Serum C-Reactive Protein Levels in Normal-Weight Polycystic Ovary Syndrome
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Background/Aims: Serum levels of highly sensitive C-reactive protein (hsCRP), a vascular inflammatory marker, may predict the development of cardiovascular disease (CVD) and type 2 diabetes. Women with polycystic ovary syndrome (PCOS) are at greater risk for type 2 diabetes and CVD. The aim of this study was to compare hsCRP levels between normal weight women with PCOS and controls with a normal menstrual cycle and to determine the factors associated with serum hsCRP levels. Methods: Thirty-nine lean PCOS patients and 24 healthy, regular cycling women were enrolled in this study. We performed anthropometric measurements, fat computed tomography (CT), and blood sampling to determine blood chemistry and levels of hsCRP, gonadotropins, testosterone, and sex-hormone binding globulin. We also conducted 75-g oral glucose-tolerance test and euglycemic hyperinsulinemic clamp to assess insulin sensitivity. Results: Serum hsCRP concentrations were higher in women with PCOS than in women with regular mensturation. However, this difference was no longer significant after adjusting for body mass index (BMI). hsCRP levels were correlated with waist circumference (r=0.46, p<0.01), BMI (r=0.46, p<0.01), visceral fat area (r=0.45, p<0.01), and systolic (r=0.42, p<0.05) and diastolic blood pressure (r=0.39, p<0.05). hsCRP also tended to be negatively associated with insulin-mediated glucose uptake (IMGU) (r=-0.31, p=0.07). A multiple regression analysis revealed that BMI (β=0.29, p<0.05), systolic blood pressure (β=0.39, p<0.01), and IMGU (β=-0.31, p<0.05) predicted serum hsCRP levels in women with PCOS. Conclusions: PCOS by itself does not seem to be associated with increased hsCRP levels, whereas known CVD risk factors affect serum hsCRP levels in PCOS.
Abstract
Background/Aims: Serum levels of highly sensitive C-reactive protein (hsCRP), a vascular inflammatory marker, may predict the development of cardiovascular disease (CVD) and type 2 diabetes. Women with polycystic ovary syndrome (PCOS) are at greater risk for type 2 diabetes and CVD. The aim of this study was to compare hsCRP levels between normal weight women with PCOS and controls with a normal menstrual cycle and to determine the factors associated with serum hsCRP levels. Methods: Thirty-nine lean PCOS patients and 24 healthy, regular cycling women were enrolled in this study. We performed anthropometric measurements, fat computed tomography (CT), and blood sampling to determine blood chemistry and levels of hsCRP, gonadotropins, testosterone, and sex-hormone binding globulin. We also conducted 75-g oral glucose-tolerance test and euglycemic hyperinsulinemic clamp to assess insulin sensitivity. Results: Serum hsCRP concentrations were higher in women with PCOS than in women with regular mensturation. However, this difference was no longer significant after adjusting for body mass index (BMI). hsCRP levels were correlated with waist circumference (r=0.46, p<0.01), BMI (r=0.46, p<0.01), visceral fat area (r=0.45, p<0.01), and systolic (r=0.42, p<0.05) and diastolic blood pressure (r=0.39, p<0.05). hsCRP also tended to be negatively associated with insulin-mediated glucose uptake (IMGU) (r=-0.31, p=0.07). A multiple regression analysis revealed that BMI (β=0.29, p<0.05), systolic blood pressure (β=0.39, p<0.01), and IMGU (β=-0.31, p<0.05) predicted serum hsCRP levels in women with PCOS. Conclusions: PCOS by itself does not seem to be associated with increased hsCRP levels, whereas known CVD risk factors affect serum hsCRP levels in PCOS.
