, Sahin T, Duman C. Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and lowgrade chronic inflammation. J Clin Endocrinol Metab 2004, 89:5592-5596.
  • Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: A retrospective cohort study. Clin Endocrinol (Oxf). 2000, 52:595-600.
  • Yudkin JS, Stehouwer CD, Emeis JJ & Coppack SW. Creactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: A potential role for cytokines originating from adipose tissue? Arteriosclerosis, Thrombosis, and Vascular Biology 1999, 19: 972–978.

POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ

Year 2010, Volume: 73 Issue: 4, 97 - 101, 10.11.2011

Abstract

Amaç: Polikistik over sendromlu hastalar, kardiovasküler hastalık gelişimi için birçok risk faktörü taşırlar. Düşük derecede
kronik inflammasyonun endotel disfonksiyonuna neden olarak kardiovasküler hastalığa yol açtıgı bilinmektedir.Biz de polikistik
over sendromlu hastalarda bu sürecin belirteçlerinden olabileceğini düşündüğümüz hs-CRP, sICAM-1, sVCAM-1 ve sE-Selektin
düzeylerini araştırdık.
Materyal ve metod: Rotterdam 2003 PKOS( polikistik over sendromu) tanı kriterleri kullanılarak PKOS tanısı konulan 40 hasta
çalışma grubunu oluşturuken 39 sağlıklı premenapozal kadının kontrol grubunu oluşturduğu toplam 79 olgu çalışmaya dahil edildi.
Ġnsülin direncini hesaplamada açlık glukoz/insülin oranları ve HOMA indeksi kullanıldı. Plazma hs-CRP, sICAM-1, sVCAM-1 ve
sE-Selektin düzeyleri sandviç ELISA yöntemi kullanılarak ölçüldü. Parametrelerin karşılaştırılmasında Mann Whitney –U ve
Spearman korelasyon testleri kullanıldı.
Bulgular: PKOS‟lu hastaların %40 ında insülin direnci saptandı. PKOS‟lu hastalarda total kolesterol (p < 0,05), VLDL
(p < 0,0001) ve trigliserit (p < 0,01) düzeylerinde kontrol grubuna kıyasla anlamlı bir artış saptandı. LDL ve HDL
konsantrasyonlarında ise kontrol grubuna kıyaslandığında anlamlı bir fark saptanmadı. hs-CRP, sICAM-1, sVCAM-1 ve sEselektin
seviyeleri açısından yapılan karşılaştırmada PKOS‟lu kadınlarda plazma hs-CRP (p < 0,001), sICAM-1 (p < 0,001) ve sEselektin
(p < 0,0001) düzeyleri kontrollere kıyasla daha yüksek olduğu saptandı, sVCAM konsantrasyonlarında ise bir fark
bulunmadı.
Spearman korrelasyon testi uygulandığında hs-CRP/sICAM-1 (r=0,251; p < 0,05) ve sE-selektin/sICAM-1 (r=0,317; p < 0,05)
arasında pozitif bir korrelasyon olduğu saptandı.
Sonuç: PKOS‟lu hastalarda endotel hasarına neden olarak kardiovasküler hastalık riskini arttıran düşük seviyede kronik
inflammasyonun varlığı gösterilmiştir. Her ne kadar kardiovasküler mortalitenin PKOS‟lu hastalarda artmış olduğu tam olarak
gösterilememiş olsa da henüz prospektif randomize bir çalışma mevcut değildir

