The effect of obesity on inflammatory markers in patients with PCOS: a BMI-matched case-control study.

BACKGROUND: Previous studies have shown increased inflammatory activity in patients with polycystic ovary syndrome (PCOS); however, it remains uncertain whether this increased inflammatory activity is a consequence of the disorder itself or of the accompanying obesity. We therefore aimed to test the inflammatory marker levels in obese and lean patients with PCOS by using two separate control groups with matching body mass index (BMI).
METHOD: A total of 120 women in reproductive age with (n = 62) and without (n = 60) PCOS were recruited for the study. Patients with PCOS were divided into two groups as obese (n = 32) and lean (n = 30) PCOS groups according to BMI. Two BMI-matched control groups were created. Furthermore, high sensitive CRP protein (hsCRP), neutrophils, lymphocytes, white blood cell count (WBC) and neutrophil to lymphocyte ratio (NLR) were evaluated with complete blood count.
RESULTS: The hsCRP (5.5 ± 0.8 vs. 3.1 ± 0.7, p < 0.001), neutrophil count (3.8 ± 0.4 vs. 2.9 ± 0.7, p < 0.001), leukocyte count (7.2 ± 1.8 vs. 5.6 ± 1.6, p < 0.001), and NLR (2.6 ± 1.4 vs. 1.5 ± 0.4, p < 0.001) were higher in patients with PCOS compared to the control group while lymphocyte count was lower (1.71 ± 0.65 vs. 1.98 ± 0.39, p = 0.008). Similarly, both obese and lean patients with PCOS had higher levels of hsCRP, neutrophils, leukocytes and NLR ratios compared to BMI-matched controls. The correlation analysis revealed a moderate correlation between NLR and hsCRP (r 0.459, p < 0.001), and between HOMA-IR (r 0.476 p < 0.001) and BMI (r 0.310, p 0.001).
CONCLUSION: Our study results demonstrated that both lean and obese patients with PCOS have increased inflammatory markers compared to BMI-matched control groups indicating that the inflammation seen in PCOS might be related with the presence of the disorder rather than with obesity.