TY - JOUR T1 - ENHANCING DIAGNOSTIC ACCURACY IN POLYCYSTIC OVARY SYNDROME USING NOVEL INFLAMMATORY INDICES TT - Polikistik Over Sendromunda Tanısal Doğruluğun Yeni İnflamatuar İndekslerle Artırılması AU - Bulut Arıkan, Funda AU - Sağsöz, Nevin PY - 2025 DA - August Y2 - 2025 DO - 10.24938/kutfd.1718713 JF - The Journal of Kırıkkale University Faculty of Medicine JO - Kırıkkale Uni Med J PB - Kırıkkale Üniversitesi WT - DergiPark SN - 2148-9645 SP - 217 EP - 224 VL - 27 IS - 2 LA - en AB - Objectives: Polycystic ovary syndrome (PCOS) is characterized by a complicated and incompletely understood pathophysiology. This study investigates the role of inflammation in its pathophysiology, compares the diagnostic performance of inflammatory indices, and assesses the clinical utility of novel biomarkers.Material and Methods: This retrospective study included 30 patients with PCOS and 32 healthy controls. Inflammatory indices including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), neutrophil to monocyte ratio (NMR), platelet to lymphocyte ratio (PLR), platelet large cell ratio (PLCR), mean platelet volume to lymphocyte ratio (MPVLR), systemic immune inflammation index (SII), systemic inflammation response index (SIRI), multi-inflammatory index (MII), and monocyte to high density lipoprotein ratio (MHR) were calculated. Receiver operating characteristic (ROC) curve analysis evaluated their diagnostic performance. Biochemical, hormonal, hematological, and inflammatory parameters were measured using ELISA and an automated analyzer.Results: Inflammatory indices SII (p=0.006), SIRI (p=0.022), MII (p=0.013), and MHR (p=0.003) were significantly higher in patients, while PLCR was lower (p=0.024). Biochemical parameters CRP (p=0.027), insulin (p=0.021), and LDL (p=0.027) were elevated, HDL decreased (p=0.035). ROC analysis identified MHR as the most accurate biomarker (AUC=0.747, 100% specificity), followed by CRP (AUC=0.726) and MII (AUC=0.713). SII and SIRI showed moderate but relevant accuracy. All were statistically significant (p < 0.05).Conclusion: The present study highlights the potential of inflammation-based indices particularly MHR, MII, SII, SIRI, and CRP as valuable biomarkers in PCOS diagnosis. MHR showed the strongest diagnostic performance (100% specificity), while CRP and MII also demonstrated good accuracy. SIRI’s high sensitivity supports its role in early detection, and both SII and SIRI may serve as complementary markers. Overall, the results underscore the significance of inflammation in PCOS and support the clinical utility of these markers. PCOS influences hematological and biochemical parameters as well as inflammatory indices. KW - PCOS KW - inflammatory indices KW - diagnostic accuracy. N2 - Amaç: Polikistik over sendromu (PCOS), kompleks ve hâlen tam olarak aydınlatılamamış bir patofizyoloji ile karakterizedir. Bu çalışma, PCOS’un patofizyolojisinde inflamasyonun rolünü araştırmayı, inflamatuar indekslerin tanısal performanslarını karşılaştırmayı ve yeni biyobelirteçlerin klinik kullanım değerini değerlendirmeyi amaçlamaktadır.Gereç ve Yöntemler: Bu retrospektif çalışmaya, 30 PCOS hastası ve 32 sağlıklı kontrol birey dâhil edilmiştir. Nötrofil/lenfosit oranı (NLR), monosit/lenfosit oranı (MLR), nötrofil/monosit oranı (NMR), platelet/lenfosit oranı (PLR), büyük platelet oranı (PLCR), ortalama platelet hacmi/lenfosit oranı (MPVLR), sistemik immün-inflamasyon indeksi (SII), sistemik inflamasyon yanıt indeksi (SIRI), multi inflamatuar indeks (MII) ve monosit/yüksek yoğunluklu lipoprotein oranı (MHR) gibi inflamatuar indeksler hesaplanmıştır. Tanısal performansları, ROC eğrisi analizi ile değerlendirilmiştir. Biyokimyasal, hormonal, hematolojik ve inflamatuar parametreler ELISA ve otomatik analizör kullanılarak ölçülmüştür.Bulgular: SII (p=0,006), SIRI (p=0,022), MII (p=0,013) ve MHR (p=0,003) değerleri hasta grubunda anlamlı olarak yüksek bulunurken; PLCR değeri anlamlı şekilde düşüktü (p=0,024). Biyokimyasal parametrelerden CRP (p=0,027), insülin (p=0,021) ve LDL (p=0,027) düzeyleri artmış; HDL düzeyi ise azalmıştı (p=0,035). ROC analizinde, MHR en yüksek tanısal doğruluk gösteren biyobelirteç olarak tanımlandı (AUC=0,747, %100 özgüllük), bunu CRP (AUC=0,726) ve MII (AUC=0,713) izledi. SII ve SIRI, orta düzeyde ancak anlamlı tanısal doğruluk gösterdi. Tüm bulgular istatistiksel olarak anlamlıydı (p CR - Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams Gynecology, Third Edition. McGraw Hill Professional; 2016. CR - https://www.who.int/europe/publications/m/item/measles-and-rubella-monthly-update---who-european-region---january-2024. 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