Serum levels of inflammatory markers and monocyte to high density lipoprotein ratio in polycystic ovary syndrome

Yıl 2020, Cilt: 3 Sayı: 3, 256 - 261, 18.06.2020

Taylan Onat , Yeşim Göçmen

https://doi.org/10.32322/jhsm.713924

Öz

Aim: This study aims to evaluate the difference between TNFα, hsCRP and M/HDL levels in polycystic ovary syndrome patients and healthy women.
Material and Method: Thirty-five polycystic ovarian syndrome patients and 35 healthy women were included in the study. In addition to the demographic data of the participants, fasting insulin, fasting blood glucose, cholesterol values, complete blood count parameters, hormone in the early follicular period of menstruation, tumor necrosis factor alpha and high sensitivity C-reactive protein values were compared. In addition, subgroup analysis was performed according to body mass index.
Results: The mean age and BMI of the participants were calculated as 27.2±5.71 and 24.8±4.39, respectively. When polycystic ovarian syndrome and healthy group are compared; age, waist/hip ratio, TNFα, hsCRP, hemoglobin, HOMA-IR, FSH, LH, LH/FSH and TSH values show significantly difference (p<0.05). The difference in monocyte/HDL (M/HDL) ratio between the two groups was not statistically significant. When the diagnostic performance of hsCRP with TNFα was evaluated; TNFα (for 33,71 pg/ml value) and hsCRP (for 3,82 mg/L value) respectively had sensitivity 69%, 91%; specifity 86%, 91%; positive predicitve value 68.6%, 91.4%and negative predictive value 85.7%, 91.4%.
Conclusion: TNFα and hsCRP (chronic inflammation) play a role in the pathogenesis of hyperandrogenism in polycystic ovarian syndrome patients.

Anahtar Kelimeler

Polycystic ovary syndrome, insulin resistance, inflammation

Polikistik over sendromunda inflamatuvar belirteçlerin serum seviyeleri ve monosit/yüksek yoğunluklu lipoprotein oranı

Öz

Amaç: Bu çalışma polikistik over sendromu hastalarında ve sağlıklı kadınlarda TNFα, hsCRP ve monosit/yüksek yoğunluklu lipoprotein (M/HDL) seviyeleri arasındaki farkı değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Otuz beş polikistik over sendromlu hasta ile 35 sağlıklı kadın çalışmaya dahil edildi. Katılımcıların demografik verilerinin yanı sıra açlık insülin, açlık kan şekeri, kolesterol değerleri, tam kan sayımı parametreleri, menstruasyonun erken foliküler dönemindeki hormon, tümör nekröz faktör alfa (TNFα) ve yüksek duyarlılıklı C-reaktif protein (hsCRP) değerleri karşılaştırıldı. Ayrıca, vücut kitle indeksine göre de subgrup analizi yapıldı.
Bulgular: Katılımcıların yaş ve BMI ortalaması sırasıyla 27,2±5,71 ve 24,8±4,39 olarak hesaplandı. polikistik over sendromlu ve sağlıklı grup karşılaştırıldığında; yaş, bel/kalça oranı, TNFα, hsCRP, hemoglobin, HOMA-IR, FSH, LH, LH/FSH ve TSH değerleri anlamlı farklılık göstermektedir (p<0,05). İki grup arasında monosit/HDL (M/HDL) oranındaki farklılık istatiksel olarak anlamlı değildi. TNFα ile hsCRP’nin tanısal performansına bakıldığında ise; TNFα’nın 33,71 pg/ml değeri için sensitivite %69, spesifite %86, pozitif prediktif değer %68,6, negatif prediktif değer %85,7 iken, hsCRP’nin 3,82 mg/L değeri için sensitivite %91, spesifite %91, pozitif prediktif değer %91,4, negatif prediktif değer %91,4 olarak saptandı.
Sonuç: TNFα ve hsCRP (kronik inflamasyon), polikistik over sendromu hastalarındaki hiperandrojenizmin patogenezinde rol oynamaktadır..