References

  • Blankenberg S, Barbaux S, Tiret L. Adhesion molecules and atherosclerosis. Atherosclerosis 2003,170:191-203.
  • BoulmanN, Levy Y, Leiba R, Shachar S, Linn R, Zinder O and Blumenfeld Z. Increased C-reactive protein levels in the polycystic ovary syndrome: A marker of cardiovascular disease. J Clin Endocrinol Metab 2004, 89: 2160–2165.
  • Cockerill GW, Huehns TY, Weerasinghe A, Stocker C, Lerch PG, Miller NE, Haskard DO. Elevation of plasma high-density lipoprotein concentration reduces interleukin-1-induced expression of E-selectin in an in vivo model of acute inflammation. Circulation 2001, 10.
  • Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004, 350:1387– 1397.
  • Diamanti-Kandarakis E, Alexandraki K, Protogerou A, Piperi C, Papamichael C, Aessopos A, Lekasis J, Mavrikakis M. Metformin administration improves endothelial function in women with polycystic ovary syndrome. Eur J Endocrinol 2005, 152:749-756.
  • Dokras A, Bochner M, Hollinrake E, Markham S,Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol 2005, 106:131–1378.
  • Ehrmann DA. Polycystic ovary syndrome. N Engl J Med 2005, 352:1223–1236.
  • Escobar-MorrealeHF, Calvo RM, Villuendas G, Sancho J and San Millan JL. Association of polymorphisms in the interleukin 6 receptor complex with obesity and hyperandrogenism. Obes Res 2003, 987-996.
  • Festa A, D‟Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000;102:42-47.
  • Karatzis EN. The role of inflammatory agents in endothelial function and their contribution to atherosclerosis. Hell J Cardiol 2005, 46:232-239.
  • Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 2001, 86:2453-2455.
  • Orio F, Palomba S, Cascella T, De Simone B, Di Biase S, Russo T, Labella D, Zullo F, Lombardi G, Coala A. Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2004, 89:4588- 4593.
  • Orio F Jr, Palomba S, Cascella T, Di Biase S, Manguso F, Tauchmanova L, Nardo LG, Labella D, Savastano S, Russo T, Zullo F, Colao A, Lombardi G. 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 2005, 2-5.
  • Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000, 102:2165-2168.
  • Pierpoint T, McKeigue PM, Isaacs AJ, Wild SH, Jacobs HS. Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol 1998, 51:581-586.
  • Ridker PM, Hennekens CH, Roitman-Johnson B, Stampfer MJ, Allen J. Plasma concentration of soluble intercellular adhesion molecule-1 and risks of future myocardial infarction in apparently healthy men. Lancet 1998, 351:88-92.
  • Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.N Engl J Med 2002, 347:1557- 1565.
  • Ridker PM, Wilson PW, Grundy SM. Should Creactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk? Circulation 2004, 109:2818-2825.
  • Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: An 8-year follow-up of 14, 719 initially healthy American women. Circulation 2003, 107:391–7.
  • Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999, 340:115-126.
  • 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.
  • Sam S, Dunaif A. Polycystic ovary syndrome: Syndrome XX? Trends Endocrinol Metab 2003, 14:365-370.
  • Sattar N, Gaw A, Scherbakova O, Ford I, O‟Reilly DS, Haffner SM et al. Metabolic syndrome with and without Creactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 2003, 108:414-419.
  • Shimokawa H. Primary endothelial dysfunction: Atherosclerosis. J Mol Cell Cardiol 1999, 31:23-37.
  • Tarkun I, Arslan BC, Canturk Z, Turemen E, Sahin T, Duman C. Endothelial dysfunction in young women with polycystic ovary syndrome: relationship with insulin resistance and lowgrade chronic inflammation. J Clin Endocrinol Metab 2004, 89:5592-5596.
  • Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: A retrospective cohort study. Clin Endocrinol (Oxf). 2000, 52:595-600.
  • Yudkin JS, Stehouwer CD, Emeis JJ & Coppack SW. Creactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: A potential role for cytokines originating from adipose tissue? Arteriosclerosis, Thrombosis, and Vascular Biology 1999, 19: 972–978.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Deniz Kanber Açar This is me

Pervin Vural This is me

Cemil Akgül This is me

Publication Date November 10, 2011
Submission Date November 10, 2011
Published in Issue Year 2010 Volume: 73 Issue: 4

Cite

APA Kanber Açar, D., Vural, P., & Akgül, C. (2011). POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ. Journal of Istanbul Faculty of Medicine, 73(4), 97-101.
AMA Kanber Açar D, Vural P, Akgül C. POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ. İst Tıp Fak Derg. November 2011;73(4):97-101.
Chicago Kanber Açar, Deniz, Pervin Vural, and Cemil Akgül. “POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN HS -CRP, SICAM-1, SVCAM-1 VE SE-SELEKTİN DÜZEYLERİ”. Journal of Istanbul Faculty of Medicine 73, no. 4 (November 2011): 97-101.
EndNote Kanber Açar D, Vural P, Akgül C (November 1, 2011) POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ. Journal of Istanbul Faculty of Medicine 73 4 97–101.
IEEE D. Kanber Açar, P. Vural, and C. Akgül, “POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ”, İst Tıp Fak Derg, vol. 73, no. 4, pp. 97–101, 2011.
ISNAD Kanber Açar, Deniz et al. “POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN HS -CRP, SICAM-1, SVCAM-1 VE SE-SELEKTİN DÜZEYLERİ”. Journal of Istanbul Faculty of Medicine 73/4 (November 2011), 97-101.
JAMA Kanber Açar D, Vural P, Akgül C. POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ. İst Tıp Fak Derg. 2011;73:97–101.
MLA Kanber Açar, Deniz et al. “POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN HS -CRP, SICAM-1, SVCAM-1 VE SE-SELEKTİN DÜZEYLERİ”. Journal of Istanbul Faculty of Medicine, vol. 73, no. 4, 2011, pp. 97-101.
Vancouver Kanber Açar D, Vural P, Akgül C. POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ. İst Tıp Fak Derg. 2011;73(4):97-101.

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