title: Does the Oral Contraceptive Pill Increase Plasma Intercellular Adhesion Molecule-1, Monocyte Chemoattractant Protein-1, and Tumor Necrosis Factor-α Levels in Women with Polycystic Ovary Syndrome: A Pilot Study.
abstract: OBJECTIVE
  Polycystic ovary syndrome (PCOS), the most common endocrinopathy of women, is a state of chronic low-grade inflammation and is closely linked to type 2 diabetes mellitus and cardiovascular disease. Oral contraceptive pills (OCPs), is the usual first choice of treatment in women with PCOS. Because OCP use has been linked to the risk of venous thrombosis and there are limited data on the effect of OCP use on the inflammatory state of women with PCOS, our objective was to compare the levels of intercellular adhesion molecule (ICAM)-1, tumor necrosis factor (TNF)-α, and monocyte chemoattractant protein (MCP)-1 between drug-naive and OCP-treated women with PCOS. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Consequent to women diagnosed with PCOS on the basis of Rotterdam 2003 criteria, either treated with OCPs (ethinylestradiol 0.03 mg, levonogestrel-0.15 mg) for a period of 6 months (n = 50) or drug-naive (n = 51) were enrolled in this cross-sectional study.
  
  
  RESULTS
  The mean ages of patients and control participants were comparable (21.99 ± 4.78 vs 21.92 ± 5.83 years; P = .947) as was body mass index (24.47 ± 3.92 vs 23.66 ± 3.43; P = .271). Clinical and androgen excess symptoms were significantly better in the OCP group compared with the drug-naive group (P = .01, P = .04). Total cholesterol and low-density lipoprotein cholesterol levels were significantly higher in the OCP group (P = .01). Plasma ICAM-1 levels, TNF-α levels, and MCP-1 levels showed a higher trend in patients but reached statistical significance only in cases of ICAM-1 and TNF-α (P = .01).
  
  
  CONCLUSIONS
  OCP treatment of 6 months increases plasma ICAM-1, MCP-1, and TNF-α levels among women with PCOS, although OCPs significantly help in ameliorating features of hyperandrogenism and regularizing menstrual cycles. These cytokines correlate positively with many metabolic parameters including plasma glucose, lipids, and homeostatic model assessment-insulin resistance. Further investigation with well designed, randomized, longitudinal studies might help to ascertain the effect of OCPs on proinflammatory profiles among women with PCOS.
authors.affiliation: Department Biochemistry, University of Kashmir, Srinagar, India.
authors.forename: Syed Douhath
authors.initials: SD
authors.lastname: Yousuf
authors.affiliation: Department Biochemistry, University of Kashmir, Srinagar, India.
authors.forename: Fouzia
authors.initials: F
authors.lastname: Rashid
authors.affiliation: Department of Obstetrics and Gynaecology, JLNM Hospital, Rainawari, Srinagar, India.
authors.forename: Tahira
authors.initials: T
authors.lastname: Mattoo
authors.affiliation: Department of Obstetrics and Gynaecology, GMC, Srinagar, J & K, India.
authors.forename: Chander
authors.initials: C
authors.lastname: Shekhar
authors.affiliation: Department of Clinical Biochemistry, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, India.
authors.forename: Syed
authors.initials: S
authors.lastname: Mudassar
authors.affiliation: Department Biochemistry, University of Kashmir, Srinagar, India.
authors.forename: M Afzal
authors.initials: MA
authors.lastname: Zargar
authors.affiliation: Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India. Electronic address: ashraf.endo@gmail.com.
authors.forename: Mohd Ashraf
authors.initials: MA
authors.lastname: Ganie
mesh_terms: D000293:Adolescent; D000328:Adult; D018932:Chemokine CCL2 / Q000097:blood*; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000494:pharmacology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D016912:Levonorgestrel / Q000494:pharmacology*; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D014409:Tumor Necrosis Factor-alpha; C072593:ethinyl estradiol, levonorgestrel drug combination; D018799:Intercellular Adhesion Molecule-1; D004997:Ethinyl Estradiol; D016912:Levonorgestrel
keywords: Intercellular adhesion molecule-1; Monocyte chemoattractant protein-1; Oral contraceptive pills; Polycystic ovary syndrome; Tumor necrosis factor-α