Original Articles: Hormones and Reproductive Health
Low Grade Chronic Inflammation in Women with Polycystic Ovarian Syndrome
Chris C. J. Kelly,
Helen Lyall,
John R. Petrie,
Gwyn W. Gould,
John M. C. Connell and
Naveed Sattar
Departments of Medicine and Therapeutics (C.C.J.K., J.M.C.C.),
Obstetrics and Gynecology (H.L.), Divisions of Biochemistry and
Molecular Biology (G.W.G.), Pathological Biochemistry (N.S.), and
Medicine (J.R.P.), University of Glasgow, Glasgow, Scotland, United
Kingdom G4 0SF
Address all correspondence and requests for reprints to: Dr. Naveed Sattar, University Department of Pathological Biochemistry, Glasgow Royal Infirmary University, National Health Service Trust, Glasgow, Scotland, United Kingdom G4 0SF. E-mail:
nsattar{at}clinmed.gla.ac.uk
Abstract
Low grade chronic inflammation as reflected by increased C-reactive
protein(CRP) concentrations independently predicts those at risk for
coronaryheart disease (CHD) and type 2 diabetes. Women with polycystic
ovariansyndrome (PCOS) are insulin resistant and have increased risk
forCHD and type 2 diabetes, but currently there are no data onmarkers
of inflammation in women with PCOS. Seventeen womenwith PCOS (defined
on the basis of elevated testosterone andoligomenorrhea) and 15
healthy women matched as a group forbody mass index were recruited.
Measurement of CRP concentrationswas made using a highly sensitive
assay. Insulin resistancewas assessed using the hyperinsulinemic
euglycemic clamp technique.The women with PCOS had significantly
elevated CRP concentrationsrelative to controls (geometric means, 2.12
and 0.67 mg/L, respectively;P = 0.016). Log CRP
correlated with body mass index in bothPCOS and controls (r =
0.58; P < 0.05 and r = 0.78;
P <0.01, respectively) and inversely with insulin
sensitivity (r= -0.57; P < 0.05 and r
= -0.69; P < 0.01). Total testosteronedid not
correlate with log CRP in either group. On adjustmentfor body mass
index and age, there remained a significant differencein log CRP
between PCOS and controls (t = 2.13;
P < 0.05).On further adjustment for insulin
sensitivity, log CRP was nolonger significantly different between
groups (t = 1.51; P =0.14). We
conclude that women with PCOS have significantly increasedCRP
concentrations relative to women with normal menstrual rhythmand
normal androgen levels. We propose low grade chronic inflammationas a
novel mechanism contributing to increased risk of CHD andtype 2
diabetes in these women.
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