Skip to main content
SpringerLink
Log in

High sensitive serum C-reactive protein and its relationship with other cardiovascular risk factors in normoinsulinemic polycystic ovary patients without metabolic syndrome

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The aims of the study were to investigate high sensitive serum C-reactive protein (HS-CRP) levels in normoinsulinemic polycystic ovary syndrome (PCOS) patients without metabolic syndrome and whether there was any relationship between HS-CRP and other cardiovascular risk factors such as obesity and serum lipids.

Methods

A total of 52 normoinsulinemic PCOS women without metabolic syndrome and 48 normoandrogenic ovulatory women were enrolled in the study. Standard clinical examinations, and ultrasonographic and endocrine screening including FSH, LH, total testosterone, free testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglyceride (TG) were measured. Normal insulin sensitivity was defined on the basis of fasting serum glucose and insulin levels, serum insulin response to an oral glucose tolerance test and homeostatic model of insulin resistance. HS-CRP was assessed spectrophotometrically.

Results

PCOS patients had increased HS-CRP compared to the control group (P < 0.0001). HS-CRP was positively correlated with body mass index (BMI) (r = 0.44, P < 0.0001), waist-to-hip ratio (WHR) (r = 0.66, P < 0.0001), LDL (r = 0.62, P < 0.0001), TC (r = 0.56, P < 0.0001) and TG (r = 0.38, P < 0.0001), and negatively correlated with HDL (r = −0.45, P < 0.0001). There was also a strong association between HS-CRP and PCOS status (r = 0.69, P < 0.0001) in the study. Multivariate regression analysis demonstrated that BMI, WHR, LDL, HDL and PCOS status were also the independent variables that influenced HS-CRP in the overall group.

Conclusion

Elevated HS-CRP was associated with cardiovascular risk factors in normoinsulinemic PCOS without metabolic syndrome. These patients need more intensive screening or treatment for this disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ehrmann DA (2005) Polycystic ovary syndrome. N Engl J Med 352:1223–1236

    Article  CAS  PubMed  Google Scholar 

  2. Cascella T, Palomba S, De Sio I, Manguso F, Giallauria F, De Simone B, Tafuri D, Lombardi G, Colao A, Orio F (2008) Visceral fat is associated with cardiovascular risk in women with polycystic ovary syndrome. Hum Reprod 23:153–159

    Article  CAS  PubMed  Google Scholar 

  3. Bevc S, Sabic S, Hojs R (2008) Atherosclerosis in hemodialysis patients: the role of microinflammation. Ren Fail 30:1012–1016

    Article  CAS  PubMed  Google Scholar 

  4. Ikonomidis I, Stamatelopoulos K, Lekakis J, Vamvakou GD, Kremastinos DT (2008) Inflammatory and non-invasive vascular markers: the multimarker approach for risk stratification in coronary artery disease. Atherosclerosis 199:3–11

    Article  CAS  PubMed  Google Scholar 

  5. Hansson GK (2009) Atherosclerosis, an immune disease: the Anitschkov lecture 2007. Atherosclerosis 202:2–10

    Article  CAS  PubMed  Google Scholar 

  6. Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N (2001) Low-grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 86:2453–2455

    Article  CAS  PubMed  Google Scholar 

  7. Thomann R, Rossinelli N, Keller U, Tirri BF, De Geyter C, Ruiz J, Kränzlin M, Puder JJ (2008) Differences in low-grade chronic inflammation and insulin resistance in women with previous gestational diabetes mellitus and women with polycystic ovary syndrome. Gynecol Endocrinol 24:199–206

    Article  CAS  PubMed  Google Scholar 

  8. Fröhlich M, Imhof A, Berg G, Hutchinson WL, Pepys MB, Boeing H, Muche R, Brenner H, Koenig W (2000) Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care 23:1835–1839

    Article  PubMed  Google Scholar 

  9. Puder JJ, Varga S, Kraenzlin M, De Geyter C, Keller U, Müller B (2005) Central fat excess in polycystic ovary syndrome: relation to low-grade inflammation and insulin resistance. J Clin Endocrinol Metab 90:6014–6021

    Article  CAS  PubMed  Google Scholar 

  10. Giallauria F, Orio F, Palomba S, Lombardi G, Colao A, Vigorito C (2008) Cardiovascular risk in women with polycystic ovary syndrome. J Cardiovasc Med (Hagerstown) 9:987–992

    Google Scholar 

  11. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25

    Google Scholar 

  12. Ferriman D, Gallwey JD (1961) Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 21:1440–1447

    Article  CAS  PubMed  Google Scholar 

  13. Baillargeon JP, Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Nestler JE (2004) Effects of metformin and rosiglitazone, alone and in combination, in nonobese women with polycystic ovary syndrome and normal indices of insulin sensitivity. Fertil Steril 82:893–902