참고문헌 (34)
- Dunaif A, "Current concepts in the polycystic ovary syndrome", Annu Rev Med, 52, pp.401~419 (2001)
- Asuncion M, "Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain", J Clin Endocrinol Metab, 85, pp.2434~2438 (2000)
- Dunaif A, "Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis", Endocr Rev, 18, pp.774~800 (1997)
- Ciampelli M, , Metabolism, 48, pp.167~172 (1999)
- Franks S, "Polycystic ovary syndrome", N Engl J Med, 333, pp.853~861 (1995)
- Dunaif A, "Profound peripheral insulin resistance, independent of obesity, in the polycystic ovary syndrome", Diabetes, 38, pp.1165~1174 (1989)
- Lovo RA, "Evidence for the importance of peripheral tissue events in the development of hirsutism in polycystic ovary syndrome", J Clin Endocrinol Metab, 57, pp.393~397 (1983)
- Dunaif A, "action in the polycystic ovary syndrome", Endocrinol Metab Clin North Am, 28, pp.341~359 (1999)
- Azziz R, "Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double blind, placebo-controlled trial", J Clin Endocrinol Metab, 86, pp.1626~1632 (2001)
- Dahlgren E, "Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow up focusing on natural history and circulating hormones", Fertil Steril, 57, pp.505~513 (1992)
- Dahlgren E, "Polycystic ovary syndrome and risk for myocardial infarction: evaluated from a risk factor model based on a prospective population study of women", Acta Obstet Gynecol Scand, 71, pp.599~604 (1992)
- Ridker PM, "Clinical application of C-reactive protein for cardiovascular disease detection and prevention", Circulation, 107, pp.363~369 (2003)
- Kelly CC, "Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome", J Clin Endocrinol Metabol, 86, pp.2453~2455 (2001)
- Boulman N, "Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease", J Clin Endocrinol Metabol, 89, pp.2160~2165 (2004)
- Mohlig M, "The polycystic ovary syndrome per se is not associated with increased chronic inflammation", Eur J Endocrinol, 150, pp.525~532 (2004)
- Zawadski JK, "Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. in: Polycystic Ovary Syndrome", pp.377~384 (1992), Blackwell Scientific
- DeFronzo RA, "Glucose clamp technique: a method for quantifying insulin secretion and resistance", Am J Physiol, 237, pp.e214~e223 (1979)
- Tsujimura A, "Comparative study on evaluation methods for serum testosterone level for PADAM diagnosis", Int J Impot Res, 14, pp.259~263 (2005)
- Talbott EO, "Cardiovascular risk in women with polycystic ovary syndrome", Obstet Gynecol Clin North Am, 28, pp.111~133 (2001)
- Talbott E, "Coronary heart disease risk factor in women with polycystic ovary syndrome", Arterioscler Thromb Vasc Biol, 15, pp.821~826 (1995)
- Wild RA, "Lipoprotein lipid concentration and cardiovascular risk in women with polycystic ovary syndrome", J Clin Endocrinol Metab, 61, pp.946~951 (1985)
- Wild S, "Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study", Clin Endocrinol, 52, pp.595~600 (2000)
- Elting MW, "Prevalence of diabetes mellitus, hypertension and cardiac complaints in a follow-up study of a Dutch PCOS population", Hum Reprod, 16, pp.556~560 (2001)
- Pierpoint T, "Mortality of women with polycystic ovary syndrome at long-term follow-up", J Clin Epidemiol, 51, pp.581~586 (1998)
- Gonzalez F, "Elevated serum levels of tumor necrosis factor alpha in normal-weight women with polycystic ovary syndrome", Metabolism, 48, pp.437~441 (1999)
- Loverro G, "The plasma homocystein levels are increased in polycystic ovary syndrome", Gynecol Obstet Invest, 53, pp.157~162 (2002)
- Sampson M, "Ambulatory blood pressure profiles and plasminogen activator inhibitor (PAI- 1) activity in lean women with and without the polycystic ovary syndrome", Clin Endocrinol, 45, pp.623~629 (1996)
- Ridker PM, "Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular event", N Engl J Med, 347, pp.1577~1565 (2002)
- Aronson D, "Obesity is the major determinant of elevated C-reactive protein in subjects with metabolic syndrome", Int J Obes Relat Metab Disord, 28, pp.674~679 (2004)
- Lemieux I, "Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity", Arterioscler Thromb Vasc Biol, 21, pp.961~967 (2001)
- Albert MA, "C-reactive protein levels among women of various ethnic groups living in the United States (from the Women’s Health Study)", Am J Cardiol, 93, pp.1238~1242 (2004)
- Saijo Y, "Relationship between Creactive protein and visceral adipose tissue in healthy Japanese subjects", Diabetes Obes Metab, 6, pp.249~258 (2004)
- Pieroni L, "Interpretation of circulating C-reactive protein levels in adults: body mass index and gender are a must", Diabetes Metab, 29, pp.133~138 (2003)