Body fat and insulin resistance independently predict increased serum C-reactive protein in hyperandrogenic women with polycystic ovary syndrome.
OBJECTIVE
Increased serum C-reactive protein (CRP), an independent predictor of coronary heart disease, was reported in women with polycystic ovary syndrome (PCOS). It remains unclear whether this finding is due to the association between PCOS and either insulin resistance, obesity, or androgen excess, which are all common features of this condition. The aims of this study were to assess whether increased serum CRP is a specific feature of PCOS and to investigate the mechanisms underlying this association.


METHODS
Serum high-sensitivity CRP (hs-CRP) was measured in 86 hyperandrogenic women (age 21.6+/-4.2 years, body mass index (BMI) 23.6+/-3.5 kg/m2), 50 with PCOS and 36 with idiopathic hyperandrogenism (HA). Thirty-five BMI-matched healthy women were also studied as controls. In these subjects, endocrine and metabolic profiles were assessed. In all hyperandrogenic subjects and 14 controls, insulin sensitivity was measured by the glucose clamp technique. Body fat was measured by bioelectrical impedance.


RESULTS
Hs-CRP concentrations were higher in PCOS women (3.43+/-2.01 mg/l) than in HA subjects and healthy women (2.43+/-1.04, P<0.005; and 2.75+/-0.86 mg/l, P<0.05 respectively versus PCOS). In multiple regression analyses, increased serum hs-CRP was independently predicted by higher body fat and lower insulin sensitivity. However, in lean women, serum-free testosterone was an additional, negative, predictive variable.


CONCLUSIONS
PCOS is accompanied by a low-grade chronic inflammation. Body fat appears the main determining factor of this finding, which is only partly explained by insulin resistance. At least in lean women, androgen excess per se seems to play an additional, possibly protective, role in this association.
Tosi
Flavia
F
Endocrinology and Metabolism, Department of Biomedical and Surgical Sciences, University of Verona, 37126 Verona, Italy.
Dorizzi
Romolo
R
Castello
Roberto
R
Maffeis
Claudio
C
Spiazzi
Giovanna
G
Zoppini
Giacomo
G
Muggeo
Michele
M
Moghetti
Paolo
P
D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D001823:Body Composition / Q000502:physiology; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D017097:Electric Impedance; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D012044:Regression Analysis; D055815:Young Adult
D002097:C-Reactive Protein