    Article  CAS  PubMed  Google Scholar 

  14. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419

    Article  CAS  PubMed  Google Scholar 

  15. Comim FV, Spritzer PM (2004) Increased growth hormone response to clonidine in nonobese normoinsulinemic patients with polycystic ovary syndrome. Fertil Steril 81:108–113

    Article  CAS  PubMed  Google Scholar 

  16. World Health Organization (1994) WHO study group prevention of diabetes mellitus. Technical report series 844. World Health Organization, Geneva

  17. Expert Committee on the Diagnosis and Classification (2003) Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26:3160–3167

    Article  Google Scholar 

  18. Yildirim B, Sabir N, Kaleli B (2003) Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril 79:1358–1364

    Article  PubMed  Google Scholar 

  19. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association, National Heart, Lung, Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation 112:2735–2752

    Article  PubMed  Google Scholar 

  20. Rizzo M, Berneis K, Spinas G, Rini GB, Carmina E (2009) Long-term consequences of polycystic ovary syndrome on cardiovascular risk. Fertil Steril 91(4 Suppl):1563–1567

    Article  PubMed  Google Scholar 

  21. Anuurad E, Tracy RP, Pearson TA, Kim K, Berglund L (2009) Synergistic role of inflammation and insulin resistance as coronary artery disease risk factors in African Americans and Caucasians. Atherosclerosis 205:290–295

    Article  CAS  PubMed  Google Scholar 

  22. Escobar-Morreale HF, Villuendas G, Botella-Carretero JI, Sancho J, San Millán JL (2003) Obesity, and not insulin resistance, is the major determinant of serum inflammatory cardiovascular risk markers in pre-menopausal women. Diabetologia 46:625–633

    CAS  PubMed  Google Scholar 

  23. Mather KJ, Kwan F, Corenblum B (2000) Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity. Fertil Steril 73:150–156

    Article  CAS  PubMed  Google Scholar 

  24. Apridonidze T, Essah PA, Iuorno MJ, Nestler JE (2005) Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 90:1929–1935

    Article  CAS  PubMed  Google Scholar 

  25. Möhlig M, Spranger J, Osterhoff M, Ristow M, Pfeiffer AF, Schill T, Schlösser HW, Brabant G, Schöfl C (2004) The polycystic ovary syndrome per se is not associated with increased chronic inflammation. Eur J Endocrinol 150:525–532

    Article  PubMed  Google Scholar 

  26. Wu Y, Zhang J, Wen Y, Wang H, Zhang M, Cianflone K (2009) Increased acylation-stimulating protein, C-reactive protein, and lipid levels in young women with polycystic ovary syndrome. Fertil Steril 91:213–219

    Article  CAS  PubMed  Google Scholar 

  27. Berneis K, Rizzo M, Hersberger M, Rini GB, Di Fede G, Pepe I, Spinas GA, Carmina E (2009) Atherogenic forms of dyslipidaemia in women with polycystic ovary syndrome. Int J Clin Pract 63:56–62

    Article  CAS  PubMed  Google Scholar 

  28. Guzelmeric K, Alkan N, Pirimoglu M, Unal O, Turan C (2007) Chronic inflammation and elevated homocysteine levels are associated with increased body mass index in women with polycystic ovary syndrome. Gynecol Endocrinol 23:505–510

    Article  CAS  PubMed  Google Scholar 

  29. König D, Deibert P, Winkler K, Berg A (2005) Association between LDL-cholesterol, statin therapy, physical activity and inflammatory markers in patients with stable coronary heart disease. Exerc Immunol Rev 11:97–107

    PubMed  Google Scholar 

  30. Boulman N, Levy Y, Leiba R, Shachar S, Linn R, Zinder O, Blumenfeld Z (2004) Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab 89:2160–2165

    Article  CAS  PubMed  Google Scholar 

  31. Kaya C, Pabuccu R, Berker B, Satiroglu H (2009) Plasma interleukin-18 levels are increased in the polycystic ovary syndrome: relationship of carotid intima-media wall thickness and cardiovascular risk factors. Fertil Steril [Epub ahead of print]

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Yenisehir, 63050, Sanliurfa, Turkey

    Fatma Ferda Verit

Authors
  1. Fatma Ferda Verit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fatma Ferda Verit.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verit, F.F. High sensitive serum C-reactive protein and its relationship with other cardiovascular risk factors in normoinsulinemic polycystic ovary patients without metabolic syndrome. Arch Gynecol Obstet 281, 1009–1014 (2010). https://doi.org/10.1007/s00404-009-1226-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-009-1226-6

Keywords

Search

Navigation