Anahtar Kelimeler

Polikistik over sendromu, insülin direnci, inflamasyon

Kaynakça

• 1. Lauritsen M, Bentzen J, Pinborg A, et al. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Müllerian hormone. Hum Reprod 2014; 29: 791-801.
• 2. Mortada R, Williams T. Metabolic syndrome: polycystic ovary syndrome. FP Essent 2015; 435:30-42.
• 3. Taghavi SA, Bazarganipour F, Montazeri A, Kazemnejad A, Chaman R, Khosravi A. Health-related quality of life in polycystic ovary syndrome patients: A systematic review. Iran J Reprod Med 2015; 13: 473.
• 4. Savic-Radojevic A, Antic IB, Coric V, et al. Effect of hyperglycemia and hyperinsulinemia on glutathione peroxidase activity in non-obese women with polycystic ovary syndrome. Hormones 2015; 14: 101-8.
• 5. Sıklar Z, Berberoğlu M, Çamtosun E, Kocaay P. Diagnostic characteristics and metabolic risk factors of cases with polycystic ovary syndrome during adolescence. J Pediatr Adolesc Gynecol 2015; 28: 78-83.
• 6. Asmat U, Abad K, Ismail K. Diabetes mellitus and oxidative stress-a concise review. Saudi Pharm J 2016; 24: 547-53.
• 7. Bansal AK, Bilaspuri G. Impacts of oxidative stress and antioxidants on semen functions. Vet Med Int 2011; 2011. doi:10.4061/2011/686137.
• 8. MJ, Janež A, Dolžan V. Interplay between oxidative stress and chronic inflammation in PCOS: The role of genetic variability in PCOS risk and treatment responses. Polycystic Ovarian Syndrome: Intech Open; 2019.
• 9. Caserta D, Adducchio G, Picchia S, Ralli E, Matteucci E, Moscarini M. Metabolic syndrome and polycystic ovary syndrome: an intriguing overlapping. Gynecol Endocrinol 2014; 30: 397-402.
• 10. Ebejer K, Calleja-Agius J. The role of cytokines in polycystic ovarian syndrome. Gynecol Endocrinol 2013; 29: 536-40.
• 11. Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015; 149: R219-27.
• 12. Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril 2011; 95: 1048-58.
• 13. Kim JW, Han JE, Kim YS, Won HJ, Yoon TK, Lee WS. High sensitivity C-reactive protein and its relationship with impaired glucose regulation in lean patients with polycystic ovary syndrome. Gynecol Endocrinol 2012; 28: 259-63.
• 14. Toulis KA, Goulis DG, Mintziori G, et al. Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome. Hum Reprod Update 2011; 17: 741-60.
• 15. Hotamisligil GS, Budavari A, Murray D, Spiegelman BM. Reduced tyrosine kinase activity of the insulin receptor in obesity-diabetes. Central role of tumor necrosis factor-alpha. J Clin Invest 1994; 94: 1543-9.
• 16. Stephens JM, Pekala P. Transcriptional repression of the GLUT4 and C/EBP genes in 3T3-L1 adipocytes by tumor necrosis factor-alpha. J Biol Chem 1991; 266: 21839-45.
• 17. Canpolat U, Çetin EH, Cetin S, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016; 22: 476-82.
• 18. Ossoli A, Remaley AT, Vaisman B, Calabresi L, Gomaraschi M. Plasma-derived and synthetic high-density lipoprotein inhibit tissue factor in endothelial cells and monocytes. Biochem J 2016; 473: 211-9.
• 19. Vahit D, Akboga MK, Samet Y, Hüseyin E. Assessment of monocyte to high density lipoprotein cholesterol ratio and lymphocyte-to-monocyte ratio in patients with metabolic syndrome. Biomark Med 2017; 11: 535-40.
• 20. ESHRE TR, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25.
• 21. Azziz R, Carmina E, Dewailly D, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91: 456-88.
• 22. Vilcek J. First demonstration of the role of TNF in the pathogenesis of disease. J Immunol 2008; 181: 5-6.
• 23. Spaczynski RZ, Arici A, Duleba AJ. Tumor necrosis factor-α stimulates proliferation of rat ovarian theca-interstitial cells. Biol Reprod 1999; 61: 993-8.
• 24. Gao L, Gu Y, Yin X. High serum tumor necrosis factor-alpha levels in women with polycystic ovary syndrome: a meta-analysis. PLoS One 2016; 11: 10. e0164021.
• 25. Oh JY, Lee J-A, Lee H, Oh J-Y, Sung Y-A, Chung H. Serum C-reactive protein levels in normal-weight polycystic ovary syndrome. Korean J Intern Med 2009; 24: 350.
• 26. Makedos A, Goulis D, Arvanitidou M, et al. Increased serum C-reactive protein levels in normal weight women with polycystic ovary syndrome. Hippokratia 2011; 15: 323.
• 27. Usta A, Avci E, Bulbul CB, Kadi H, Adali E. The monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome. Reprod Biol Endocrinol 2018; 16: 34.
• 28. Dincgez Cakmak B, Dundar B, Ketenci Gençer F, Aydin BB, Yildiz DE. TWEAK and monocyte to HDL ratio as a predictor of metabolic syndrome in patients with polycystic ovary syndrome. Gynecol Endocrinol 2019; 35: 66-71.
• 29. Çadırcı K, İsra O, Tuba U, Keskin H, Çarlioğlu A, Arikan Ş. Monocyte to HDL-Cholesterol Ratio in Male with Hypogonadotropic Hypogonadism. Ankara Eğt Arş Hast Derg 2019; 52: 128-32.
• 30. Gunes H, Duksal F, Parlak M. Can monocyte to HDL ratio be used as an inflammatory marker in children with familial mediterranean fever? Ann Med Res 2019; 26: 1453-7.