Research Article
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Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study

Year 2026, Volume: 12 Issue: 1, 76 - 80, 20.01.2026
https://doi.org/10.30934/kusbed.1830233

Abstract

Objective: To evaluate the effect of age on the neutrophil-lymphocyte ratio (NLR), a marker of systemic inflammation, and other hematological parameters in women diagnosed with polycystic ovary syndrome (PCOS).
Materials and Methods: This retrospective study examined 280 women aged 18–43 who had been diagnosed with PCOS according to the Rotterdam criteria between May 2022 and May 2024. The patients were divided into four groups according to their age: Group 1 (18–24 years, n = 100); Group 2 (25–30 years, n = 130); Group 3 (31–35 years, n = 37); and Group 4 (36–43 years, n = 13). The Kruskal–Wallis test was used to compare neutrophil, lymphocyte, and NLR levels between groups. Spearman correlation analysis was used to evaluate the relationship between age and inflammatory parameters. The independent effect of age on NLR was examined using multivariate linear regression analysis.
Results: No significant difference in NLR levels was found between age groups (p = 0.160). However, the neutrophil count was significantly lower in Group 3 than in the other groups (p = 0.013). A weak negative correlation was found between age and neutrophil count (r = -0.142, p = 0.024), but no significant correlation was found between age and NLR (r = 0.084, p = 0.162). Multivariate regression analysis revealed that age had no independent effect on NLR (β = -0.088, p = 0.156), whereas BMI positively affected NLR (β = +0.176, p = 0.005).
Conclusion: In this cohort of women with PCOS, NLR did not show a significant association with age, whereas it was associated with BMI. These findings emphasise the importance of considering metabolic factors when evaluating the inflammatory process in PCOS.

Ethical Statement

The study was approved by the Local Ethics Committee of Yozgat Bozok University (2025-GOKAEK-258-2025.04.30-463). All authors involved in the study fully complied with the principles of the Declaration of Helsinki.

Supporting Institution

Yozgat Bozok University

References

  • Skiba MA, Islam RM, Bell RJ, Davis SR. Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(6):694-709. doi: 10.1093/humupd/dmy022.
  • Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi: 10.1016/j.fertnstert.2003.10.004.
  • Dokras A. Polycystic ovary syndrome in 2025-insights and innovations. Fertil Steril. 2025;124(5 Pt 2):907-9. doi: 10.1016/j.fertnstert.2025.09.025.
  • Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K. Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci. 2021;22(7). doi: 10.3390/ijms22073789.
  • Özay AC, Özay Ö E. The importance of inflammation markers in polycystic ovary syndrome. Rev Assoc Med Bras (1992). 2021;67(3):411-7. doi: 10.1590/1806-9282.20200860.
  • Li L, Yu J, Zhou Z. Association between neutrophil-to-lymphocyte ratio and polycystic ovary syndrome: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2022;101(38):e30579. doi: 10.1097/MD.0000000000030579.
  • Hsu MI. Changes in the PCOS phenotype with age. Steroids. 2013;78(8):761-6. doi: 10.1016/j.steroids.2013.04.005.
  • Çelik Ö, Köse MF. An overview of polycystic ovary syndrome in aging women. J Turk Ger Gynecol Assoc. 2021;22(4):326-33. doi: 10.4274/jtgga.galenos.2021.2021.0077.
  • Ozkan HD, Ayas Ozkan M. Inflammatory status and clinical phenotypes of PCOS: the role of NLR, SII, SIRI, and AISI. BMC Womens Health. 2025;25(1):463. doi: 10.1186/s12905-025-04033-2.
  • Almaeen AH, Alduraywish AA, Nabi M, Shah NN, Shaik R, Tantry BA. Quantitative changes in white blood cells: correlation with the hallmarks of polycystic ovary syndrome. Medicina (Kaunas). 2022;58(4):535. doi: 10.3390/medicina58040535.
  • Vedavathi V, GK VG, Patil SV, Gandham R. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful markers of inflammation in polycystic ovary syndrome? A Asian J. Med. Sci. 2023;14(6):99-103. doi: 10.3126/ajms.v14i6.51673
  • Taşkömür AT, Erten Ö. Relationship of inflammatory and metabolic parameters in adolescents with PCOS: BMI matched case-control study. Arch Endocrinol Metab. 2022;66(3):372-81. doi: 10.20945/2359-3997000000497.
  • Tfayli H, Arslanian S, Witchel SF. POLYCYSTIC OVARY SYNDROME: ORIGINS AND IMPLICATIONS: PCOS in adolescents: ontogeny of neuroendocrine and metabolic disturbances. Reproduction. 2025;170(6). doi: 10.1530/REP-25-0115
  • Dey R, Bhattacharya K, Basak AK, Paul N, Bandyopadhyay R, Chaudhuri GR, et al. Inflammatory perspectives of polycystic ovary syndrome: role of specific mediators and markers. Middle East Fertil Soc J. 2023;28(1):33. doi: 10.1186/s43043-023-00158-2.
  • Pergialiotis V, Trakakis E, Parthenis C, Hatziagelaki E, Chrelias C, Thomakos N, et al. Correlation of platelet to lymphocyte and neutrophil to lymphocyte ratio with hormonal and metabolic parameters in women with PCOS. Horm Mol Biol Clin Investig. 2018;34(3). doi: 10.1515/hmbci-2017-0073.
  • Cho M, Kim S, Chun S. Relationship between hematologic parameters related to systemic inflammation and insulin resistance-associated metabolic parameters in women with polycystic ovary syndrome. Clin Exp Reprod Med. 2023;50(3):206-12. doi: 10.5653/cerm.2023.05932.

