The Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder among the women of reproductive again, which is characterised by chronic anovulation and biochemical or clinical hyperandrogenism. In addition, the clinical spectrum of PCOS includes components of the metabolic syndrome, such as central obesity, insulin resistance, dyslipidemia, arterial hypertension and, even, disturbances of the clotting mechanism (1).
All these disorders are epidemiologically related to clinical conditions, such as cardiovascular disease, most probably through low-grade intravascular chronic inflammation (2). C- reactive protein (CRP) is an acute phases protein, which is measured in the serum and is widely used in the routine clinical practice for the monitoring of bacterial infections,as well as the efficacy of the antimicrobial therapy (3). CRP serves not only as a marker of severe infection but also of low-grade chronic inflammation, as it constitutes a useful screening marker of intravascular inflammatory processes (4).
Many studies have demonstrated that CRP levels have important prognostic implications for patients (5). The JUPITER study showed that reducing CRP levels can mitigate this risk (6). A number of previous studies reported that PCOS is associated with increased hsCRP levels (7). It is now clear that PCOS is a proinflammatory state and emerging data suggest that chronic low-grade inflammation underpins the development of metabolic disturbances and ovarian dysfunction in this disorder (8,9). Many studies have demonstrated a positive relationship between CRP values and insulin resistance, body weight and fatty mass in women with PCOS (10,11). Women with PCOS are predisposed to increased visceral adiposity and this appears to be across all categories of BMI.
Using DEXA it has been shown that subjects with PCOS had similar percentage of total and trunk fat but higher percentage of central abdominal fat compared with weight-matched controls (12). The presence of increased visceral adipose tissue is associated with insulin resistance, hyperglycemia and dyslipidemia which as mentioned above are co-morbidities associated with PCOS. Furthermore recent studies raise the possibility of an intriguing association of PCOS with low-grade infections.
One of the most important markers of inflammation is CRP. CRP is an acute-phase reactant produced by hepatocytes under the stimulatory control of pro-inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor alpha (13). Hence this study aims to comparatively analyse the high sensitivity C- reactive protein levels in women with and without Polycystic Ovary Syndrome.MATERIALS AND METHODS: Patients were selected from those attending the out patient department of Saveetha Dental College, and hospitals and divided into two groups as follows:Group I – Normal healthy individuals – 25 individualsGroup II – Poly cystic ovarian syndrome patients – 25 individualsInclusion criteria: ?Individuals with the age group of twenty to thirty years?PCOS PatientsExclusion Criteria:? *Individuals with other systemic illness like cardio vascular disease, Renal failure, Stroke, endocrine illness.? *Individuals with acute illness like fever.
? *Immunocompromised individualsSample collection:?Informed consent was obtained from the patient before sample collection. 3ml of venous blood was collected and distributed in plain collection tubes and centrifuged in 3000rpm for serum. Then serum was separated and analysed to estimate the CRP by Turbilatex Method using ERBA CHEM 5 plus autoanalyser.RESULTS: All the data were analysed by using SPSS package. Paired sample t test analysis was done to find out significant differences between the two groups.
All the tests were considered significant at p < 0.05 level. Table 1: Mean, SD, p values of two groups Women with PCOS are known to be at increased risk for insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus. Also, women with PCOS are often obese, obesity being strongly associated with insulin resistance and chronic low-grade inflammation 14-16. Circulating levels of the proinflammatory cytokine tumor necrosis factor-? (TNF?) are elevated in obesity, and are also elevated in PCOS independent of obesity 17,18. In fact, the discovery of TNF? elevations in PCOS served as the initial indication that PCOS is a proinflammatory state.
It seems there is a genetic basis for the chronic low-grade inflammation observed in PCOS. CRP Level Mean SD p value Control 3.4 1.43 0.0001 PCOS 12.57 3.75 0.0001