Reproductive Medicine

Archives of Gynecology and Obstetrics

, Volume 286, Issue 4, pp 1065-1071

First online:

A macrophage activation marker chitotriosidase in women with PCOS: does low-grade chronic inflammation in PCOS relate to PCOS itself or obesity?

  • Ibrahim AlanbayAffiliated withObstetrics and Gynecology Department, Gulhane Military Medical Faculty
  • , Cihangir Mutlu ErcanAffiliated withObstetrics and Gynecology Department, Gulhane Military Medical Faculty
  • , Mehmet SakinciAffiliated withObstetrics and Gynecology Department, Akdeniz University Medical Faculty Email author 
  • , Hakan CoksuerAffiliated withObstetrics and Gynecology Department, Gulhane Military Medical Faculty
  • , Mustafa OzturkAffiliated withObstetrics and Gynecology Department, Gulhane Military Medical Faculty
  • , Serkan TapanAffiliated withDepartment of Clinical Biochemistry, Gulhane Military Medical Faculty

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Polycystic ovary syndrome (PCOS) is described as a low-grade chronic inflammatory state where the macrophage infiltration increased in visceral fat play the major role. The aim of this study was to assess chitotriosidase (ChT) activity (an activated macrophage marker) in women with PCOS and controls and to evaluate its correlation with anthropometric and biochemical parameters.

Study design

Seventy-nine women with PCOS and 60 healthy controls were included in the study. PCOS and controls were divided into two subgroups according to body mass indexes (BMIs) as normoweight (<25 kg/m2) and overweight (≥25 kg/m2). ChT activity, biochemical (free testosterone, luteinizing hormone, insulin resistance index, etc.) and clinical parameters [BMI, waist-to-hip ratio, modified Ferriman–Gallwey scores (mFG)] were analyzed according to groups.


Serum ChT activity was significantly (p < 0.001) higher in women with PCOS than controls (normoweight, 87.1 ± 90.1 vs. 18.4 ± 9.0 nmol/ml/h; overweight, 92.0 ± 96.7 vs. 17.9 ± 12.1 nmol/ml/h PCOS and controls, respectively). No statistically significant difference was noted between ChT activity of normoweight and overweight PCOS subgroups. A positive correlation was found between ChT activity and PCOS status (r 0.598, p < 0.001), mFG scores (r 0.525, p < 0.001), free testosterone (r 0.402, p 0.001) and total testosterone (r 0.168, p 0.048) for the combined groups (PCOS + controls). In multivariant linear regression analysis participants’ PCOS status (presence or absence) and LH levels were the main predictors of ChT activity in the whole study population (p 0.002 and p 0.041, respectively).


ChT activity elevates in PCOS independent of obesity. Our findings support the concept of PCOS is a state of low-grade chronic inflammation where the macrophages could play the major role. Hyperandrogenism might also be related to this inflammatory state and can be a subject of further trials.


Chitotriosidase Inflammation Macrophage PCOS