Polikistik Over Sendromu Olan Kadınlarda Nötrofil-Lenfosit Oranının Yaşa Göre Değerlendirilmesi: Retrospektif Bir Çalışma

Year 2026, Volume: 12 Issue: 1, 76 - 80, 20.01.2026
https://doi.org/10.30934/kusbed.1830233

Abstract

Amaç: Polikistik over sendromu (PCOS) tanılı kadınlarda yaşın, sistemik inflamasyonun bir göstergesi olan nötrofil-lenfosit oranı (NLR) ve diğer hematolojik parametreler üzerindeki etkisini değerlendirmek.
Yöntem: Bu retrospektif çalışmaya, Mayıs 2022 ile Mayıs 2025 tarihleri arasında Rotterdam kriterlerine göre PCOS tanısı konmuş 18-43 yaş arası 280 kadın dahil edildi. Hastalar yaşlarına göre dört gruba ayrıldı: Grup 1 (18-24 yaş, n=100), Grup 2 (25-30 yaş, n=130), Grup 3 (31-35 yaş, n=37) ve Grup 4 (36-43 yaş, n=13). Gruplar arasında nötrofil, lenfosit ve NLR düzeyleri Kruskal-Wallis testi ile karşılaştırıldı. Yaş ile inflamatuvar parametreler arasındaki ilişki Spearman korelasyon analizi ile değerlendirildi. Yaşın NLR üzerindeki bağımsız etkisi çok değişkenli doğrusal regresyon analizi ile incelendi.
Bulgular: Yaş grupları arasında NLR düzeylerinde anlamlı farklılık saptanmadı (p=0,160). Ancak nötrofil sayısı Grup 3'te diğer gruplara göre anlamlı şekilde düşüktü (p=0,013). Yaş ile nötrofil arasında zayıf negatif korelasyon bulundu (r=-0,142, p=0,024), ancak yaş ile NLR arasında anlamlı korelasyon saptanmadı (r=0,084, p=0,162). Çok değişkenli regresyon analizinde yaşın NLR üzerinde bağımsız etkisi olmadığı (β=-0,088, p=0,156), buna karşın vücut kitle indeksinin (VKİ) NLR'yi pozitif yönde etkilediği gösterildi (β=+0,176, p=0,005).
Sonuç: PCOS'lu kadınlardan oluşan bu kohortta, NLR yaşla anlamlı bir ilişki göstermezken, VKİ ile ilişkiliydi. Bu bulgular, PCOS'taki inflamatuvar sürecin değerlendirilmesinde metabolik faktörlerin önemini vurgulamaktadır.

