Increased follistatin levels after oral contraceptive treatment in obese and non-obese women with polycystic ovary syndrome.
BACKGROUND
Follistatin levels have recently been considered as a marker for inflammation. Our objective was to evaluate the level of circulating follistatin and high-sensitivity C-reactive protein (hsCRP) in women with polycystic ovary syndrome (PCOS) after oral contraceptive (OC) treatment.


METHODS
A total of 56 Taiwanese women with PCOS were enrolled in this prospective observational study in which they were treated for 3 months with OCs (ethinyl estradiol-cyproterone acetate). Blood samples were taken at baseline after treatment during the withdrawal bleed. Body mass index (BMI), lipid profiles, plasma follistatin, hsCRP, fasting glucose, insulin for the homeostasis model assessment of insulin resistance (HOMA-IR) and hormone profiles were measured and analyzed.


RESULTS
Total testosterone, free androgen index (FAI), dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol levels were significantly lower, but total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, circulating follistatin and hsCRP were significantly higher than baseline in women with PCOS after treatment with OCs. An elevation of fasting insulin, HOMA-IR and hsCRP after OC treatment was more evident in non-obese than obese women, whereas the elevation of follistatin was significant in both obese and non-obese women. Follistatin and hsCRP levels all showed significant correlations with each other at baseline and after treatment. The differences in follistatin and hsCRP levels from baseline to after OC treatment were significantly associated with the difference in triglyceride levels.


CONCLUSIONS
Both hsCRP and follistatin levels increase after OC treatment in women with PCOS. Follistatin seems more sensitive than hsCRP alone to represent the aggravated low-grade inflammatory status after OC treatment in obese and non-obese women with PCOS.
Chen
Mei-Jou
MJ
Department of Obstetrics and Gynecology, National Taiwan University Hospital, No 7 Chung-Shan South Road, 100 Taipei, Taiwan.
Yang
Wei-Shiung
WS
Chen
Hsin-Fu
HF
Kuo
Jahn-Jahn
JJ
Ho
Hong-Nerng
HN
Yang
Yu-Shih
YS
Chen
Shee-Uan
SU
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D038681:Follistatin / Q000097:blood*; D006801:Humans; D009765:Obesity / Q000097:blood* / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D011446:Prospective Studies
D003278:Contraceptives, Oral, Hormonal; D038681:Follistatin; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D002097:C-Reactive Protein