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Increased C-Reactive Protein Levels in the Polycystic Ovary Syndrome: A Marker of Cardiovascular Disease

Reproductive Endocrinology, Departments of Obstetrics and Gynecology (Z.B.) and Internal Medicine D (N.B., Y.L.), Department of Clinical Biochemistry (O.Z.), and Statistical Unit (R.L.), Rambam Medical Center, Rappaport Faculty of Medicine, Technion 31096, Israel; and Institute of Technology and Meuhedet Medical Services (S.S., R.L.), Haifa 31096, Israel

Address all correspondence and requests for reprints to: Z. Blumenfeld, M.D., Reproductive Endocrinology, Rambam Medical Center, Haifa 31096, Israel. E-mail: bzeev{at}techunix.technion.ac.il.

The polycystic ovary syndrome (PCOS), one of the most common reproductive abnormalities, shares some components of the metabolic cardiovascular syndrome. Therefore, PCOS patients may represent the largest group of women at high risk for the development of early-onset cardiovascular disease (CVD) and/or diabetes. C-reactive protein (CRP) is a strong independent predictor of future CVD and/or stroke. Only one small published study has looked for such an association (17 PCOS patients vs. 15 controls). The objective of this study was to compare the levels of CRP and other risk factors of CVD in a large group of PCOS patients and controls. CRP measurements were undertaken in 116 PCOS patients and 94 body mass index-matched controls with regular menstrual cycles. Whereas 36.8% of the PCOS patients had CRP levels above 5 mg/liter, only 9.6% of the controls exhibited high CRP levels (P < 0.001). The mean ± SD was 5.46 ± 7.0 in the PCOS group vs. 2.04 ± 1.9 mg/liter in the control (P < 0.001). The body mass index, white blood cell count, TSH, glucose, cholesterol, and homocysteine levels were not significantly different between the two groups. CRP levels are elevated in patients with PCOS and may be a marker of early cardiovascular risk in these patients. High CRP levels may explain why some PCOS women may possibly be at an increased risk for the development of early-onset CVD. Consequently, whether treatment regimens directed toward lowering CVD risk factors should be more aggressive for those PCOS women with increased CRP levels, awaits further clinical experience.

Abbreviations: BMI, Body mass index; CRP, C-reactive protein; CVD, cardiovascular disease; HDL, high density lipoprotein; HDL-C, high density lipoprotein cholesterol; HS-CRP, high sensitivity C-reactive protein analysis; LDL, low density lipoprotein; LDL-C, low density lipoprotein cholesterol; PCOS, polycystic ovary syndrome; R-CRP, regular C-reactive protein analysis.

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