title: Evaluation of the pro-inflammatory cytokine tumor necrosis factor-α in adolescents with polycystic ovary syndrome.
abstract: BACKGROUND
  Patients with polycystic ovary syndrome (PCOS) often suffer from comorbidities associated with chronic inflammation characterized by elevations in pro-inflammatory cytokines. There is limited data on markers of chronic inflammation, in particular Tumor Necrosis Factor-alpha (TNF-α), in adolescents with PCOS.
  
  
  OBJECTIVE
  To compare serum levels of TNF-α in overweight or obese adolescents with PCOS and obese controls. In the PCOS group, to correlate serum TNF-α levels with body mass index (BMI) z-score, severity of hyperandrogenism, degree of insulin resistance, and ovarian ultrasonographic characteristics.
  
  
  METHODS
  We performed a cross-sectional retrospective analysis of clinical and biochemical findings in 23 overweight or obese adolescent females with PCOS (mean BMI z-score 2, mean age 15.2 yrs) and 12 obese age- and sex-matched controls (mean BMI z-score 2, mean age 14.1 y). All subjects were post-menarchal. Serum TNF-α levels were compared between groups. In the PCOS group, cytokine levels were correlated with BMI z-score, androgen levels, fasting insulin and glucose levels as well as ovarian ultrasonographic features.
  
  
  RESULTS
  Both groups were comparable in age, BMI z-score, fasting glucose, and fasting insulin. Mean free testosterone was 9.76 ± 5.13 pg/mL in the PCOS group versus 5 ± 2.02 pg/mL in the control group (P = .0092). Serum TNF-α was 7.4 ± 4 pg/mL in the PCOS group versus 4.8 ± 3.16 pg/mL in the control group (P = .0468). There was no significant correlation between serum TNF-α and BMI z-score, free testosterone, fasting insulin, or fasting glucose. No correlation existed between serum TNF-α and ovarian follicle number, distribution, or volume.
  
  
  CONCLUSIONS
  Serum TNF-α is elevated in overweight/obese adolescents with PCOS. Chronic inflammation in adolescents with PCOS render them at a potential increased risk for the development of atherosclerosis, type 2 diabetes, cancer, infertility, and other comorbidities. Every effort should be made to identify adolescents with PCOS early and initiate aggressive therapy to prevent future complications.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, New York University School of Medicine, New York, New York.
authors.forename: Melissa
authors.initials: M
authors.lastname: Pawelczak
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, New York University School of Medicine, New York, New York.
authors.forename: Jamie
authors.initials: J
authors.lastname: Rosenthal
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, New York.
authors.forename: Sarah
authors.initials: S
authors.lastname: Milla
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, New York.
authors.forename: Ying-Hua
authors.initials: YH
authors.lastname: Liu
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, New York University School of Medicine, New York, New York. Electronic address: bina.shah@nyumc.org.
authors.forename: Bina
authors.initials: B
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications; D007249:Inflammation / Q000097:blood* / Q000150:complications; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D009765:Obesity / Q000097:blood* / Q000150:complications; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013739:Testosterone / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D007328:Insulin; D014409:Tumor Necrosis Factor-alpha; D013739:Testosterone
keywords: Adolescents; Polycystic ovary syndrome; Tumor necrosis factor-α (TNF-α)