References

  • Skiba MA, Islam RM, Bell RJ, Davis SR. Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(6):694-709. doi: 10.1093/humupd/dmy022.
  • Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi: 10.1016/j.fertnstert.2003.10.004.
  • Dokras A. Polycystic ovary syndrome in 2025-insights and innovations. Fertil Steril. 2025;124(5 Pt 2):907-9. doi: 10.1016/j.fertnstert.2025.09.025.
  • Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K. Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci. 2021;22(7). doi: 10.3390/ijms22073789.
  • Özay AC, Özay Ö E. The importance of inflammation markers in polycystic ovary syndrome. Rev Assoc Med Bras (1992). 2021;67(3):411-7. doi: 10.1590/1806-9282.20200860.
  • Li L, Yu J, Zhou Z. Association between neutrophil-to-lymphocyte ratio and polycystic ovary syndrome: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2022;101(38):e30579. doi: 10.1097/MD.0000000000030579.
  • Hsu MI. Changes in the PCOS phenotype with age. Steroids. 2013;78(8):761-6. doi: 10.1016/j.steroids.2013.04.005.
  • Çelik Ö, Köse MF. An overview of polycystic ovary syndrome in aging women. J Turk Ger Gynecol Assoc. 2021;22(4):326-33. doi: 10.4274/jtgga.galenos.2021.2021.0077.
  • Ozkan HD, Ayas Ozkan M. Inflammatory status and clinical phenotypes of PCOS: the role of NLR, SII, SIRI, and AISI. BMC Womens Health. 2025;25(1):463. doi: 10.1186/s12905-025-04033-2.
  • Almaeen AH, Alduraywish AA, Nabi M, Shah NN, Shaik R, Tantry BA. Quantitative changes in white blood cells: correlation with the hallmarks of polycystic ovary syndrome. Medicina (Kaunas). 2022;58(4):535. doi: 10.3390/medicina58040535.
  • Vedavathi V, GK VG, Patil SV, Gandham R. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are useful markers of inflammation in polycystic ovary syndrome? A Asian J. Med. Sci. 2023;14(6):99-103. doi: 10.3126/ajms.v14i6.51673
  • Taşkömür AT, Erten Ö. Relationship of inflammatory and metabolic parameters in adolescents with PCOS: BMI matched case-control study. Arch Endocrinol Metab. 2022;66(3):372-81. doi: 10.20945/2359-3997000000497.
  • Tfayli H, Arslanian S, Witchel SF. POLYCYSTIC OVARY SYNDROME: ORIGINS AND IMPLICATIONS: PCOS in adolescents: ontogeny of neuroendocrine and metabolic disturbances. Reproduction. 2025;170(6). doi: 10.1530/REP-25-0115
  • Dey R, Bhattacharya K, Basak AK, Paul N, Bandyopadhyay R, Chaudhuri GR, et al. Inflammatory perspectives of polycystic ovary syndrome: role of specific mediators and markers. Middle East Fertil Soc J. 2023;28(1):33. doi: 10.1186/s43043-023-00158-2.
  • Pergialiotis V, Trakakis E, Parthenis C, Hatziagelaki E, Chrelias C, Thomakos N, et al. Correlation of platelet to lymphocyte and neutrophil to lymphocyte ratio with hormonal and metabolic parameters in women with PCOS. Horm Mol Biol Clin Investig. 2018;34(3). doi: 10.1515/hmbci-2017-0073.
  • Cho M, Kim S, Chun S. Relationship between hematologic parameters related to systemic inflammation and insulin resistance-associated metabolic parameters in women with polycystic ovary syndrome. Clin Exp Reprod Med. 2023;50(3):206-12. doi: 10.5653/cerm.2023.05932.
There are 16 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Çağlayan Ateş 0000-0002-4200-2659

Mustafa Bakırcı 0000-0002-4063-4409

Submission Date November 25, 2025
Acceptance Date December 29, 2025
Publication Date January 20, 2026
Published in Issue Year 2026 Volume: 12 Issue: 1

Cite

APA Ateş, Ç., & Bakırcı, M. (2026). Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, 12(1), 76-80. https://doi.org/10.30934/kusbed.1830233
AMA Ateş Ç, Bakırcı M. Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study. KOU Sag Bil Derg. January 2026;12(1):76-80. doi:10.30934/kusbed.1830233
Chicago Ateş, Çağlayan, and Mustafa Bakırcı. “Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women With Polycystic Ovary Syndrome: A Retrospective Study”. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 12, no. 1 (January 2026): 76-80. https://doi.org/10.30934/kusbed.1830233.
EndNote Ateş Ç, Bakırcı M (January 1, 2026) Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 12 1 76–80.
IEEE Ç. Ateş and M. Bakırcı, “Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study”, KOU Sag Bil Derg, vol. 12, no. 1, pp. 76–80, 2026, doi: 10.30934/kusbed.1830233.
ISNAD Ateş, Çağlayan - Bakırcı, Mustafa. “Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women With Polycystic Ovary Syndrome: A Retrospective Study”. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 12/1 (January2026), 76-80. https://doi.org/10.30934/kusbed.1830233.
JAMA Ateş Ç, Bakırcı M. Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study. KOU Sag Bil Derg. 2026;12:76–80.
MLA Ateş, Çağlayan and Mustafa Bakırcı. “Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women With Polycystic Ovary Syndrome: A Retrospective Study”. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, vol. 12, no. 1, 2026, pp. 76-80, doi:10.30934/kusbed.1830233.
Vancouver Ateş Ç, Bakırcı M. Age-Related Evaluation of Neutrophil-to-Lymphocyte Ratio in Women with Polycystic Ovary Syndrome: A Retrospective Study. KOU Sag Bil Derg. 2026;12(1):76-80.